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Care Home MANAGEMENT www.chmonline.co.uk

September/October 2019 • ISSUE 81

ALL IN THE MIND

Why employee mental health matters GREEN FINGERS Good for the mind, body and soul

PL THE CUAS: SHOW RE All you 2019 to knoneed w

FOOD AND NUTRITION How to put pleasure on a plate

SECURITY

Feel secure with the help of data

Digital Care Planning

Quality in Evidence, Service Delivery and Compliance sekoia-care.co.uk


WELCOME EDITOR’S LETTER

WELCOME

to the September/October issue of Care Home Management magazine

B Care Home Management

September/October 2019

Issue 81

Annual Subscription £40.00 Where sold cover price of £7.50 Managing Editor Ailsa Colquhoun Publishing Editor Steve Hemsley Podcast Presenters and Editors Steve Hemsley Alan Rustad Design/Production Emily Hammond emilyh@freelancedesignpro.com Published by S&A Publishing Ltd Hillside office, 9 St James Park, TUNBRIDGE WELLS TN1 2LG Tel: 01892 680670 Email: editorial@chmonline.co.uk sales@chmonline.co.uk Advertising Rebecca Randall Head of Sales Tel: 01892 538880 Email: sales@chmonline.co.uk www.chmonline.co.uk Copyright: Care Home Management Magazine 2019 The Publisher holds all copyright and any items within may not be reproduced in any way, for any purpose, without the written permission of the Publisher. While every care has been taken to ensure accuracy, the information contained within this publication is based on submissions to the Publishers who cannot be held responsible for errors and omissions. The publisher does not necessarily agree with the views expressed by contributors and cannot except responsibility for claims made by manufacturers and authors, nor do they accept any responsibility for any errors in the subject matter of this publication.

September/October 2019

rowsing through the initiatives and events coming up during September and October I was struck by the presence of a number of events aimed at happiness in the work context. Among these are International Week of Happiness at Work (September 23 – 27). This is followed up, on Thursday 10 October, by World Mental Health Day. In a report written for the event in 2017, 1 there was an interesting section looking at “psychosocial hazards” that are detrimental to a worker’s mental health. And, as the text goes on, you might be forgiven for thinking that this was written specifically about a typical day working in care: these are hazards that result in an environment in which there are “higher expectations as regards performance”, “fast-paced and intensive work”, and “irregular and longer working hours”. Fear of losing their jobs, reduced motivation, decreased satisfaction and creativity, and decreased financial stability all have serious consequences for workers’ mental health and wellbeing, with a significant impact on the employer’s financial bottom line. According to the World Federation for Mental Health (WFMH), which runs World Mental Health Day, difficulties in concentrating, making decisions and remembering, are present up to 94 per cent of the time during an episode of depression, causing significant impairment in work function and productivity. Of course, specific to care sector psychology, is the challenge of working in an environment where many carers and carees become close, where bereavement is a norm that must managed in a professional way. It is a sad tribute to the quality of care provided by the social care workforce that too many carers are so focused on the care of their residents that they fail to look after themselves. According to the WFMH in the general workplace, an average of one in five people experiences a mental health condition, and an average of 36 workdays

are lost per depression episode. One can only wonder how much higher the statistics are within the care business. It’s with great pleasure, therefore, that this issue of Care Home Management brings you information on a wide range initiatives designed to improve employee wellbeing – from the launch of Care Sourcer’s free Employee Assistance Programme and the forthcoming new report by the Care Workers’ Charity (see news page 5) - to the practical tips and hints offered by the Balhousie Care Group and Acacia Training (Ask the Expert on page 27), as well as the employee counselling service run by Valerie Manor, which won the Best Individual Care Home category in this year’s Care Home Awards (see page 22-23). As for us, we’ll be spending this year’s World Mental Health Day at the NEC in Birmingham, which is hosting the 2019 Care Show (see page 10 for more information), where I’m sure this very pertinent topic won’t be very far from the discussion agenda. However, as well as all these very worthwhile and valuable local initiatives, there is an urgent need for a ‘top-down’ vision for wellbeing in social care that creates a shared vision for mental health – a gold standard in care employment, if you like – that ensures that all carers receive the support they need given the specific challenges of their employment. That way carers can continue to deliver a service that is not only fitting for an elderly population in a 21st Century developed nation, but which also enables family members of working age to remain economically productive for the good of society as a whole. A sizeable chunk of new money to enable social care employers to properly invest in these gold standard initiatives probably wouldn’t go amiss either.

1 Mental Health in the Workplace report 2017 [online] at: https://wfmh.global/past-events/ world-mental-health-day-2017-2/

editorial@chmonline.co.uk

Ailsa Colquhoun Publisher/Editor

@Carehomemanage Care Home MANAGEMENT 3


Care Home MANAGEMENT

Contents

www.chmonline.co.uk

7  Eleanore’s Words to the Wise

The practical implications of professionalism

8 Market Barometer

A new, behind-the-scenes look at your operating business environment

13 Leadership

Exploring the road to outstanding in the well-led KLOE

17 Training

 Understand the implications of the apprenticeship levy

18 HR

Keep your staff happy;What’s the evidence for body cameras?

20 Best Practice

The Ombudsman critiques a a home’s communication

22 Care Home Profile

Valerie Manor: on the up in the Sussex Downs

24 Outstanding

S ee who’s made it into the five-star Outstanding club

26 Wellness Whistlestop How to support residents with dementia in pain

BES

ALTH HE

RACT TP

LEGAL

E IC

REGULARS

UITME CR

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ERSH AD

IP

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HR

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September/October 2019 • ISSUE 81

27 Ask the Expert

p22

Employee mental health under the microscope

42 People and Events

See who’s on the move and where to go during September and October

NEWS 10 The Care Show 2019 – read the editor’s picks of where to go and who to see

FEATURES

GARDENS 28 Why green fingers are good for the mind, body and soul

30 Floral tributes. Get some garden

inspiration from our garden hall of fame

31 Five steps to great garden design

p24

FOOD 33-35 Healthy ageing eating; Improve food interactivity and reduce waste

SECURITY 36-37 Data – and dosh. How to keep both safe

ENERGY 39-41 Keep a cool head with energy costs

p30

p10 4 Care Home MANAGEMENT

www.chmonline.co.uk


NEWS ROUND-UP

Care Workers’ Charity makes the case for better mental health in social care MENTAL WELLBEING OF staff has been highlighted as the core issue for care workers in a survey by the Care Workers’ Charity for a forthcoming new report, The Beating Heart of Care: Supporting Care Workers Better, to be launched next month (October). Survey data showed that the two factors care workers liked most about their role were helping others and seeing those cared-for happy. However, positive sentiment about work in care is erased when teams feel they can’t deliver a high standard of care. Mental wellbeing was highlighted as the core issue for care workers in the CWC survey of over 210 care staff, with almost half saying that they experienced stress on a regular basis as a result of their work. The main findings are:

• Despite the joyful aspects of the job, many

care workers feel the role has a negative impact on their mental health - health and social care sectors have the second highest rates of stress, depression and anxiety amongst the workforce after the education sector • Not having time to do the job well – 53 per cent of care workers are thinking of leaving their job because they don’t have enough time • Poor staff mental health causes sickness absence and presenteeism • Poor mental health, sickness absences and stress can damage the service quality for those being cared for • Some employers offer mental health support, but much more is needed • Registered managers need greater resources to support their own and their staff’s mental health.

37%

Number of staff who said they had taken time off for stress or poor mental health caused by their work

19%

Social care workers take 19% more sick days than the UK average

76%

Number of care workers who felt pressure to go to work despite feeling unwell

68%

Number of survey participants who would like formal training in mental wellbeing selfmanagement at work

22%

Number of registered managers leaving their role in the previous 12 months Read more information, visit the CWC [online] at: www.thecareworkerscharity.org.uk September/October 2019

Care Sourcer launches free health and wellbeing support CARE COMPARISON and matching site Care Sourcer has launched a free Employee Assistance Programme (EAP) to all UK care provider employees. The free programme, provided through Health Assured and initially funded by Legal & General, is available to employees of both care homes and care-at-home providers. The EAP will offer advice and guidance to support employees with issues including mental or physical stress, bereavement, money worries, and general low morale. Legal & General will fund the EAP for the first 12 months of its operation. Last year, the FTSE100 financial services company announced it was investing £6m in Care Sourcer, before launching its care-focused Retirement Living Solutions division earlier this year. Care providers can register for the free EAP at caresourcer.com/behind-every-care-worker For more information, visit: https:// chmonline.co.uk/care-sourcer-launches-freehealth-and-wellbeing-support

Care Home MANAGEMENT 5


NEWS ROUND-UP

Medicines dosette boxes given out without personcentred understanding

Care Home Management partners with SP&P to broadcast the Care Home Show online

CARE HOME MANAGEMENT (CHM) has agreed to broadcast The Care Home Show video podcast on chmonline. co.uk as part of a brand partnership with Simon Parker & Partners (SP&P). The Care Home Show is a digital product from SP&P, which helps care home operators to build high-performance teams, deliver outstanding care and grow their business. The agreement means every episode will appear on the CHM website, providing readers with access to thought-leadership interviews with care industry leaders. Care Home Management will be at the Care Show, on Stand D90. Come and visit us to get your free copy of our 2020 Year Planner. Read more information, visit: https://chmonline.co.uk/ care-home-management-partners-with-spp-to-broadcastthe-care-home-show-online/

RESEARCHERS AT THE University of East Anglia have criticised pharmacies for giving out twice as many medicines dosette boxes (MDS) as they were ten years ago without understanding the benefit to patients. In new research, ‘Quantifying and characterising Multicompartment Compliance Aid provision; a national survey of community pharmacies’, the researchers conclude that there is limited evidence of pharmacists considering patient choice or risk of adverse events associated with use. In new guidance endorsed by the Royal College of Physicians and the Royal Pharmaceutical Society, prescribers are encouraged to

evaluate the appropriateness of dosette boxes, along with other compliance aids such as easyopen medicine bottles, coloured labelling, social support or medication review. The guidance also encourages prescribers to “consider the emotional and practical barriers” to taking medicines which can include the patient’s levels of anxiety, confidence, motivation or experience of unwanted side effects.

