Care Home Management magazine Sept/Oct 2017

Care Home www.chmonline.co.uk

September/October 2017

Management

The industry consolidates‌.

Patel snaps up 122 Bupa homes Care Homes More action needed on feedback

Care plans Giving every resident their special day

Care Home Awards Bigger and better new categories for 2018

Issue 69

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Editor’s Letter

Welcome to the September/October edition of Care Home Management

Care Home Management September/October 2017

Issue 69

Annual Subscription £30.00 Where sold cover price of £4 Editor/Publisher Alan Rustad Design/Production Phil Cunningham www.creative-magazine-designer.co.uk Published by JNJ Media Ltd Croham Lodge, Croham Road, Crowborough East Sussex TN6 2RH Tel: 01892 663350 Email: editorial@jnjmedia.co.uk sales@jnjmedia.co.uk Advertising Space Marketing Tel: 01892 677721 Email: antoinettem@spacemarketing.co.uk www.spacemarketing.co.uk www.chmonline.co.uk Copyright: Care Home Management Magazine 2017

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.

Care Home www.chmonline.co.uk

September/October 2017

Management

T

he ‘silly season’ is over. Everyone is back to work. And life goes on for the UK’s care homes – as it has all summer long.

Except that this year’s ‘silly season’ – that period every August when the politicians are on holiday and journalists are scratching around for other stories to fill their pages – wasn’t very silly at all.

As we explain in the following pages, August was a pretty hectic time in the care home business with a number of issues raised which all ought to filter in to the thinking of politicians when we eventually see the promised Green Paper on the future of social care in this country.

Everyone involved has been crying out for ‘joined up care’ involving the NHS and social care providers. We are all getting older and in theory the future for care homes should be rosy. We have known all the well-rehearsed arguments for years.

But the care home market cannot wait for ever to see what the government wants to do for our elderly. The market does not stand still and as we have seen HC-One led by arguably the biggest figure in the industry, Dr Chai Patel, has gone ahead with its deal to buy 122 Bupa care homes to become the largest player in the market.

Consolidation has been coming but this particular deal was simply a case of one big player adding beds bought from another big player. For all the consolidation that has been talked about, care homes are still in the main run by small businessmen and women who may own just a handful of care homes or even just one home.

They have been finding life tough for all the local authority austerity reasons. What does the future hold for them? The crystal ball looks no less cloudy and some definite planning cannot come too soon.

This edition also reports on how a report for the Lancet predicted the vast increase in care homes beds that will soon be needed and a report from Healthwatch England on how care homes must accept and react positively to feedback they receive from residents and their relatives and friends.

We also have the official launch of the 2018 Care Home Awards. After the successful debut this year, the 2018 awards will be bigger and better with some wonderful opportunities for care homes and their suppliers to demonstrate all that is best in the sector.

This edition is also available at the Care Show at the NEC Birmingham in midOctober. If you are taking a look for the first time – welcome! We hope you find it interesting. And if you are at the show, feel free to drop by our stand and say ‘hello’.

As ever you can keep up to date with the latest care home news via our website – www.chmonline.co.uk and feel free to let us know your views on any issues at editorial@ jnjmedia.co.uk

editorial@jnjmedia.co.uk The industry consolidates….

Patel snaps up 122 Bupa homes Care Homes More action needed on feedback

Care plans Giving every resident their special day

Care Home Awards Bigger and better new categories for 2018

Issue 69

@Carehomemanage

Alan Rustad Publisher/Editor

September/October 2017 | Care Home Management 3

Contents

6

6 Industry HC-One buys 122 Bupa homes

24 Competition investigation The implications so far

8 Care Study calls for greater acceptance of feedback

26 Finance Are one in six homes really at risk?

10 Capacity 71,000 extra places needed

12 Community Bringing the outside in to cure loneliness Care Home Awards 14 New categories for 2018

18 Showering Creating the right environment

22 Washrooms Avoiding contamination

10 4 Care Home Management | September/October 2017

28 Dementia Care UK calls in academics 32 Recruitment Finding – and keeping – essential staff 36 Catering Latest thinking on controlling costs 37 Nutrition The importance of presentation and quality 38 Nutrition case study Getting it right in the home of chocolate

18

40 Flooring The smart way to counter falls Care Plans 42 Give every resident their ‘day’ 44 Rural Homes Keeping energy costs in check

24

45 Lighting LEDs – a brighter idea?

46 Business Take care with care home partnerships

47 Legal What is allowed on top up fees Events and Appointments 48 Where to go and latest movers

36

45

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It is increasingly recognised that Activity Provision can make a significant contribution to well-being and quality of life, and the Care Sector reports a need for specialist training for their staff in this area. NAPA is delighted to offer two courses that meet the needs of the specialist activity workforce.