For more information, visit: https://chmonline.co.uk/medicinesdosette-boxes-given-out-without-person-centred-understanding

Care badge grants now available

NOMINATIONS ARE NOW open for Care badge charitable grants of between £500 and £3,000 each. The grants are open to deserving causes across the UK, and beneficiaries of CARE badge grants are selected by a committee of care professionals. Between 30p and 45p in every £1 raised by the Care badge is being distributed to care-related charities. Care Home Management magazine is delighted to have been able to support this very worthwhile initiative. In a consultation the Department for Work and Pensions and the Department of Health and Social Care are putting forward a package of measures which encourage early and supportive action by employers for their employees with health conditions. For more information, visit: https://chmonline.co.uk/carebadge-grants-now-available For more information on the consultation: please see ‘Ask the Expert’ on page 27

DHSC launches ‘Why not home?’ campaign

NHS DOCTORS, NURSES and other staff are being encouraged to ask themselves ‘Why not home? Why not today?’ when planning discharge care in a campaign called ‘Where Best Next?’ According to the Department of Health and Social Care, nearly 350,000 patients currently spend over three weeks in acute hospitals each year. Research suggests that more than one in three 70-year-olds experience muscle ageing during a prolonged stay in hospital, rising to two thirds of those aged over 90. For more information, visit: https://chmonline.co.uk/dhsclaunches-why-not-home-campaign/

6 Care Home MANAGEMENT www.chmonline.co.uk


NEWS ROUND-UP

Person Centred Software in talks to extend e-red bag project

Survey aims to improve dementia care

ALZHEIMER’S RESEARCH UK has launched a ‘Shaping Future Treatments’ survey to inform the development of more person-centred treatments for dementia. The online survey asks for people’s views on the aspects of daily life that are most important to them, and which they’d most like to protect if they were to develop a disease that causes dementia. According to Alzheimer’s Research UK, there are over 240 potential treatments for dementia in clinical trials, but there is currently little data available on what the general public would want to see from such a treatment. For more information, visit: https://chmonline.co.uk/survey-aims-to-improve-dementia-care

PERSON CENTRED SOFTWARE, which has worked with NHS Digital on an e-red bag pilot project in the London borough of Sutton, is now in talks with other areas and software providers to extend the scheme. The e-red bag initiative enables homes to send residents’ care record information to hospital electronically. Participating homes have to pass the DSP Toolkit. NHS Digital, which has worked with PCS on the pilot project in two care homes, is now extending the project to all care homes in the London boroughs of Sutton and Merton, as part of the Paperless 2020 project. This aims to link NHS, local authorities and social care to digitally streamline records and improve social care outcomes. Read more information, visit: https://chmonline.co.uk/ person-centred-software-in-talks-to-extend-e-red-bagproject-to-other-providers

ELEANORE’S WORDS TO THE WISE The practical implications of professionalism By Eleanore Robinson, freelance social care journalist THE PROFESSIONALISATION OF the social care workforce has been a goal for the sector for decades. Putting employees on the same footing as those working in the NHS or schools, while improving the status of the social care worker, can only be a good thing, right? Assisting the sector in this process is one of the goals of the Welsh government, which is now registering all care home workers, first on a voluntary basis and then mandatory, by 2022. Delivering increased public assurance and improving the quality of care and support are the other, very worthy reasons. Nurses and other healthcare professionals such as psychologists and occupational therapists would be exempt. Whether agency or bank staff would also need to be registered is still up for discussion. September/October 2019

This all sounds great but there is no mention of who is going to foot the bill or how this system will actually work. As social care providers have experienced, literally to their cost, registration usually comes with extra fees. A shift in Government policy to make the Care Quality Commission become self-sufficient has seen massive increases in registration costs in England. In a sector where margins are tight, this has pushed many operators to the brink of the financial viability. Imagine if providers had to pay a separate registration fee for every social care worker their business employed? Quite a few operators would not be able to take on this burden. If the Welsh government decides to take on the costs themselves, there is still the question of the time care home operators would need to spend administering the system from their end. At a time where care operators are having to streamline

their businesses in order to remain competitive, it is unlikely there would be someone with the capacity to take on this task, and employing someone just to carry out this task is not an option for many smaller care home providers. So while these proposals should be welcomed in theory, the sector needs to ask some serious questions about how they would work in practice. Care Home MANAGEMENT 7


CONTEMPORARY DURABLE PERFORMANCE

MARKET

BAROMETER By Michael Hodges, Christies & Co managing director – healthcare consultancy

M

www.danfloor.co.uk

8 Care Home MANAGEMENT

0330 014 3132

aintaining trends from July, the care market continues to benefit from investment confidence: our recently launched Alternatives Investment Index shows that yields for prime care home investments are continuing to compress.This trend is also setting new value benchmarks, with some super-prime investments achieving record yield compression of below 4 per cent. Increasingly, the care market is seen as a growing, and reliable asset class. Activity continues to be strong, not just for super-prime, but also prime and secondary investments. An increasing range of operators are becoming receptive to taking lease agreements, creating more opportunities in this strengthening market. A copy of the Alternative Investment Index, which provides more insight into the care market, can be found at: https://bit.ly/2KtWEmi In addition, our 2019 report on fee rate and workforce-related issues will be launched in midautumn. This is the third and final year of the current Council Tax Social Care Precept policy, and this year, care homes may find there is a greater degree

of variation in available funding. This is because some councils, for example Buckinghamshire, have already used the allocated six per cent over the first two years, leaving them with a zero per cent social care precept for 2019/20.

What is yield compression? Yield compression indicates the growing strength of an investment class: the more compression, the greater the security of the income stream, and the stronger (and more attractive) the investment overall. www.chmonline.co.uk


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SHOW PREVIEW CARE SHOW 2019

IT’S

SHOW TIME! There’s around one month to go to the 2019 Care Show. Have you registered for your place?

M

ore than 3,500 care professionals are expected to attend the Care Show, taking place on October 9-10, at the NEC, Birmingham. Among them will be the Care Home Management editorial and sales team, on stand D90, where you’ll find our brand new, super-useful 2020 Year Planner, which is free to our stand visitors to take back and start filling in with those all-important appointments and tasks. A signature feature of the Care Show is its expert-led CPD accredited conference sessions, hands-on training, latest solutions and networking

Hall 3A, NEC, Birmingham

designed exclusively for care homes

10 Care Home MANAGEMENT

Come and see us on Stand D90, and get your free 2020 Year Planner

Location:

wallpaper murals View our wallpaper collection online and discover how to create colourful feature walls that engage and inform.

opportunities – not to mention the exclusive show deals on offer from over 250+ leading healthcare suppliers all located in one, easy-to-reach hall. It’s fair to say that you’ll learn and see more in two days at The Care Show than you would in months in your office. It can often feel like you’re too busy to take time out, but spending even one day at the event is guaranteed to save you time and money in the long-term.

carehomemurals.co.uk

Dates & Times: Wednesday 9 October, doors open 10:00 - 17:00

01283 712171

Thursday 10 October, doors open 10:00 - 16:30

CareHome Murals

Registration opens from 08:30 both days for badge collection

www.chmonline.co.uk


SHOW PREVIEW CARE SHOW 2019

Editor’s picks of the show

We recommend you visit the following exhibitors. Read below for more about their show offers or check out their adverts in this issue of Care Home Management magazine. APETITO Stand B50 At apetito, chefs and nutritionists take pride in creating dishes for specific requirements and nutritional needs without compromising on a delicious meal. Each care home is different, and they know what it takes to give your residents a delicious and nourishing dining experience, that makes a real difference. CARE HOME MURALS Stand: D62 COURTNEY THORNE LTD Stand: E62 DANFLOOR UK Stand: D60 Danfloor UK is a manufacturer and supplier of commercial carpets, which are designed for the demands of nursing and care homes, hospitals and specialist care facilities. Danfloor’s impervious healthcare collection is hardwearing and is Dementia Services Development Centre-accredited, which means many ranges are suitable for dementia-inclusive design schemes.

FASTROI LTD Stand: C23 GAINSBOROUGH SPECIALIST BATHROOMS Stand: C30 Gainsborough Specialist Bathrooms, formerly Gainsborough Specialist Bathing, will be displaying its complete G360 accessible bathroom and wet room services at The Care Show. G360 encompasses all aspects of specialist bathroom and wet room implementation – from concept to completion and beyond. Senior representatives from Gainsborough will be available throughout The Care Show to explain why these services deliver multiple care and commercial benefits including power-assisted baths, accessible bathrooms and wet rooms, transfer, toileting and washing equipment. Alongside

the high specification wet room feature, Gainsborough will be demonstrating its popular powerassisted Gentona and Sentes baths. HORNE Stand: D22 MY LEARNING CLOUD Stand: C32 REPOSE FURNITURE Stand: A70 Bespoke seating manufacturer Repose Furniture will debut its Arden Bariatric chair at this year’s Care Show. A special feature of the Arden is a four-motor mechanism which allows various functions: tilt in space, backrest recline, leg rest elevation and rise. The chair has a 50 stone weight capacity and 25 stone leg rest limit combined with a 16” seat height option and extendable leg rests. Seat depth adjusters enable staff to fine-tune the seating position. Options include pressure management seat cushions. Following the Care Show, the Repose team will be gearing up for The OT Show (Birmingham NEC November 27/28) where they will be exhibiting on stand A40.

The Arden bariatric seat PLANDAY Stand: F60 Planday streamlines scheduling, communication, payroll and HR for healthcare providers. With Planday, staff can communicate with each other, swap shifts and clock in and out, while managers can create smart schedule templates and keep track of wage costs and hours worked. QUALITY COMPLIANCE SYSTEMS (QCS) Stand: H60 Quality Compliance Systems (QCS) is the leading compliance management system for the Care sector. The service provides over 53,000 care, dental and medical professionals with access to the most comprehensive set of customised policies, procedures and compliance toolkits, enabling users to stay compliant with current CQC policies. ROTOWASH Stand: E50

Versatile porter and rise recliner chairs for healthcare environments

C-air

Harlem

Boston

Delivering care and comfort into care homes and hospitals

Model shown: Multi C-air

• Adapt your chair for a single user’s changing conditions or for a new client • Use your chair as part of a 24 hour pressure care management programme • A range of interchangeable pressure management seat and back cushions • Unique portering features reducing manual handling • Made to measure options For more information visit

See us on Stand A70 9-10 October 2019 NEC Birmingham REPOSE CARE SHOW ADVERT 190x135 AW.indd 1

September/October 2019

www.reposefurniture.co.uk or contact us on

0844 776 6001

Email: info@reposefurniture.co.uk

13/08/2019 10:10

Care Home MANAGEMENT 11


Regulations! Regulations! Regulations! inally booked arah on for her moving handling course

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LEADERSHIP ENGAGEMENT & INVOLVEMENT

OUTSTANDING LEADERSHIP:

DO YOU HAVE WHAT IT TAKES?