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News

HC-One completes Bupa purchase

HC-One has acquired 122 care homes from Bupa, subject to regulatory approval, in a deal totalling about £300 million.

Bupa will keep around 150 care homes and six Richmond Villages caring for more than 9,000 residents, with a further four care homes and two retirement villages under construction.

Bupa UK chief executive David Hynam said Bupa would remain one of the main providers of residential care in the UK, and a major investor in the sector.

“This move enables us to focus our investment to continue to provide high quality care for our residents, both now and in the future,” he said. “This year, Bupa will invest more than £120 million into refurbishing existing homes and building new care homes and retirement villages.

“Bupa and HC-One have a shared commitment to excellence in care. We

will work together over the coming months to ensure there is minimal change for residents and their families, and that they continue to receive the high quality care from the same dedicated teams.”

The deal completes HC-One’s recently completed refinancing.

Formed as a result of the Southern Cross collapse in 2011, HC-One was acquired in November 2014 in a transaction led by Court Cavendish, Formation Capital and Safanad in a deal that has already delivered more than £100m of investment in the HCOne business. Over the last three years the company has bought 30 homes from Meridian and 20 from Helen McArdle Care.

HC-One chairman Dr Chai Patel (above) said the purchase of the Bupa care homes built his company’s sector leading investment programme

on which huge amounts of time and resource on learning and development programmes, IT systems, and homes had been spent.

“We also have taken huge steps to ensure we operate with tried and tested processes that put residents first and which will support our continued growth,” said Dr Patel.

“The investment we have made gives us the confidence to reach out to serve even more local communities across Britain. We will be larger going forward but we will ensure that every single person we care for experiences the same culture and focus on kindness that have characterised HC-One since our first day of operation.

“The homes we have acquired from Bupa are dispersed across the UK, and demonstrate HC-One’s ongoing strategy to focus on strong regional growth. HC-One’s growth is financially sustainable – our debt levels are both prudent and manageable – and our ever strengthening and stable financial position means residents will continue to receive the kindest high-quality care through a range of specialist services and equally that we will continue to invest in our staff.

“I am truly delighted and honoured to announce this acquisition, the latest step in our journey from turnaround to transformation.”

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News

Accept feedback to drive improvements says Healthwatch

Care homes need to get the basics right and act upon feedback from residents, their relatives and staff to drive improvements says a new report from the independent champion for people who use health and social care services, Healthwatch.

The Healthwatch report outlines key next steps for care homes and how feedback can be used to identify a whole host of small, low cost changes that ensure all residents feel ‘at home’.

Between January 2016 and April 2017, local Healthwatch staff and volunteers across England visited 197 care homes across 63 different local authority areas, to find out what day to day life is really like for many of those living in care homes.

The majority of residents and relatives Healthwatch spoke to considered the care they received to be good, with innovative homes showing what is possible without breaking the bank.

Healthwatch representatives saw staff going above and beyond the

call of duty to connect with those they care for and really helping them to live their lives - including one activities coordinator from Cheshire who arranged for her own wedding reception to take place in the care home she worked at to enable residents to join in the party.

However, Healthwatch volunteer visitors also witnessed homes not getting the basics right with even those providing excellent care failing to tick all the boxes. Issues local Healthwatch found involved environment, activities, staffing and wider health needs.

Residents themselves identified problems with things as simple as getting dressed. For example, one person in Wiltshire told her local Healthwatch that, “the staff just pull things out of the wardrobe and say “that’s nice” and put it on me – they don’t ask what I want to wear.”

Although some of the reports produced by local Healthwatch organisations raise concerns about people’s experiences, the vast

8 Care Home Management | September/October 2017

majority of care home managers have responded to the feedback very positively, often agreeing to review processes and making changes very quickly.

But not all replied, raising concerns about a worrying culture of apathy towards the views and experiences of residents in some homes. Care home managers are encouraged to work with their local Healthwatch to actively seek out and use feedback to drive improvement.

Imelda Redmond (left), national director of Healthwatch England, said: “It’s not easy running a care home, particularly as the sector as a whole is trying to get to grips with the dual challenge of managing rising demand with limited resources. But getting the basics right doesn’t have to cost the earth and should be the least we should all be able to expect for our loved ones and ourselves should we need care support.