In the third of this new five-part series, Chris Gage, joint MD, Ladder to the Moon, explores what it takes to be outstanding in each of the five elements of the CQC’s Well-led KLOE IN THIS ISSUE: ENGAGEMENT AND INVOLVEMENT by a commitment from the manager to either action the idea (in which case it gets a tick) or to prompt a conversation with the person who put the idea up.

Engaged staff

T

o be outstanding is to deliver something different, something surprising or delightful in some way.To use CQC language - creativity and innovation. When people talk about creativity they often think of the arts in some way, and with innovation technology; while both are very valid examples, often creativity and innovation are much simpler. For example, creativity is anything that is both new and valuable: new just for an individual, or the first time that something has happened in a service; the value might be as simple as making someone laugh or smile, or it might add efficiency or transparency. In a nutshell it is anything different that makes a difference. All services do something to engage and involve people but the challenge for the would-be outstanding home is how to be creative and innovative so that what you do is different from what everyone else is doing. How do you provide that element of surprise and delight that makes your service stand out? If you want to be in the top three per cent of services that are outstanding, then you need to be doing

September/October 2019

The flip side of idea generation is the ability to raise concerns: often the two go hand-in-hand, as ideas are often a response to things that aren’t working as they should be. Thus, a culture of trust and support is just as crucial to supporting whistleblowing as it is to generating ideas. Do staff know who is going to answer the call at the end of a whistleblowing hotline? We often have conversations with staff who say they are reluctant to call because they think the manager might answer. things that the other 97 per cent aren’t – and that something is creative and innovative.

Active staff

Normally, it takes a lot of ideas to produce one good one. It also takes more than one person. It is not the role of the leader to have all the ideas, and in an outstanding service the leader recognises that they have a rich source of ideas all around them and that their role is to create the conditions so that everyone can contribute their ideas. This means having an approach that is supportive of ideas and which nurtures and encourages contributions. Outstanding organisations have a “yes, and…” culture that welcomes ideas and builds on top of what’s positive about them. If your first response is to dismiss an idea as wrong or flawed, you’ll soon see the well of ideas dry up. As well as getting the culture right, outstanding homes also have processes to support the flow of ideas: homes can put up an ideas board and a supply of Post-it notes by the manager’s office for staff, residents and families to use, supported

Local links

Your local community, as well as being your market, is a fantastic resource for bringing surprise and delight into your service. It’s worth thinking about how you can provide mutual benefit, for example, a local band or drama club might want rehearsal space and would be very happy to do something for you in return. Finding ways to get young people to engage with your service is always worthwhile and often leads to surprises. And it’s not just about bringing people in – a local community group may offer an opportunity for a resident to get involved. Part of your role as an outstanding service is to change perceptions of what a care home is, and to do that you need to harness the creativity of everyone around you. For more information on the Wellled KLOE, visit the CQC [online] at: https://www.cqc.org.uk/guidanceproviders/adult-social-care/key-linesenquiry-adult-social-care-services

Care Home MANAGEMENT 13


ADVERTORIAL

On your marks get set... AN UPDATE ON THE LIBERTY PROTECTION SAFEGUARDS

D

eprivation of Liberty Safeguards (DoLS) are being replaced by the more positively named, Liberty Protection Safeguards (LPS) from October 2020. The aim is the same, providing a process to satisfy Article 5 of the European Convention on Human Rights (the right to liberty). So, will LPS be any better for social care providers than DoLS? The signs are not good.

Where are we?

The Mental Capacity (Amendment) Act 2019 exists. A draft Code of Practice is in the pipeline and should be published before Christmas. The devil will be in the detail.

The impact on social care providers

Key points to note at this stage are: • Where service users are CHC funded the relevant CCG will be responsible for the LPS authorisation. In other cases it will be the relevant Local Authority. • LPS is wider than DoLS and will cover “arrangements” that can include different locations, transfers and settings that are not care homes or hospitals.This can cover community and respite arrangements in a single authorisation. • The cared for person must be aged 16 or over, lack capacity to consent to the arrangements and have a mental disorder. • The arrangements must be necessary to prevent harm and proportionate to the likelihood and seriousness of harm. The Code of Practice will expand on this but expect arguments about what this means in individual cases.

Stephen Evans, Partner, s.evans@hempsons.co.uk Stephen’s work covers some very technical legal areas but the overall theme is ‘dispute resolution’. He always looks for pragmatic solutions, without compromising your position. Where appropriate, Stephen’s advice on the law, options and risks will bear in mind any long term ongoing therapeutic relationship and that the resolution of acute problems needs to support, not undermine that. In 2009 Stephen obtained his Master’s Degree in Mental Health Law. His final project brought together his mental health and capacity experience by considering the problems in developing the Deprivation of Liberty Safeguards.

Perhaps the most important points are:

• Where care is wholly or partly in a care home and the

cared for person is aged 18 or over the Local Authority must decide whether it should carry out the assessment process or whether that should be led by the care home manager. Local Authorities may press for care home managers to get themselves up to speed and ready to lead the assessment role. It is not at all clear that the shift in responsibilities would be accompanied by a shift in funding. • It seems likely that the CQC will enforce LPS more rigorously than DOLS. I suspect that is chilling enough news to give LPS a difficult start within the social care sector.

What to do

• Watch out for the draft Code, consider it and comment; • Think about a programme of training for staff leading up to October 2020;

• Talk to your Local Authority and CCG contacts about who you need to work with and how LPS might work;

• Plan a programme of reviewing and revising policies. 14 Care Home MANAGEMENT

www.chmonline.co.uk


ADVERTORIAL

How technology is helping to manage the care home ecosystem

J

ust like their patients, care workers come from all walks of life. In order to care for our loved ones, care homes need to be equipped with a range of workers and amenities that provide everything they need to be comfortable. From the food they eat, to the cleanliness and maintenance of their living spaces, 24-hour flexibility, scheduling and efficiency is essential. Since 2004 Planday has been improving the lives of shift workers and employers across the globe with its workforce collaboration platform. Its easy-to-use, flexible shift worker management platform empowers both managers and employees to collaborate and work more efficiently by increasing transparency, open communication and integrated business tracking and reporting. The Planday platform works as a digital point of contact between managers and their staff via a smartphone app. Managers can create smart schedule templates to roster employees, measure wage costs and track the hours each employee has worked. Employees can communicate with each other, swap shifts, as well as clock in and out of work at any number of specified GPS locations within the app. As the needs and demands of the world’s ageing population increases, Planday is leading the way in empowering care homes and their employees to achieve a better work-life balance, so they can spend more time on the things that matter. Nicola Ray, Regional Manager of Oaklands, says Planday helps saves up to 20 hours in September/October 2019

Having Planday has empowered our employees to take control of their working and personal lives planning and scheduling each month. Having previously used an Excel spreadsheet and paper for staff rotas, Oaklands, a 29-bed care home, decided to implement a cloudbased solution for scheduling. “Before Planday, it would take us 15 to 20 hours a month to do the scheduling and payroll. Now it takes us one hour maximum,” Nicola says. “Being able to track when employees clock in and out has helped highlight absence or lateness patterns that can then be addressed with employees directly. “Having Planday has empowered our employees to take control of their working and personal lives.They have a comprehensive overview of their holiday requests and can access schedules anytime, anywhere.” Christian Brøndum, CEO of Planday, says

planning will help empower flexibility in scheduling and ensure care home workers can focus on their patients. “Care home workers are a vital group of people who work towards the common goal of making people comfortable at difficult times in their life,” Christian says. “It is essential care home owners ensure the right processes are put in place to help workers and continue to embrace technologies to make our care homes ready for the future.” With an ageing population, the care sector is set to continue to grow and be relied upon to look after the needs of millions of elderly people. It is more essential now, more than ever, that care homes are prepared for that demand with the right people who have the right skills on hand to provide the best form of care. Investment in technology is the only way to ensure this transformed sector can transition successfully from traditional management processes into modern and efficient models, which motivate, enliven and assure the health of our care home workforce. Planday will be exhibiting at the Care Show 2019 on October 9th and 10th, 2019 in Birmingham NEC Hall 3A, Stand F60. To find out more about the Planday platform and how it could help your organization, John Coldicutt, CMO at Planday, will be speaking at Theatre 3 Technology and People at 10:50am on 9 October. Care Home MANAGEMENT 15


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TRAINING APPRENTICESHIP LEVY

APPRENTICESHIPS: THE IMPACT OF THE LEVY Skills for Care project manager Pete Barron looks at the impact of the levy on the take up of apprenticeships in adult social care, and what’s next

T

he apprenticeship levy was launched in April 2017 in a bid to help the Government meet its target of three million apprenticeships by 2020. The launch of this levy, combined with the introduction of the new apprenticeship standards, initially had a negative impact on the number of apprenticeship starts across all sectors of the economy although the signs are that this is now beginning to change. For the adult care worker and lead adult care worker apprenticeships, in 2017-18 there were 18,620 starts but, in 2018-19, this figure will be higher with 20,440 starts in the first nine months. The newly-designed apprenticeship ‘standards’ have been written by groups of relevant employers to make sure they deliver what their industry needs. The social worker degree apprenticeship was launched earlier this year and is already proving to be a popular option with 110 starts to date.

New for 2019

In 2019 two new apprenticeships for adult social care were due to be launched: the eagerly-awaited leader in adult care (level 5) and the lead practitioner in adult care (level 4). It’s also important to remember that within the adult social care sector, employers September/October 2019

Investing in high quality training helps the worker feel more valued by their employer. The combination of the on- and off-the-job learning helps to develop a confident and competent employee can also recruit apprentices to work in other jobs within their organisation such as business administrator, assistant accountant or chef. Employers are also starting to use integrated apprenticeships which provide the apprentice with the opportunity to develop the skills and knowledge needed to be competent in a common occupation across different sectors. These help to encourage an integrated culture, share learning and facilitate the development of diverse skills. A good case in point is The West Kent Nursing Associate (NA) programme, an integrated apprenticeship programme created through a collaborative approach between Maidstone and Tunbridge Wells NHS Partnership Trust, Kent and Medway NHS and Social Care Partnership Trust (mental

health services), Kent County Council (representing independent nursing providers) and Hospice in the Weald. This programme brings together trainee nursing associates (TNAs) from statutory and private health and social care services under one programme of learning. This provides an opportunity to share experiences, to encourage a culture of shared learning and a better understanding of different sectors and the daily challenges experienced. In adult social care where annual staff turnover is high – typically 31 per cent – apprenticeships have the potential to help stabilise the workforce. Investing in high quality training helps the worker feel more valued by their employer. The combination of the on- and off-the-job learning helps to develop a confident and competent employee. Both factors can help to reduce staff turnover, which in turn reduces recruitment costs and can help to raise the profile of both the organisation and a career in adult social care. Want to know more? Visit Skills for Care apprenticeship online at: www.skillsforcare.org.uk/apprenticeships

Care Home MANAGEMENT 17


HR STAFF RETENTION

Keep your staff happy to keep your staff Brian Boxall-Hunt, CEO at maritime charity The Royal Alfred Seafarers’ Society, and Will Shepherd, CEO at recruitment agency Cohesion, unlock the secrets of staff retention

Clear reporting lines help staff to understand the management structure and receive mentoring from colleagues

Creating a working environment in which an employee feels valued, listened to and supported in their professional development is key to creating a workplace fit for retaining long-serving staff

DID YOU KNOW? Between 2017 – 2018, the average vacancy rate for care home services with nursing was 8.9 per cent, equating to an estimated 25,000 vacancies at any one time? Source: Skills for Care report: The state of the adult social care sector and workforce in England

Staff benefits:

pension plans, flexible working hours, staff reward schemes, uniform contributions and allowing staff to partake in team-building and social activities all create a positive environment in the workplace

Staff training is an investment

in both employees and residents: staff are supported in their development, while care for residents is of the highest quality. Shadowing and supernumerary shifts can have a huge impact on their confidence and enjoyment of the role

Opportunities for staff to give feedback

allow employees to give their opinions and share ideas, and they guarantee a dialogue between employees and senior managers, highlighting any gaps in the provision of care from the ground up. Feedback channels can include employee surveys and ‘stay interviews’

18 Care Home MANAGEMENT

Share successes:

Social media is a great way to share successes, encouraging new starter recommendations and motivating existing employees. Staff want to see, and want others to see, how they are making a difference in their role

www.chmonline.co.uk


HR BODY CAMERAS

CARE THROUGH A LENS

Can body cameras reduce violence and aggression in patients, reduce the need for restraint and boost quality standards? Able Training Support looks at the research Study abstract BACKGROUND: A study of police wearing body-worn cameras showed a reduction in complaints, and a decrease in occurrences and crimes. Mental health staff working in in-patient settings do not routinely wear cameras. The aim of this project was to examine the feasibility of using bodyworn cameras in an in-patient mental health setting. METHOD: Calla supplied 12 Reveal cameras which were worn by the Prevention and Management of Violence and Aggression team and nursing staff on five psychiatric in-patient wards in Northampton and elsewhere in England following training.

A

lmost three in four (71 per cent) care home workers have faced violence and aggression in their workplace, most commonly verbal. In the UK alone, police recorded 1,200 assaults between residents living at care homes between 2014 and 2016. Kicking, hair-pulling, biting, swearing, hitting and spitting are not uncommon occurrences in care homes; care workers say that anger, confusion and fear experienced by people with dementia can sometimes result in aggressive and violent behaviour. In the study at the Northamptonshire Healthcare NHS Foundation Trust (NHFT), front-facing screen cameras were worn by 60 staff for three months. The study found that the technology reduced the need for emergency restraints (where there was a high or immediate risk of harm) from 41 incidents to 18.

September/October 2019

RESULTS: The training prepared staff to use the cameras effectively. There were very few technical issues with the body-worn cameras though some refinement to the harness is required to improve comfort. Both staff and patients considered that their use in an in-patient mental health setting was beneficial. Compared to the same period the year before, there was a reduction in complaints and incidents during the duration of the pilot. The cost of equipment was £7,649 and storage of footage for three months was £569. Other costs were for staff time: 48.5 hours to set up and seven hours per week to maintain.

Nurses participating in the study felt the cameras were helpful in de-escalation: residents could see that they were being recorded, which had a calming effect and boosted staff confidence. For residents, the cameras provided reassurance that episodes of care were being recorded and could boost standards. Lindsay Bennett, NHFT’s prevention and management of violence and aggression manager, said: “Violence and restraint does happen in the NHS. But we can get better at stopping it, by learning trigger signs.”

CONCLUSION: We have demonstrated that it is feasible to employ body-worn cameras in an in-patient mental health setting. Their use is acceptable to both patients and staff. Costs could be offset by the reduction in complaints, incidents and restraints, but further research is required to support this. A study of body-worn cameras in an in-patient mental health setting has shown that use can reduce complaints and incidents involving staff. Using the technology is considered acceptable to both patients and staff, and the costs of implementation could be offset by a reduction in complaints, incidents and restraints.

Need help to tell your care home's story more effectively and powerfully? Do you need to feel more confident when talking to the media or presenting to stakeholders?

Let the Care Home Management team help you! We work with leading media trainers and presentation skills coaches to help you get your message across to different internal and external audiences.

Contact: editorial@chmonline.co.uk Call: 01892 680670

Mental Health in Family Medicine (2017) 13: 393-400 research article. The Feasibility of Using Body Worn Cameras in an Inpatient Mental Health Setting [online] via the link: https:// tinyurl.com/y2ooexva

1

Care Home MANAGEMENT 19


BEST PRACTICE FROM THE OMBUDSMAN

My care provider hasn't resolved my complaint. What can I do now?

LESSONS FROM THE

OMBUDSMAN THIS TIME IN CHM MAGAZINE

The Local Government and Social Care Ombudsman decisions relating to complaints about local public services offer useful learnings for care home providers

Anchor Care Homes SUMMARY: Mr X complains that when his mother (Mrs Y) died in hospital, the care provider, Anchor Care Homes, failed to provide information about Mrs Y’s food and fluid intake when he asked for it, and that they failed to respond effectively to his complaints about this.

Mr X says the way he was treated left him very angry and frustrated, and suspicious that Mrs Y was not treated properly before she was admitted to hospital.

DECISION UPHELD:

The care provider did not respond adequately, either to Mr X’s request for information, or to his complaint about this. The investigating officer (IO) did not speak to Mr X and did not

20 Care Home MANAGEMENT

get the complaint right. There was no in-depth investigation required so the delay in dealing with this complaint was excessive: over three months when it said ten das. The care provider was at fault in the way it handled Mr X’s complaint and this was a potential breach of regulation 16. The care provider did not let Mr X know that Mrs Y’s health had deteriorated and that it had called the GP. As Mrs Y did not have the mental capacity to decide about her care, Mr X was Mrs Y’s legal representative, and should have been consulted. This was a potential breach of regulation 9. The lack of communication and failure to provide information caused Mr X avoidable and significant distress at an already difficult time.

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ANALYSIS

Mrs Y had sight loss and health conditions which caused her difficulty with cognition and daily living activities. She lived in Greenacres care home. The care provider’s records show she could mobilise independently, though she was liable to bump into doorways and furniture. There was a high risk to her skin integrity and a medium risk of malnutrition. She was weighed weekly and given a high protein diet, and pressure relieving cushion. The GP had checked some purple spots or bruises on 2 July 2018. On 12 July, staff put a food and fluid monitoring form in place. The care provider’s daily records note that Mrs Y bit a staff member and ate little breakfast despite encouragement. However, the food record chart says she ate all her egg and bacon, toast and cornflakes. The care provider says the food and fluid charts were just a precaution but from 14 July she was refusing to eat or drink much. However, the fluid chart shows she was also refusing drinks on 12 and 13 July. On 15 July, staff called the GP who advised staff to continue supporting Mrs Y to eat and drink and to obtain a urine sample for testing. He advised to call the surgery if she worsened. Staff did not tell Mr X about the call. On 17 July, the care provider’s records note that Mrs Y stayed in bed all morning and refused all food, all day. She sat up all night then had three teaspoons of cereal and three of porridge and half a cup of tea but refused all food for the rest of the day. On 19 July, staff felt Mrs Y’s health had worsened so they called the surgery who advised to call an ambulance. Mrs Y was taken to hospital. On 20 July, September/October 2019

staff contacted the hospital who advised they were still running tests. Mr X called into the home to pick up some items for Mrs Y and told two staff members who asked about Mrs Y, that she was not well. On 23 July, Mr X advised the care provider that Mrs Y had died over the weekend. He complained to the manager as staff had not let him know when they had called her GP. He asked what she had eaten and drunk in the few days before she went into hospital. He thought the manager had gone to get the information but when she returned, she said nothing was written down. He asked her to find the information about what Mrs Y had drunk on 16 and 17 July before staff called the GP. However, he was there for over two hours and the care provider did not give him this information.

care”, though Mr X had not complained about this. The response he received did not provide the information he had asked for and barely mentioned the lack of communication. The care provider says that the senior manager

investigating Mr X’s complaint was on sick leave for several months and had only made initial enquiries before going on sick leave. The complaint should have been picked up by another manager but this did not happen.

AGREED ACTIONS: The home should:

• apologise to Mr X for the faults identified above; ensuring it is clear what his complaint was, and what went wrong

• ensure verbal complaints are actioned properly • ensure staff contact representatives when a resident’s health deteriorates, unless there is good reason not to

• ensure that complaint investigations look at the complaint made and provide a proper response

• ensure its records are accurate and consistent in future.

Read the whole decision [online] via the link: https://tinyurl.com/y43jtp8y

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After ten days, Mr X had heard nothing from the manager so contacted the care provider’s customer relations department. He repeated his complaints and asked to speak to the IO when appointed. On 10 August, the care provider acknowledged his complaint by email giving the name of the IO. It referred to his complaint about “lack of communication in relation to the death of your mother” and said there would be a response within a ten-day deadline.