“Even the best homes we visited aren’t perfect, and it is vital that managers and carers regularly speak with their residents to work out what’s going well and where they might need to improve. None of us would want someone dictating how we should live our lives in our own homes, so why should we expect care home residents to tolerate it?

“Care homes are not institutions, they are people’s homes, and the only way to ensure they feel like this for residents is to put them at the heart of shaping how the care home runs.

Healthwatch is here to help with this and I would urge anyone who wants to share their experiences, good or bad, to get in touch.”

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News

Lancet study calls for an extra 71,000 care home places

A report in the Lancet that says an extra 71,000 care home places will be needed by 2025 has been given a warm welcome by industry figures.

The study compares levels of dependency in adults aged 65 years and over in England in 1991 and 2011 - 15000 adults in total. Adults were classed as high dependency if they required 24 hour care, medium dependency if they required care at regular times each day, low dependency if they required care less than daily, or independent.

Healthwatch, who brought out their own report about life in care homes, said the figures came as no shock but painted a picture of the stark reality social care faces (see page 8).

Neil Tester, deputy director of Healthwatch England, said: “We

know from what people tell us every day that the care sector is already in a fragile state, and it is clear these daunting challenges aren’t going away. As a country we have some really big questions to face about how we plan and fund care.

“But finding solutions to the lack of space, appropriate care, and the best use of resources, requires far more than simply increasing the number of care home places. To deliver the right sort of care we must listen carefully to people living in care homes right now as well as the rest of us who may need care in the future.

Janet Morrison (above), chief executive of Independent Age, the older people’s charity, said: “This report is further evidence, if it were needed, that the government

10 Care Home Management | September/October 2017

must act urgently to put in place a sustainable social care system that is able to meet the demands of an ageing population.

“Creating over 70,000 new care home places seems to a tall order for a care sector commonly recognised to be in crisis. Given the government committed to a Green Paper back at the Budget in March, and reports like these highlight how acute the pressures in social care have now become, older people and their families really can’t wait much longer to see a long-term solution to the crisis in adult social care.”

Rob Burley, director of policy at Alzheimer’s Society said: “By 2025 there will be more than one million people living with dementia. They are the biggest users of the social care system and need a high level of support as the condition progresses.

“Yet we hear daily about how the system is unable to meet the needs of people with dementia – from being turned down by a care home, to facing extortionate costs for inadequate care. A social care system that is unable to fully meet the needs of people with dementia also places strain on the wider health system, with things such as delayed discharges from hospitals creating costs for the NHS as well as being detrimental to the health of a person with dementia.

“The Government and sector as a whole must act now to ensure we have future-proof plans to accommodate the enormous rise in demand. A new approach that recognises the needs of people with dementia is desperately needed.”

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News

Norfolk homes launch community initiatives to tackle loneliness

Two care homes in Norfolk have launched new services to encourage older members of the community to join their staff and residents for activities, entertainment and meals.

Olive House in Newton Flotman and Bilney Hall near Dereham are offering day care services and ‘friendship lunches’ and are encouraging anyone to attend The homes, which are part of the Healthcare Homes Group, provide residential services, including specialist dementia care and are looking to widen

the reach of their care expertise to help even more people.

Recent statistics show that almost three-quarters of older people in the UK are lonely and more than half of those have never spoken to anyone about how they feel. The day care services give individuals access to the communal areas at the homes throughout the day, with food and drink also provided, and friendship lunches offer a free opportunity to come and enjoy lunch at the homes, socialising with residents and taking part in the day’s activities.

Full assessments can be provided before attending the home and individuals who require medication can be supported in receiving this throughout the day.

Lisa Brown, regional manager (Norfolk) for Healthcare Homes, said: “Loneliness is often seen as a taboo subject and something that those who are feeling lonely are ashamed to talk about.

“It’s really important that we encourage people to talk about this, but also, to find ways to offer opportunities for social interaction and friendship within our communities. Our homes are hives of activity, and we hope that our new initiatives will be of real interest to people in the local area who would like to come and make some new friends, enjoy our activities and find out more about what we do.”

Dementia village plan for Canterbury

Developers behind plans for the Mountfield Park project have announced that Canterbury could become the first location in the UK to have a village designed and built for the needs of people with dementia.

The dementia village would form part of Corinthian Land’s 4,000 home Mountfield Park scheme planned for the southern outskirts of the city. Land has been earmarked for the dedicated dementia village which could become home for up to 250 people. If given the go ahead, the village will be the first community of its kind in the country.

The idea for the dementia village is modelled on a successful scheme, Hogeweyk, already operating near Amsterdam.