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On 24 September, Mr X asked to speak to customer relations about the complaint and was told they would ring him back. Four days later he had still had no response. On 26 October, the IO wrote to Mr X and apologised for the communication with the manager and the delay replying. It referred to his complaint about “lack of

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Care Home MANAGEMENT 21


Valerie Manor owner Zoe Fry (seen here receiving the 2019 Care Home Award) considers the awards ceremony a valuable team-building event

ON THE UP IN THE DOWNS An illustrious guest list and a glittering gallery of award wins have secured Valerie Manor a place in the care home hall of fame

S

ince 1651 Valerie Manor (as it is now known), in Upper Beeding, West Sussex, has received some very distinguished guests: King Charles II is thought to have stopped there, en route over the Sussex Downs after the defeat of the royal forces at Worcester; also among the home’s glitterati is Churchill, who is reputed to have dined in the establishment. Over its long and illustrious history, the now 23-bed nursing home has also been a farmhouse and gentleman’s club. It is, perhaps, testament to the on-going spirit of generous hosting at the home, that Valerie Manor is now a multi award-winning care home: continuing its run of award success, this year the home scooped the top prize of Best Individual Care Home in the 2019 Care Home Awards, which are supported by Care Home Management magazine. At this year’s awards, which were presented at a glittering ceremony in London, around 20 22 Care Home MANAGEMENT

Valerie Manor staff were able to share in the glory of their win. Owner and manager Zoe Fry makes a specific effort to invite every staff member in turn to such events, as she feels that the occasion is a great opportunity for team-building and to acknowledge the role that each staff member has in the success of the home. All staff and residents get copies of the specially published awards ‘Winners’ Book’ to keep as a souvenir, and for those that cannot attend the events in person, wins are celebrated at the home’s annual garden party and in the home’s awards ‘wall of fame’. Fry says: “Wins like this lift everybody.” Fry was also interviewed for CHM’s Care Home Awards podcast special https://chmonline.co.uk/podcast/

Valuing staff

In its most recent CQC report, which awarded outstanding ratings to the home in four key lines of enquiry (KLOE) – safe, effective, caring www.chmonline.co.uk


PROFILE VALERIE MANOR

and well-led – inspectors described the care at Valerie Manor as exemplary. There are around 50, mostly local, staff working at the home, and it is one of very few homes to have a waiting list for staff who want to come and work there.While it is true that there are fewer care home employers in the Upper Beeding area, relative to other areas, that is not the whole story behind the home’s workforce successes, Fry believes. She says: “I think it’s because we value our staff; we empower them to make changes in the home.” At the home, staff are supported through peer supervision – junior staff members are supported and mentored by senior staff. Fry says: “This works better, as is it not a manager telling them what to do.” The home also offers staff a counselling service to support those who are affected by bereavements at the home, as well as personal problems. Fry says: “We started

We have very strong links with the local community, both going into schools and hosting visits from the local community, and that really helps to raise the profile of care September/October 2019

this service after specific incidents, but now we offer it routinely.We reflected on how well we were really looking after staff and considered this was one way to give staff something they may need, but might not be able to afford themselves. It has really improved the emotional resilience of the staff.We’re all human, and as carers, if you are not affected when somebody dies, then you are probably in the wrong job.” When recruiting, one of her favourite interview questions is to ask: “What would your friends and family tell us about you as a person?” Fry says: “We look for staff with the Valerie Manor ethos: those who are willing to join our family, and who see care as a career not a job.”

Next steps

Located in the heart of West Sussex, at the foot of the South Downs within a designated national park,Valerie Manor is a home that typifies the concept of ‘less is more’. The smallness of the home makes it possible to take the time to get to know staff skills for the benefit of residents’ care. It allows residents to have more personalised care and investments or changes to the business can be made quickly. On the downside, as a smaller home, there is no team to deal with all the business regulation, policies and procedures. Finance is also a challenge, but Fry says: “Anyone that

operates a home of this size is not in it for the money.” But such is the value of the Valerie Manor proposition to the local community that the local neighbourhood plan is pushing the management team to open another 30-bed home with dementia care on some adjoining land. In terms of the home’s outstanding rating, Fry says that future inspection preparations start the minute the inspector leaves and the home has its eyes firmly on upgrading its good responsiveness rating to outstanding. “We start our folder of evidence of our responsiveness to incidents and to learning immediately. It’s better to be inspection-ready all the time, because if you don’t document it at the time, it’s really hard to remember later on. “Things that make a difference to an inspection rating don’t have to be expensive. We are demonstrating our responsiveness to residents by acting on their requests to grow sunflowers.” And, of course, the home already has its eyes on next year’s awards. Fry says: “I’ve got my eye on the ‘Best Communications’ award, as we do a lot of communicating with residents, their families, staff and the multidisciplinary team. “We have very strong links with the local community, both going into schools and hosting visits from the local community, and that really helps to raise the profile of care.” Care Home MANAGEMENT 23


BEST PRACTICE OUTSTANDING

CONGRATULATIONS TO...

Care Home Management is delighted to be able to share with you these examples of outstanding care home practice

Wolverton Court, Dover Safe:

Effective:

What Wolverton Court did: Safe

Risks and triggers are well-managed, which supports people to share the environment in a positive way, and to achieve goals and activities previously considered unattainable. Following every incident, staff complete a debrief, and after particularly challenging events, staff are changed to give them a break. There is learning from each incident, including with external healthcare professionals, and risk assessments and care plans are changed, as necessary. Staffing is based around people’s needs and preferences, relationships, personalities and interests. Rotas also ensure sufficient numbers of staff who can drive to support residents’ activities. Medicines are regularly reviewed, and ordered, administered and disposed of safely. Proactive support offered by dedicated staff has led to a reduction in the use of medicines as required (PRN). People take part in household tasks to keep the service clean, tidy and odour-free, and are supported to improve their independence skills, 24 Care Home MANAGEMENT

Caring:

More information on Wolverton Court is available [online] at: https://www.cqc.org.uk/location/1-116521814

Responsive:

What Wolverton Court did: Effective

Staff are proactively supportive of each other, including starting shifts early to give respite to another staff member, and coaching other staff on how to build successful relationships. Staff have also received specific training in crisis management and person-centred care, and review restrictive practices regularly, reducing significantly the need for physical restraint. There is collaborative working, both with people (for example, in their nutrition and hydration and in the design of the service) and with other healthcare professionals. The service also shows tireless advocacy on behalf of its residents.

What Wolverton Court did: Caring

Each person has an equality and diversity profile to ensure staff uphold people’s human rights, and each has a visual achievement board to empower, recognise and celebrate achievements. Staff show exceptional kindness and treat people with dignity. Communication diaries are in place for all people, along with communication passports

Well-led: to help people develop their skills. People’s needs are comprehensively discussed within keyworker meetings.

What Wolverton Court did: Responsive

Detailed person-centred support plans with clear and thorough guidance help staff to support people. People use pictures to support individual preferences, which staff combine with their knowledge of a person.

What Wolverton Court did: Well-led

The registered manager is said to have a very proactive and progressive management style and the service benefits from a consistent staffing team. The manager was also nominated for, and became, a finalist in the National Learning Disabilities and Autism Awards.There is a culture of involving people in the running of the service, including in the recruitment of staff members. Staff are described as excellent at keeping families involved. Champions have been appointed, and the audits they produce are checked by the registered manager. www.chmonline.co.uk


BEST PRACTICE OUTSTANDING

Dystlegh Grange, Stockport Effective:

Caring:

What Dystlegh Grange did: Effective People are supported to host visitors within their own suite or in other communal parts of the home. Staff eat with people living in the home and can quickly identify a change of appetite or if a person appears unwell.There are creative approaches to encourage people to eat and drink: food, snacks and drinks are available in a range of locations throughout the home; there is a weekly baking event and during supper nights the room is decorated as a bistro and people get dressed up. The home has detailed medical files for each person and employs healthcare technology, for example, for assessing urine samples. A tissue viability champion has also been appointed to improve staff knowledge and skills. The home is open to making bespoke adaptations for residents, including lowering patio doors and installing higher decking to support mobility. Staff receive a variety of excellent training, including shadowing prior to starting employment, and there is ring-fenced learning time. ‘Champions’ enable experienced staff to gain more responsibility and knowledge.

What Dystlegh Grange did: Caring

Staff adapt their care and support to maintain residents’ interests and skills, and to encourage activity. September/October 2019

Responsive:

More information on Dystlegh Grange is available [online] at: https://www.cqc.org.uk/location/1-120651547

Well-led:

Most staff have worked in the home for a long time and demonstrably share their lives with the residents: children and grandchildren of both residents and staff often visit the home and take an active interest in each other’s lives. Social events are recorded and used in socialising and when encouraging reminiscence. Examples of staff going the extra mile include buying flowers for people on important anniversaries.The registered manager accompanies people to all healthcare appointments and visits them every day during hospital stays. Equality and diversity champions source information and are accredited with inclusivity schemes. Weekly meetings involve people in the running of the home and in organising community events.

What Dystlegh Grange did: Responsive

There is a ‘Friends of Dystlegh Grange’ group for people who have had respite stays at the home, and members are invited back for lunches and events. A stimulating range of social and recreational activities encourages residents to engage in home activities and staff support people to attend clubs externally, visit friends or take part in research projects.

The home has appointed an end of life champion and all staff are trained in palliative care.The home is also accredited in Six Steps to Success End of Life Care Programme.

What Dystlegh Grange did: Well-led

Staff members are keen to take on the role of champion and they speak with passion about their respective specialisms. Staff undertake self-management audits to evaluate their own performance against the home’s values which are used in an appraisal. Other audits and checks are undertaken by the management team. All managers spend time working alongside staff, modelling and demonstrating high standards of care. The home celebrates diversity: it is listed by Vegetarian for Life as being able to cater for vegans and vegetarians. The home has the status of Research Ready Care Home by the National Institute of Health Research and several people have taken part in a project with Manchester University looking at meaning and purpose in their lives. People also have taken part in local GP initiatives, ‘Fit for Frailty’ and ‘More than Meds’. The registered manager is extremely proactive in sharing good practice with others and puts in place a strong focus on learning from incidents and adverse events. Care Home MANAGEMENT 25


WELLNESS WHISTLESTOP PAIN IN DEMENTIA

Pain in dementia

In this regular series, Care Home Management looks at health conditions affecting care home residents and advises staff how to best support rapid diagnosis and treatment BY SHARRON TOLMAN, CONSULTANT ADMIRAL NURSE, AND VICTORIA LYONS, SENIOR CONSULTANT ADMIRAL NURSE, AT DEMENTIA UK Q: Why do I need to be more alert to pain in dementia? A: A person with dementia may be less likely to be able to express how pain is affecting them due to the changes which occur in the brain. They may not be able to say they are in pain, use the wrong words to describe it or say ‘no’ when they are asked if they are in pain and decline treatment. People with dementia are highly likely to have other underlying health conditions, which may be painful in themselves, including: gum disease, arthritis and constipation. Consequently, pain is often missed and not well-managed. Assessing and managing pain well can also avoid the need for unnecessary prescription of treatments for restlessness or agitation, depression and social isolation. Q: What signs should I look out for? A: Observing and managing behavioural, psychological and physiological symptoms is key, as symptoms of pain are often attributed to the dementia rather than the underlying cause of the pain. Signs of pain in dementia include: increased and repetitive calling out repetitive movements and fidgeting tense muscles and body bracing changes in sleep pattern reduced function tearful/crying being more withdrawn flushed skin. Q: Are there any tools to help me? A: Using a pain assessment tool such as Abbey or PAINAD can help to provide a framework for assessment and measurement 26 Care Home MANAGEMENT

any pain management treatment plan and paying attention to side effects are essential to ensure comfort for the person with dementia. If there is difficulty with swallowing, other options can be considered, such as a patch. Q: How can families help? A: As each person with dementia is unique, it’s important to look at the person’s previous experiences which can include their responses to pain prior to a diagnosis. They may have been a person to rarely complain about pain or seek medical help. They may have used different words to describe it or have been more likely to go quiet or irritable when in pain. Families and specialist dementia Admiral Nurses can provide this sort of detailed and unique information.

of symptoms. The online links are available at the end. These tools are based on observation so are helpful when the person with dementia is less able to express the pain they are feeling. The tools can also help to provide a picture of any triggers, the frequency as well as the extent of the pain. They can aid discussion with the GP as well as relevant care home workers when formulating a plan of care. Q: What can a healthcare professional do to help? A: Discussion with key professionals involved in care of the person with dementia can help to devise a treatment plan, including regular analgesia and nonpharmacological treatment options. Reviewing

Q: Where can I find resources and get one-to-one help? A: Review the following resources: • The Abbey Pain Scale: For assessment of pain in patients who cannot verbalise i.e. patients with dementia or communication difficulties available [online] via the link: https://tinyurl.com/kfmpcsl • Pain Assessment in Advanced Dementia Scale (PAINAD) available [online] via the link: https://tinyurl.com/yyd5nty9 • Admiral Nurse Dementia Helpline on 0800 888 6678 or helpline@dementiauk.org, Monday to Friday, 9am-9pm and at weekends from 9am-5pm. Dementia UK leaflet on managing pain is available [online] via the link: https://tinyurl.com/y6o64gej

www.chmonline.co.uk


ASK THE EXPERT EMPLOYEE MENTAL HEALTH

ASK THE EXPERT:

Care Home Management asks our panel of experts to answer your common care queries

IN THIS ISSUE: SUPPORTING COLLEAGUES WITH MENTAL HEALTH By Jamie Stewart, people development advisor at the Balhousie Care Group

Small changes can make a big difference in mental health Acacia Training owns two care homes, Mayfield House in Crewe and Samuel Hobson House in Newcastle-underLyme and uses an online assessment tool called Wellonomics to understand how employees are feeling. Data tracks unhealthy behaviours such as checking emails late at night, or when employees are feeling left ‘out of the loop’. This has led to remedial actions such as introducing a cut-off point for sending emails and a chat group to keep people informed. According to Acacia training director Victoria Sylvester: “These are small changes but they make a big impact as our employees know they’re being listened to and that their views do make a difference.”

Q: As an employer, what can I do to support colleagues with mental health issues? Balhousie Care Group has launched a Mental Health & Wellbeing Charter to promote mental health. Among its commitments is to adopt wellbeing toolkit with tips to positive mental health and support from external resources. Think of a scenario where an employee is struggling with a mental health problem or a mental illness. Their productivity is low, their absence is high and they feel uncomfortable talking about it in fear of being treated differently by their manager or their colleagues. The result of this is mutually negative for both the struggling employee and the frustrated employer. More important still is the fact that people in our industry are hired to provide essential care and support to vulnerable adults. The first thing an employer can do for employees is recognise mental health in the same way as we view physical health. Mental health can be good, bad and somewhere

September/October 2019

in between and vary from all these points during different periods of time, just like physical health. Raising awareness of this takes a significant amount of effort, for example, providing learning opportunities around mental health for employees. In addition, line managers will need additional training to assist and guide them towards practical interventions such as supportive conversations. Senior management can play its part in this by creating formal support mechanisms such as an Employee Assistance Programme (EAP) with a designated on-site person with whom to have supportive conversations and signpost to appropriate help. This can be in the form of accredited mental health first aiders or internally trained wellbeing champions. It is also worth considering what help is available from organisations such as Mind, Samaritans and a multitude of other places. Support might be available to help your organisation develop a wellbeing action plan, which is a tool that helps employees identify mental health triggers and to develop practical remedial steps.

HAVE YOUR SAY ON WORKPLACE WELLBEING LEGISLATION In a consultation, the Department for Work and Pensions and the Department of Health and Social Care are putting forward a package of measures which encourage early and supportive action by employers for their employees with health conditions. The data shows that around 300,000 people with a longterm mental health condition fall out of work every year. Government believes that there is a case for employers to do more to support their employees who are managing health conditions, or who are experiencing a period of sickness absence. In return, the government can provide more help for employers, recognising the differences in employers’ capacity and capability to act. HAVE YOUR SAY. The consultation closes on Monday 7 October and is available online at: https://getinvolved.dwp.gov.uk/ work-and-health/consultation/

Care Home MANAGEMENT 27


GARDENS ACTIVITIES

GREEN-FINGERED

WELLBEING

What will I learn from this feature? How to involve residents of all abilities in gardening

Alison Marsden, a gardening advisor and tutor specialising in Social and Therapeutic Horticulture, explains how care home residents can benefit from getting their fingers green this autumn

T

he wealth of contemplative display gardens featuring at this year’s flower shows, as well as all the testimonials to the healing power of gardening in the media are testament to the public’s recognition of the therapeutic value of green spaces and gardening. Beyond the headlines, there is a wealth of research to evidence the much wider benefits to physical and mental health of engaging with the natural world In the 2018 publication, ‘A Green Future: Our 25 Year Plan to Improve the Environment’, the UK government committed to improve health and wellbeing by using green spaces and connecting with the environment. Care homes have a vital role to play for their residents, especially those whose physical or mental health support needs preclude just going out for a walk even if there is accessible green space close by.

Great autumn gardening activities PLANTING BULBS FOR SPRING POTS. This is a typical autumn gardening task and garden centres offer a huge range of bulbs. There are no fiddly seeds to handle and this is a good group activity with two or three people working on a pot together. There is scope for crumbling compost, carefully placing bubs with a conversation about which way up they go, choosing which pansies to add for winter colour, watering and a discussion about aftercare, the seasons and looking forward to flowers in spring.

SEASONAL COLLAGE. This is an activity for indoors and one that can be repeated at different times of the year reflecting the

28 Care Home MANAGEMENT

changing seasons. The modern slant on a traditional collage means going gluefree. Leaves, flowers and grasses are simply arranged on a sheet of paper and preserved by a photograph which can then be printed out to keep and trigger conversations with visiting family.

Let’s get physical

Care homes can offer many different gardenbased activities, each with their own benefits – and the first step is to encourage residents simply to get outdoors. It is easy for people, especially with reduced mobility or dementia, to lose the habit of going outside and to choose indoor pastimes by default. But we know that time in a natural environment can reduce stress and anxiety. Equally, a garden offers multi-sensory engagement: feeling fresh air and sunshine, looking at the shapes and colours of plants, picking up scents and listening to birdsong. Add in the opportunity for socialisation, chatting over a cup of tea or taking other activities outside, and the benefits to wellbeing become clear. The second stage is to engage residents in gardening either through hands-on participation or watching. Table-top www.chmonline.co.uk


GARDENS ACTIVITIES

WHY GARDENING?

Gardening is the most familiar, accessible and flexible of the ‘green care’ activities, making it ideal for boosting the wellbeing of residents. A 2016 review of nature-based interventions for mental health care found the following benefits: Increased general mental wellbeing Improvement in dementia-related symptoms

Increased social contact, inclusion and sense of belonging

Improved self-esteem, confidence and mood Improved happiness, satisfaction and quality of life

Reduction in depression, anxiety and stress related symptoms

Increased attentional capacity and cognition

gardening is a great place to start, as it allows people to sit round a table and join in as much as they want. This involves sowing and growing in containers that are worked at on the table and then moved onto a patio or flower bed for display. Gardening in this way is a very sociable activity, residents may be continuing a hobby and using skills that they thought were lost and there is always something new to learn. Seeing plants thrive and ultimately flower can bring a sense of achievement and helps to make the home attractive for everyone.

Seeds of success

The joy of gardening is that you do not need much to get started. Basics include: an accessible, level, paved space - ideally close to the main building - where tables and chairs can be set out for table-top gardening; gardening gloves for everyone (close fitting nitrile-coated gloves are ideal); a few hand trowels and forks; potting trays and containers, plus compost and seeds or plants.

As with any activity, choosing and tailoring sessions to suit residents will produce the greatest participation and the most benefit. Adaptations for safety and pleasure for care home residents may include: removing thorns from roses so that residents, including those with dementia, can hold and smell them, and choosing Nasturtiums to sow because their pale seeds are easily seen against dark compost. Activities can be chosen for specific wellbeing outcomes: examples range from sowing individual seeds to exercise fine motor movement to a ‘smell & tell’ with fresh cooking herbs to stimulate memory. Activities for pleasure can include the tactile task of crumbling compost before filling a pot, and giving your activity a few minutes of mindfulness as everyone focuses on the texture between their (gloved) fingers. Care home staff with their knowledge of residents’ capabilities and needs are the best placed to create a gardening programme that delivers maximum benefits of social and therapeutic horticulture for their residents.

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Care Home MANAGEMENT 29


GARDENS INSPIRATION

BOROUGH CARE During National Gardening Week (27 April-5 May) Borough Care residents, (such as Dorothy Kettlety, pictured here, right, with housekeeper Chris McQuade) helped by family members and staff, grew their own fruit and herbs. Residents who can’t get outdoors were able to use window boxes and other small containers to plant seeds, small plants, flowers and shrubs. Residents also regularly join forces with Year 5 pupils at a local primary school for their gardening activities

BALHOUSIE CLEMENT PARK care home in Dundee has opened a dementia garden with a purple theme, the brand colour of Alzheimers Scotland, and a putting green, all developed in collaboration with the local Carse of Gowrie Men’s Shed. Emma Roberts, Balhousie dementia nurse advisor, says the garden project has helped cement friendships and bonds between residents and the Men’s Shed volunteers

green fingers!