Simon Wright (left), chief executive of Corinthian Land visited the Dutch facility recently with leading care home provider Avante to see the village for himself.

“It was very impressive,” said Mr Wright, “and in my opinion just the kind of facility we need across the UK as the number of dementia suffers is set to rapidly increase. I would like to build the

12 Care Home Management | September/October 2017

first one in Canterbury. The concept is simple yet ground-breaking; we build a village for dementia suffers which can also accommodate their carers and immediate family and make it totally safe and secure.

“Within the village there would be a range of facilities such as shops, a care centre, a cinema and recreational facilities. Housing would be a mix of accommodation with a focus on encouraging couples affected by dementia from not having to split up."

News

Refining the categories for a better Care Home Awards in 2018 The Care Home Awards 2018 are now open for entries with the biggest change being the expanded Overall Achievement categories.

There are now more chances for the best care homes and groups to impress the judges and secure themselves a top accolade gold award, provided each care home considered has previously entered at least one of the twelve Care Home categories.

The Gold Award categories are now: ■ Best Individual Care Home ■ Best Single Care Home in a Group ■ Best Residential Community ■ Best Small Care Home Group (up to 9 homes) ■ Best Regional or National Group (10-49 homes) ■ Best Large Care Home Group (over 50 homes) Additionally there are 12 other categories open to care homes.

The Communal Spaces category is

merged with Best for Architecture and Interior Design, a new Best for Communication category is introduced, as is a new Facilities Management or Maintenance Team category.

Best for Wellbeing is merged with the Non-clinical Facilities category and the Best Marketing Initiative has changed to Best Care Home Marketing, Advertising or PR Campaign or Initiative, including digital and social media.

In the suppliers’ categories, changes include a new category for Best Maintenance Service and a renaming of the Specialist Service Provider category to Best Paramedical or Therapy Service or Product. There is a new category for the Best Architecture or Interior Design Specialists, and a new Best Marketing, Advertising, PR or Digital Specialist.

The closing date is 22 January 2018 but care homes and suppliers are urged to submit their entries sooner rather than later to avoid any

possibility of a logjam near the closing date.

The 2018 Call for Entries leaflet is contained in the pages of this issue. If your copy is missing you can obtain another copy either by sending an email to helen.burgin@ carehomeawards.com, or by downloading a copy from the website – www.carehomeawards.com

Integration in practice a highlight at Care Show 2017 Care Show organisers UBM have unveiled some ‘reasons to attend’ the show on 10/11 October. Significant investment has been made into dementia care and supporting care professionals working towards a truly integrated care system in the UK. A first ever partnership with NHS England brings integrated care to the fore with the launch of Care Show’s Integrated Care Zone. This education theatre will host a packed programme of case study presentations delivered by some of the sector’s most respected thought leaders.

Thousands of new products and services will be on display, providing an immersive experience for visitors to

touch, play and learn about some of the latest innovations on the market.

Visitors can meet with over 250 suppliers including headline sponsor NH Group which will be showcasing its enhanced service offering.

The new Virtual Dementia Tour will help visitors understand what people

14 Care Home Management | September/October 2017

with dementia experience every day.

Visitors can attend the Dementia in Care theatre. Chaired by Professor June Andrews, topics include how to deal with challenging behaviour and different ways care homes should prepare for dealing with a more needs based audience.

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CPD accredited seminar sessions Two days of CPD accredited construction seminars covering: forecast of home build requirements in the UK; what makes a care home desirable for residents and innovative case studies on new care projects.

New Integrated Care Zone will be led by the NHS England, delivering best practice examples of the NHS and social care providers working together for better outcomes for the public.

Exploring best practice in dementia care whatever the setting, including tips on keeping people with dementia at home for longer and dealing with challenging behaviour, as well as new ways to manage dementia in the digital age.

Offering an insight into how care homes and businesses can ensure they stay profitable and better run their business.

Care Forum offers free practical sessions and workshops which are designed to help care managers, directors and owners make a real difference in the lives of the people they’re responsible for and to share their experiences.

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Source products & services from a range of categories to meet your clients’ needs Make your budget go further with exclusive offers from care solution providers, only accessible to visitors, and have access to 100s of the latest products and services from our confirmed high profile suppliers from a range of industries including health and safety, wellbeing and dementia, pharmacy services, furniture and catering/food supplies. Suppliers include: • Access UK • Aidcall • apetito • ArjoHuntleigh • Boots The Chemists • Care Quality Commission

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Showering

Showered in success - creating the right showering environment for care homes Creating a modern, convenient showering environment for your residents and care professionals is a key consideration. Whether you’re looking for a multi-functional wetroom or a wheelchair-friendly showering area, there are many combinations to choose from.