BRITAIN’S CARE HOMES HAVE

The team at PRIORY COURT Burnham-on-Sea, joined forces with local street artist Damian Nicholson to transform a dull wall into a fabulous beach area. The wall art features local landmark the Low Lighthouse, and a stunning sunset across Bridgewater Bay. Residents shared ideas with Damian about his plans for the wall and got involved with planting hanging baskets and planters and in creating a beach-hut, beach and ‘rock pools’

Take a look at how other care homes are cultivating their residents’ gardening skills

The garden at the CANFORD PARKFIELD HOUSE home in Hillingdon has been used to host arts sessions and showcase residents’ masterpieces. The home also involves residents in the care of chickens to reduce social isolation. Brownie the hen is seen here posing with manager Wendy Bristow, and residents Audrey (far left) and Sylvia. Supported by creative ageing charity Equal Arts, Parkfield House residents have taken part in weekly sessions led by professional visual artists exploring weaving, poetry and ceramics

BROADWATER LODGE, GODALMING In August 2018, Broadwater Lodge converted its garden area into a smallholding with pigs, goats, a rabbit, chickens and some guinea pigs. Since opening ‘Codger’s Farm’, as it has been dubbed by residents, the farm has boosted inter-generational contact within the home. Residents also find it therapeutic to stroke the animals, and as reminiscence therapy. The garden, in which the farm space is situated, is also designed to allow residents to move freely around and incorporates dementia-friendly design such as meandering paths, raised beds, activity space and seating areas. In 2019 Broadwater Lodge garden and farm took the top prize in the Best Garden or Outdoor Space category in the 2019 Care Home Awards

30 Care Home MANAGEMENT

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GARDENS DESIGN

STEP-BY-STEP

GARDEN DESIGN

The ideal garden for people with dementia needs to be a space for reflection, as well as mental and physical stimulation, that is inclusive and accessible to people with a range of physical and mental abilities, and their visitors. Here’s how you can help a designer to help you achieve your garden aims. By Timotay marketing manager Rebecca White

1 2 3 4 5 Understand the views and requirements of staff, residents and their families

Know what you want to achieve: sensory, inclusivity, accessibility, space for activities

Remember your safety ‘must-have’s’: safe pathways; minimal steps and obstacles, shelter

Purposeful plants: What colours, scents, textures and flowering time-span do you need?

Draw up your plan, taking expert advice as required

September/October 2019

All pictures courtesy of Timotay

Care Home MANAGEMENT 31


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NUTRITION AGEING

What will I learn from this feature? How to keep care home diets healthy and interesting

A TASTE OF

OLDER AGE

Care homes have a variety of tools available to them to encourage residents to adopt a healthy and varied diet, says Helen Willis, dietitian at apetito and Wiltshire Farm Foods

T

here are many lifestyle factors that can contribute to healthy ageing, but with older people at more risk of nutritional deficiency, achieving a healthy, balanced diet is key. What’s more, a good diet can play a protective role in some age-related conditions such as dental, bone and joint health. In 2014, the National Diet & Nutrition Survey showed that in older adults, fibre, oily fish and fruit and vegetable intakes were all below the recommended levels. Additionally, some populations had low intakes of protein, vitamins and minerals – all of which, can significantly impact an individual’s overall health. Dietary needs change with age. As physical activity lessens, energy requirements also decrease. However, if insufficient levels of food are consumed, this can consequently increase an individual’s risk of nutritional deficiencies. One of the main physical changes that occurs with age is the change in body composition and metabolism. Physical

September/October 2019

inactivity can cause muscle fibres to weaken and accelerate bone loss. As a result, a large proportion of older people in care suffer from physical ailments such as osteoporosis. Calcium-rich foods such as leafy green vegetables, dried fruit and yoghurt can help reduce this risk.Vitamin D is also key, helping the body to absorb calcium. Current recommendations advise that people living in care homes take a daily supplement containing 10 micrograms of vitamin D throughout the year. Eating oily fish, red meat, fortified breakfast cereals and fortified yoghurts can also help to keep bones, teeth and muscles healthy.

Appearance, texture, temperature of food, the variety of meal options and the dining setting all play a part in encouraging care home residents to eat more regularly

A taste of older life

Age, as well as certain medications, can affect our ability to taste, all of which can reduce the pleasure older people get from mealtimes. Using strong flavoured and aromatic ingredients such as garlic, onions, lemon, lime, mustard and a variety of spices can help enhance taste perception. Similarly, garnishes can increase visual appeal. Appearance, texture, temperature of food, the variety of meal options and the dining setting all play a part in encouraging care home residents to eat more regularly. Frequent tasting sessions, or interactive food experiences (see overleaf) can all help residents to try new meals and expand their dietary profile, whilst providing feedback on their preferences for future menu planning. It is recommended that care homes develop four-week, rather than two-week menu cycles to prevent menu fatigue. Care homes can also develop themed menus within these menu cycles for specific occasions such as Easter. Care Home MANAGEMENT 33


NUTRITION AGEING

Interactivity on the menu Interactive food activities take place every two weeks at the Chelsea Court care home in London, which was a finalist in the 2019 Care Home Awards’ nutrition, food and dining experience category. Chef Matt Dodge, who also appeared in the recent Channel Four TV programme, ‘The restaurant that makes mistakes’, says: “Residents are from an era when they did prepare food for their families.” He says it has encouraged residents to try new foods and has improved nutrition. In the care home’s fortnightly cooking classes, residents get involved in making sushi, bread, cakes, tortilla wraps and tarts. With support from staff, and with activities tailored to the individual’s abilities, able residents get involved in all aspects of the food preparation, including using knives - although any cooking is done by the catering team. At Chelsea Court they benefit from resident to staff ratios of 2:1 but that is far above the minimum required for safety, Dodge believes. He says: “It’s just about having another

pair of eyes, knowing the residents, and what’s involved in the task.” He says that topical dietary preferences such as vegan or carb-free eating are increasingly commonplace in care homes, and the catering team may sometimes need to manage dietary expectations in line with the resident’s actual nutritional needs. Dodge says: “We do sometimes need to have difficult conversations.”

Did you know?

60%

of people decide a care home based on its food and drink offer

Dementia friendly menus R

esearch shows that as people age, they can lose up to 50 per cent of taste sensation. When you add in the extra complication of dementia, food can become very boring and bland. Making food appetising for residents with dysphagia is particularly challenging. The solution is to train and equip chefs to improve food textures and presentation, putting the focus on colour, reconstruction and using herbs and spices to enhance the flavour profile of traditional staples like stews and fish and chips. Using spices can raise a few eyebrows because the general

Source: Caterplus

Balhousie Care Group has relaunched its care home menus to focus on people with dementia

belief is that old people don’t eat spicy food, but this just isn’t true when spices are used properly. Finger foods are also helpful for people living with dementia. Food in the hand serves as a helpful prompt to eat. Some people can find it difficult to concentrate or focus so expecting them to sit down for a full meal is unrealistic. It may be that they just don’t recognise the mealtime experience, or they believe that they have eaten already because they are sitting at a table. Where possible, finger foods should be the same as everyone else is eating.

34 Care Home MANAGEMENT

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NUTRITION REDUCING WASTE

FOUR STEPS TO

WASTE REDUCTION Healthcare Homes Group home Blandford Grange uses the following four steps to monitor and decrease food wastage in the home. They are: 1 Use vegetables that were not served during lunchtime service in teatime soups, vegetable patties or ‘bubble and squeak’

2 Use all cuts of meat for a range of dishes – for example, serve

roast chicken breast for a main course, use leg or wing meat in pies, soups or pastas, and carcasses as a stock

3 Use discarded bread crusts to make breadcrumbs, for use as ingredients in other dishes

4 Recycle used cooking oil and food waste from plates ‘Stop Food Waste Day’ takes place annually in April. For more tips and hints on reducing food waste, visit: www.stopfoodwasteday.com

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Care Home MANAGEMENT 35


SECURITY BIG DATA

What will I learn from this feature? How data is changing the face of care home security

How big data drives big security Tech-driven facilities management can offer added security and a host of other benefits. So, how do you use data to improve security? By Trevor Ball, business development manager UK & Ireland at Allegion UK

I

ntelligent access control, such as cloud-based systems, can track a host of useful metrics, all with the potential to improve both security and processes in general: systems track both users and access points, collecting and storing what is known as ‘big data’ on information including approved access, declined access and lockdown instances. Collecting and using this information can present facilities with a myriad of security improvements. At a basic level, knowing which (and, more importantly, when) access points of a building are being used helps determine whether those areas are being used correctly. Take the healthcare sector as an example. Most healthcare environments are designed to house open-plan areas, but all contain ‘offlimit’ areas that house confidential records, equipment and drugs. Medicine cabinets, for example, require stringent security and by collecting data on access, a facility can detect any instances of declined access or wrongful access (think unusual after-hours activity). This information can then be used as the 36 Care Home MANAGEMENT

rationale for changing or revoking access rights, or adding an extra layer of security when it is most needed. A facility’s physical environment can also be optimised by data: collecting and analyising data on footfall, for example, allows a facility to understand more about the flow of movement within the building to inform future adjustments to the benefit of residents, their families and staff.

The data divide

If data-driven facilities management can enhance security and processes, why aren’t we seeing widespread use of it? Until recently, the UK has been slow to move on the use of data in facilities management, meaning the experience and track-record in this field is limited: both installers and end users are unclear as

to how data-driven management could be helping their facilities. Accountability is also a potential issue – does responsibility lie with the IT team or with the facility manager? The advent of data-driven security tech gives care homes a structured, strategic option - securing facilities with the use of analytics and evidence. And, with care home security a key regulatory responsibility, can care homes really afford to use intuition or wait for potentially serious incididents to push them into a security decision?


SECURITY ACCREDITATION

SECURE YOUR

ENVIRONMENT ‘Secured Environments’ is a police certification scheme that advises and accredits organisations on security. It offers the following six principles of an effective, secured environment

1

COMMIT: Managers need to show that they have taken steps to help to create a safe and secure working environment and staff need to believe that the organisation is committed to implementation. Insecure environments are at risk of costs arising from expensive insurance premiums and compensation payments, as well as those associated with burglary or vandalism or anti social behaviour. UNDERSTAND: Managers need to be able to describe the risks posed by lack of security, and explain how risks and incidents are recorded, monitored and analysed to create a secure working environment. Employees should be able to explain what they need to do to report an incident and provide examples of when they have done this.