James Walker, national specification manager from showering solutions manufacturer Impey, highlights some of the best options.

Wetroom or Shower Tray?

Accessible or level access showering solutions are a crucial part of the care home setting, not only enhancing the everyday care experience for residents, but also pivotal in assisting care staff to provide effective and safe showering practise.

When specifying inclusive showering facilities one of the primary decisions is whether to opt for a completely level access wetroom, or a low-level shower tray installation. Increasingly, installations and refurbishments are considered with the idea of futureproofing in mind, incorporating an element of flexibility into the design, but still integrating a modern aesthetic.

Creating an Accessible Wetroom An accessible wetroom is an openplan, level-access showering area with built in drainage. Instead of zoning the wet and dry areas of the bathroom (as is normal when installing a shower enclosure or tray), in a wetroom, the whole room including floor and walls, is waterproofed, with a gradient and drainage incorporated.

Once complete it creates a spacious, step-free, easy-access showering area which is low maintenance, leak-free, highly functional and hardwearing.

The open-plan nature of a wetroom maximises available floor-area and ensures an effective showering-solution

18 Care Home Management | September/October 2017

when space is needed to facilitate wheelchair entry or assisted showering options. With no shower enclosure or bath to step into, trip hazards are eradicated – meaning that a wetroom is particularly beneficial for less mobile individuals or wheelchair users.

A wetroom solution can be utilised in most showering locations including ground floors, upper floors, loft/attic/ basement conversions – provided that appropriate floor formers and drainage options are selected.

Ensuring that you choose a floorformer that is strong enough to withstand heavy loads is imperative, as there may be a two people and/ or a wheelchair user accessing the showering area at the same time.

Designed to replace floor-boarding, the strongest type of floor-former can be fitted directly onto structural joists. Weight bearing capacity differs depending on brand, so ensure you’re opting for a floor former suitable to your requirements.

By selecting an adaptable EasyFit floor-former, which has a rotating drain-plate, it will be simple for the installer to avoid joists or existing pipework without the need for underboarding – saving time and money.

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Showering Creating an Accessible Shower Area with a Shower Tray A sturdy, slip-resistant shower tray is central to creating an accessible showering area. The large variety of shower trays available addresses the needs of a less-mobile individual and creates a safe and efficient showering area.

It’s important to specify a shower tray which will offer relevant features and benefits. Check that the specified tray is compatible with wheelchair ramps (if needed), can be used with a half-height door or shower curtain if needed and, essentially, can handle the flow rate of the shower which will be used – to avoid flooding.

The large variety of low-level shower trays available facilitates the removal of a bath, ensuring more effective use of floor space, and greater ease of access. The lowest tray on the market has a step height of just 24mm, and can accessed by a wheelchair user with no ramps.

Understanding Shower Tray Slip Resistance Slip-resistant shower trays are hugely important, firstly to safeguard against fall prevention and to ensure that your residents and care professionals feel confident using the showering facilities.

Although no shower tray can be classed as 100% slip-resistant, they can be measured and classified according to the level of slip resistance

they offer, using a measurement called a DIN (51097) Rating. Where ‘A’ is the least resistant and ‘C’ which offers a coarser slip resistant texture.

The DIN (51097) rating offers the closest test to a true showering environment, and can act as a useful guide to which shower trays are safest in wet and soapy situations. To ensure user safety, Impey’s Mantis and Radiate trays incorporate a slip resistant satin tread pattern that achieves a DIN (51097) Class ‘B’ on slip resistance. Ensure you check the DIN (51097) rating of any shower trays you are installing, to offer a direct comparison and aid in the creation of safer showering spaces.

Specifying Shower Screens Designed to minimise splash to other parts of the bathroom, and for user comfort and safety, shower screens are an important addition.

From luxury, full-height glass screens to free-standing half-height options, a variety of shower doors and screens are available which are compatible with both shower tray and wetroom installations and can offer varying degrees of support for less-mobile users and their carers.

If a glass screen is going to be used, choose thick, toughened safety glass.

Contemporary screens which include a floor to ceiling support-pole can offer added user stability and provide practical support and ease of entry in a wetroom or with a shower tray.

Also compatible with both wetroom or shower tray installations, half-height shower doors offer considerable benefits for users and carers. They’re a safe and functional option ensuring that carers can communicate with, and assist the showerer, whilst simultaneously staying dry. Half-height shower doors allow maximum space to enter the shower area – ideal for assisted showering or wheelchair users – and are compatible with rails and shower curtains to allow increased privacy when needed.

Impey has recently launched the revolutionary Elevate half-height

20 Care Home Management | September/October 2017

shower door – which, with use of the colour contrasting handle, lifts clear of the floor when opening and closing.

Shower Seating A shower seat is an important addition. Choices vary between wall mounted or freestanding models and, for smaller spaces, it may be important to assess the size and layout of the showering area before deciding upon an option.

Consider the strength or load bearing properties of the seat and remember that some patients may need a wider or bariatric seat. Also think about ease of operation; cleaning; transfer from a wheelchair; need for cushioning; whether the seat is warm to the touch; colour contrasting properties for those with impaired sight; aesthetic value of the seat; and whether it stows away when not in use.

Wall mounted seating is available in regular, bench and horseshoe options to cater for individual requirements and can make a practical solution for carers and end users. Despite an elegant and modern appearance, it is possible to opt for wall-mounted seating which is rigorously tested to withstand weights of up to 300kg (47 stones), and provides a versatile choice for accessible showering areas, easily stowed when not in use.

For further information about showering adaptations visit: www.impeyshowers.com/ caresolutions or tel.

James Walker on 07887 765059.

Care to improve facilities and get tax relief Care homes could improve client dignity and independence, in effect for free.

A survey(*) has found 40% of small and medium sized enterprises including care home operators- are unaware they can claim Capital Allowances tax relief. It applies to ‘plant and machinery’, including fixtures such as bathroom suites. And, according to HMRC, the full cost of those items can be deducted from before tax profits (under the annual investment allowance).

“In effect, a care home could invest in our toileting assistive technology and it cost them nothing,” observes Robin Tuffley, marketing manager at Clos-o-Mat, Britain’s leading provider of helpful toileting solutions.

“Then add in the other benefits. The investment makes a priceless difference to clients, in their dignity and independence, and helps achieve more efficient use of staff.”

All models in Clos-o-Mat’s Vita range of automatic toilets can be used as conventional WCs if preferred, yet have integrated douching and drying as standard, eliminating any need to manually wipe clean. Uniquely, its Palma Vita wash & dry toilet- the #1 seller in the sector- is also the only WC of its kind made in the UK, that can be fitted with a range of accessories to adapt it to individual needs, and that is supported by in-house support, service & maintenance.

See www.clos-o-mat.com, under the dedicated ‘care homes’ tab.

Gainsborough Bathing Introduce BioCote at Care Show Gainsborough Specialist Bathing, will be demonstrating its new anti-microbial technology alongside the ultra-efficient Gentona and reclining Sentes bath at the Care Show (stand D10, 10-11 October, NEC, Birmingham).

Gainsborough is regarded as the innovator in the care bath sector with operationally efficient solutions and holistic service support. Its advanced baths with hi-lo functionality and bather transfer systems are proven to deliver utmost care and performance in today’s challenging care environment. This unsurpassed reputation has just been enhanced with the introduction of anti-microbial BioCote in all Gainsborough manufactured baths – a first for the UK specialist bathing market. This protection increases bather and carer well-being by reducing the risk of cross infection and illness.

BioCote provides 99.99% protection against Influenza H1N1, E.coli, Salmonella and antibiotic resistant CRO, CRE, VRE and MRSA. It is effective for the lifetime of the product and cannot be washed off or worn away – delivering continual reassurance for bathers and care providers without the need for time-intensive deep cleaning.

The Sentes bath is a cost effective solution for advanced care.

Its smooth reclining action provides additional postural support for bathers with stability challenges whilst still facilitating deep immersion.

Sensory options are available for a spa experience and hoist access is straightforward if required. www.gainsboroughbaths.com

Preventing cross-contamination in the care home Infections can spread quickly in care homes.

Ian Catchpole of hygiene systems provider, Tork, looks at ways in which the risk of cross-contamination can be reduced.

Care homes are a potential breeding ground for bacteria and viruses. And outbreaks of illnesses are happening regularly.

Such outbreaks can cause a great deal of misery. It is bad enough for someone who is elderly and potentially confused to come down with a debilitating bug. But when that person is also denied visits from the family and friends who keep them connected to the outside world, the human cost becomes greater still.

It can be a challenge for the staff to keep their charges safe. The constant throughput of visitors, staff and residents mean that new pathogens are being brought in to the facility all the time.

So, what can be done?

Easy to miss Care homes have a duty to report any outbreak to Public Health England. But since an outbreak is defined as just two or more residents displaying the same symptoms, these can be all too easy to miss – particularly since two sufferers may not be attended to by the same member of staff.