2

3

RESPOND: Crime prevention and security measures in place should be appropriate to the organisation based on risk analysis. This analysis should be defensible. Employees should be able to explain their role in creating and maintaining a safe and secure environment. All staff should also be able to provide examples of ways in which the organisation has improved its response to, and management of security. MANAGE: Security measures should be planned. Managers should be able to show awareness of the resources (e.g. people, time, money and technology) used within the organisation to create a secure environment and that this is an efficient use of available resources.

4

When deciding on an access control system be realistic about what you want from the system and don’t get carried away by clever features and add-ons, says Stanley Security

5

IMPLEMENT: New security measures need to be introduced using project management principles. The organisation should work with other relevant agencies, for example, the police, neighbours, etc, to improve security and reduce crime and anti social behaviour. EVALUATE: Crime prevention initiatives and security measures should be assessed to determine effectiveness, through testing, auditing and evaluation. Findings should be fed back into your organisation’s security strategy.

6

For more information, visit: www.securedenvironments.com

Financial data security is changing Tim Homer of Expense Reduction Analysts explains the implications of Enhanced Payment Security for care homes

F

rom September 14, online payment security is changing, and brings with it the prospect of Secure Customer Authentication (SCA) for organisations that host payment information relating to a resident’s accommodation, as well as those accepting credit or debit card payments. The new legislation, a European Directive, aims to make paying online more secure and to reduce the risk of payment fraud. It brings with it an authentication process designed to prove that the end customer is who they say they are. The three valid categories of authentication are: • Something you know: password, PIN, signature • Something you have: card, mobile phone, wearable device • Something you are: facial recognition, fingerprint, iris scan

September/October 2019

Who’s responsible for implementation?

Fortunately, organisations taking online payments are not directly responsible for meeting SCA: that responsibility falls to the business’s intermediary Payment Service Provider, who will liaise with the payer’s bank to ensure the transaction is compliant. Customers will see an extra step during the payment process, for example, the need to use a new one-time password/passcode or provide biometric authorisation. In a recent survey of people who buy online, over one in five said they would refuse to go through the additional security steps and would abandon their purchases. For care homes this could mean making an increased marketing effort to ensure clients continue to pay their fees electronically, or to monitor online account information. The good news, though, is that

customers will have the option to assign known organisations to a list of ‘trusted beneficiaries’, a ‘whitelist’ of organisations who do not need to be paid using SCA. This may well help to reduce the burden for care home operators.

Care Home MANAGEMENT 37


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ENERGY COST MANAGEMENT

Care homes feel the heat in new climate change report

Why it pays to keep a close eye on energy costs What will I learn from this feature? How effective energy management can reduce consumption and lower bills

Buildings account for around 40 per cent of global energy use and are responsible for 30 per cent of total global CO2 emissions. If the UK is to achieve its 2050 Climate Change Act targets, care home operators need to put measures in place to reduce energy use in their buildings. By Dave Curnow, director, Black Sheep Utilities

I

n its latest report1, UN-accredited Smart tech is global energy body the World energy smart Did you Energy Council predicts Knowing your energy know? worldwide demand for energy consumption and use Electricity consumption will hit an all-time high in 2030 is the first step to is expected to increase - increasing by more than 70 reducing unnecessary by more than per cent compared to current consumption and making levels – followed by a decline those all-important as technological innovation and savings. Smart metering by 2030 government policies make their and advanced monitoring mark. This is in stark contrast to the technology are key ways to historic trend which has seen global energy identify your biggest areas of energy demand more than double since 1970. consumption; once you know where your Solar and wind, which currently account for biggest consumption is, you can efficiently approximately 4 per cent of power generation, invest in smart tech to reduce consumption will see the largest increase to account, and support a more sustainable carbon respectively, for 20 and 30 per cent of power footprint. In the important area of air generation by 2060. In comparison, over this cooling or refrigeration smart technologies time-frame fossil fuel usage could fall to as little have the potential to cut around 30 per as 50 per cent of the primary energy mix. cent off your bill.

70%

World Energy Scenarios 2016 report: Global energy demand growth set to fall [online] via the link: https://tinyurl.com/y6qfvpvj 2 Committee on Climate Change report 2019. Preparing for climate change [online] via the link https://tinyurl.com/yycjlqgq 1

September/October 2019

In a new report, Progress in preparing for climate change – 2019 Progress Report to Parliament, the Committee on Climate Change2 (CCC) calls for more regulation to avoid overheating in health and social care and to improve data collection and monitoring. It warns that care homes face significant health impacts if their homes become too hot for residents. As higher temperatures become the norm, it says there is likely to be “significant adaptation shortfall to manage the increasing risks to health”. It adds that little is being done to monitor and protect care home residents. In the past, the CCC has previously recommended that the Care Quality Commission should inspect for heat resilience and ensure that overheating risk forms part of its inspection for safety and suitability of health and social care premises. In its report, the CCC notes that homes are not adapted for current or future high temperatures, that there is a lack of awareness of the risks to health from high indoor temperatures, and that there is a lack of appropriate planning in health and social care. In buildings, new designs are needed to improve energy efficiency and reduce overheating risks. There also needs to be better monitoring of the impacts of overheating on patients and longer-term adaptation plans to mitigate the longterm risks of climate change. According to the CCC, around 20 per cent of existing homes currently overheat even in cool summers. “Failure to plan heat management in new care homes and care in the home could lock-in large numbers of people to heat risks,” it says.

Heatwave management guidance for care home professionals is available from Public Health England [online] at: https://www.gov.uk/government/publications/ heatwave-plan-for-england

Care Home MANAGEMENT 39


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ENERGY COST MANAGEMENT

Water-saving tips for care home staff INSIDE… • T urn taps off after use: a running tap uses around six litres of water a minute  in personal hygiene products, wet wipes and •B cotton buds – not flush • Report water leaks, dripping taps or leaking loos  se water-saving devices such as flush-savers •U in toilets, aerators on showers and taps, urinal controllers and even waterless urinals. …AND OUTSIDE: C  ollect rainwater with a water butt on a downpipe and use on gardens and in the loo  se a trigger gun on hoses •U  se washing-up water from kitchens on •U grassed areas Source: Water Plus

September/October 2019

Care Home MANAGEMENT 41


PEOPLE EVENTS

PEOPLE

Care home movers and shakers

New Century Care has appointed Phil Smith as managing director. Smith was previously the company’s chief operating officer. Borough Care has appointed Rekha Patel-Harrison and Michael Hinett to its Board as non-executive directors, PatelHarrison and Hinett will provide strategic support to Borough Care’s executive team. Patel-Harrison is currently CEO of Petrus, a homeless and community interest company based in Greater Manchester, while Hinett is group quality and compliance director at Fairhome Care. Also joining the Stockport-based care provider are home business managers Nicholas Witan (right), joining Meadway Court in Bramhall, and Aaron Flitcroft to Wellcroft in Gatley. Witan joins from support service provider United Response, and Flitcroft from Ideal Care Homes’ Brinnington Hall, where he was deputy manager. Learning disability nurse Andrea McGuire is to take over as manager of the newly-opened Deanston House in Doune, Stirlingshire. The home for adults with learning difficulties is part of the Enhanced Community Healthcare Options Group (ECHO). McGuire previously worked in care with Enable Scotland. Avon Lodge nursing home in Kingswood, Bristol, has appointed Luis Gil as manager to head up a new management team.

Inverness-based care provider Meallmore has appointed Jody Marshall as group hospitality manager. Marshall joins from the hotel industry.

Kate Silver has been appointed as director of people at The Royal Star & Garter Homes. She replaces director of human resources Siobhan Creighton, who is retiring after almost two decades with the charity. Tracey Hinchliffe, Santi Francheschino and Pamela Ward, pictured left to right, have been promoted to the role of registered managers at three Czajka Care Group homes. Hinchliffe will work at the Brookfield Care Home, Francheschino at the Staveley Birkleas Nursing Home, and Ward at Fairmount Nursing Home, all located in Nab Wood, Shipley.

42 Care Home MANAGEMENT

Business partners

Peter Macleod, chief executive of Scottish regulator the Care Inspectorate, has been appointed as the chair of the Technology Enabled Care (TEC) Programme Board. TEC is a Scotland-wide programme designed to significantly increase use of technologyenabled care. Business property adviser Christie & Co has made two appointments to its care valuation team: Jon Hodgkins (left) as director, and covering the Midlands and South West, including South Wales, and Jamie Savage, as associate director, covering Scotland.

EVENTS

SEPTEMBER Care Workers’ Charity writing competition. Theme: Go Further. Entries open until Monday 30 September. For more information, visit: https://www.thecareworkerscharity.org.uk/Event/ writing-competition Dementia Friends Information Session. Order of St John’s Athelstan House, Malmesbury. Tuesday 10 – Thursday 12 September. To reserve a place, please contact Sharon Villegas. Tel: 01666 848000 or email s.villegas@osjct.co.uk Enhanced health and wellbeing in care homes. Kings Fund conference, London. Thursday 19 September. For more information, visit: https://www.kingsfund.org.uk/events/enhancedhealth-and-wellbeing-care-homes World Alzheimer’s Day. Saturday 21 September, and the focus of World Alzheimer’s Month in September. To get involved, visit: https://www.alzheimers.org.uk/get-involved/events-and-fundraising International Week of Happiness at Work. September 23 – 27. To get involved, visit: https:// internationalweekofhappinessatwork.com/ Keeping well: supporting the care workforce. Scottish Care conference. Wednesday 25 September. Glasgow. More information [online] via the link: https://tinyurl.com/y68gwedw

OCTOBER The Care Show, NEC Birmingham. Wednesday 9 – Thursday 10 October. Visit the Care Home Management team on Stand D90. World Mental Health Day. Thursday 10 October. To get involved, visit: https://wfmh.global/world-mental-health-day-2019/ Health and care explained – Newcastle: how the system works and how it is changing. Kings Fund conference. Wednesday 23 October. For more information, visit: https://www.kingsfund.org.uk/ events/health-and-care-explained-newcastle www.chmonline.co.uk


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September/October 2019

LEADING THE WAY

IN HELPING THE CARE SECTOR ACHIEVE HIGH STANDARDS IN FLOOR HYGIENE AND CLEANLINESS

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Care Home MANAGEMENT 43


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Care Home Management magazine Sept/Oct 2019  

The September/October issue of Care Home Management magazine contains a great range of news, features, information and advice for care home...

Care Home Management magazine Sept/Oct 2019  

The September/October issue of Care Home Management magazine contains a great range of news, features, information and advice for care home...

Profile for chmonline
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