Typical symptoms that staff are told to look for include fever, diarrhoea, vomiting, unexpected falls and confusion. Care workers are instructed to report these signs immediately to senior management who should have a documented outbreak plan in place.

Hand hygiene is crucial. The Health

Protection Agency’s advice to staff is to wash their hands thoroughly and dry them with a single-use towel before touching a resident, before carrying out any aseptic procedure, after any risk of exposure to bodily fluids, after touching a resident and after any contact with their surroundings. Hands should also be washed before and after dealing with used bed linen and after removing gloves.

Washing before using gloves Research - carried out by Ipsos MORI on behalf of the Food Standards Agency - revealed that inadequate hand washing and drying plus the practice of not washing the hands prior to putting on gloves were among the key causes for the spread of norovirus in kitchens.

Great care should be taken in the kitchen to prevent the spread of infections via hands or surfaces. Good hand hygiene facilities should be supplied and single-use hand towels and surface wiping products should be used.

Plentiful hand hygiene equipment should be supplied in the washrooms, too, so that hand washing and drying can be carried out swiftly even by

22 Care Home Management | September/October 2017

the busiest of staff. Soap should be supplied in closed cartridges to avoid any risk of contamination before use and hand towel dispensers should give out only one towel at a time.

Signage in washrooms Since any visitor could potentially be bringing in bugs from outside while also risking picking up an infection at the home, signs should be posted in the washrooms reminding visitors of the importance of hand hygiene.

Hand sanitisers placed in strategic positions around the home will act as a further prompt. However, sanitisers should not be used as a substitute for soap and water.

And user-friendly hand hygiene products should be made available to care home residents as well since they too could be responsible for spreading infections. Gentle soaps and soft hand towels will be kind to their delicate skin and all dispensers should provide easy access to the products, even for the frail.

Tork provides a range of washroom and kitchen systems including mild soaps, soft hand towels and kitchen wiping products.

For more information, please visit www.tork.co.uk

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CMA investigation – tough times ahead for care homes?

The Competition and Markets Authority is examining how the care home industry works. It is due to report before 1 December. Iain Campbell, Sarah Brooke and Charlotte Lewis from international commercial law firm, Hill Dickinson, examine where the CMA are at present.

The Competition and Markets Authority (CMA) is now over halfway through its market study into the residential care homes sector.

Their purpose is to assess whether the sector is working well for elderly people and their families. The CMA requested comments on the market study by 5 July 2017 following publication of their update paper on 14 June 2017.

The update paper identified, amongst other things, that while many care homes offer a good service, some might not be treating residents fairly; indeed certain business practices and contract terms might be breaking consumer law.

On the basis of the results of the market study so far, the CMA also launched a consumer protection case to investigate two specific areas of concern involving self-funding residents:

■ T he requirement to pay large upfront fees ■ T he fees charged after a resident’s death The initial findings of the study also highlight wider concerns about the sector. These include: ■C oncerns that people are struggling to make decisions about care; are confused by the social care system and funding options; and do not know how to find and choose between homes.

■C oncerns regarding the effectiveness for residents of care homes’ own complaints processes. The Local Government and Social Care Ombudsman has submitted its response.

It notes that the initial CMA findings closely echo concerns the Ombudsman has highlighted in recent years about the adult

24 Care Home Management | September/October 2017

social care and care homes sector.

■C oncerns about how the sector will attract investment necessary to build greater capacity needed for the future.

■A s well as those issues covered by the consumer protection case, the CMA is cconcerned about other consumer protection issues such as a lack of information about prices on care home websites, and care homes’ contracts giving homes wide-ranging discretion to ask residents to leave, at short notice.

Citizens’ Advice has called on the CMA to consider imposing deposit protection schemes.

Consumer protection case The CMA has launched a consumer protection case to investigate its concerns that some care homes may be breaching consumer law.

Protection for consumers in relation to care home contracts is enshrined in the Consumer Rights Act 2015.

The CMA has said in its update report: ‘We have opened a consumer protection case to investigate concerns about certain care homes charging families for extended periods after a resident has died and homes charging large upfront fees. The investigation is currently focusing on these two issues because we have already identified clear, specific concerns that some care homes may be breaking consumer law, which if borne out, we consider would be most effectively addressed by consumer enforcement action.’

The CMA has not ruled out extending the scope of its consumer protection case at a later date to cover other issues of concern, and/or to publish guidance for care homes on their obligations under consumer law, where they think this would help to drive consumer law compliance across the sector.

Some will be relieved that the sector has avoided an in-depth market investigation. These tend to last longer (up to 18 months) and would place additional strain on arguably already limited resources.

The CMA is concerned that in contravention of the CRA requirements, residents are not made aware of all the applicable contract terms before they sign contracts. Terms relating to price, including any deposits or other upfront payments, were found to be confusing, or completely absent from pre-contract discussions with residents, with many complaining of ‘hidden charges’.

Residents are also being required to pay an upfront deposit at the same time as paying fees monthly in advance, potentially compensating the care home twice for the same loss.

The CMA’s initial findings in relation to fees charged after a resident’s

death show care home providers retaining the right to recover full gross fees from a resident’s estate following death, including a requirement to compensate the care home provider for any shortfall in fees that would have been paid by the state.

■F ees payable after the death of a resident should be made clear from the start and should be proportionate. Homes should not seek to recover costs for which the resident was not responsible in the first place.

Scope of the investigation The CMA is looking at ways to ensure stronger protections for residents and their families, using the range of tools they have available.

These include powers of investigation and (potentially) enforcement where the law is being flouted.

The CMA has been issuing some care homes with demands for information. Intended to establish facts about trading and business practice.

Failure to cooperate, assuming the investigative powers are being correctly exercised, could be an offence by care home businesses and even individual managers may be held accountable.

It remains to be seen whether the CMA decides to recommend to the Government that legal changes be imposed on the commercial practices of care homes. In any case, trading standards authorities can already bring prosecutions to challenge illegal current practices, while unfair contract provisions could be challenged in civil court cases by residents or their representatives.

It may also be sensible for managers to reflect on the changes to complaint procedures that have been urged on the CMA by the Local Government Ombudsman, and to decide whether to implement any of those voluntarily. Such changes could include regularly reviewing at Board meetings the number of complaints received, the findings of investigations into those complaints and how any closed complaints have been resolved.

What can care homes do now?

The clear signal for care home providers from the CMA’s initial findings and investigation is therefore to ensure: ■A ll pricing details are clearly set out in as much detail as possible on websites and in pre-contract documentation seen by residents.

■R esidents must be given time to read all contract documentation before signature.

■R equirements to pay upfront deposits and/or other management fees do not overlap with payment of monthly fees in advance.

There could be several advantages to taking such measures: ■ T o anticipate changes that may soon become compulsory anyway ■ T o be able to position the business to clients and externally as being market-leading ■W here a business faces the risk or threat of a CMA investigation or other regulatory action, an ability to mitigate adverse outcomes (such as conviction and fine) or even help to argue that such action is not needed.

Where homes do find themselves under investigation (or facing enforcement action) managers will need to access legal advice as swiftly as possible and ideally before the regulators have begun gathering evidence.

It will normally then be advisable to protect the business by cooperating with the investigation so far as it may be legally advised to do, while also taking care that a fair account of its actions is put on the investigation record, as well as any mitigating factors.

September/October 2017 | Care Home Management 25

One in six care homes at risk of failure – can it really be that bad?

The doom and gloom surrounding the future of the care home industry has not abated during the summer ‘silly season’. More reports have been issued looking to the future from various bodies and individuals. The promised government green paper on the future of social care cannot come soon enough.

Alan Rustad looks at the latest forecasts and assesses what they could mean.

Sixteen per cent of care home companies in the UK are exhibiting warning signs that they are at risk of failure.

That was the stark warning that came out of a report from accountants Moore Stephens. And that figure had increased over the last 12 months – then previous research had found that 12% of care homes in the UK were at financial risk.

Moore Stephens suggested two main drivers for the rise in the gloom.

One was the increase in the national living wage in April, which placed a significant added burden on care home companies’ profit margins.

The second was the growing use of agency staff in care homes, due to difficulties in retaining and recruiting

skilled staff. Staff costs at care homes, they reported, have reached an estimated all-time high of 55% of turnover.

Has extra funding reached the front line?

Of course the ever prevalent lack of funding from local authorities was again highlighted as another pressure on care home operators. Yes we know councils have had to make cuts in their budgets for social care despite the need for care homes and other social services growing. The government provided extra funding as a sticking plaster earlier this year – but just how much of that has found its way to the front line?

26 Care Home Management | September/October 2017

According to the Association of Directors of Adult Social Services, local authorities in England are making £824 million of savings in their social care budgets in 2017/18, despite that extra £2 billion over the next three years in social care funding being promised by the Chancellor in the March budget.

Lee Causer, restructuring partner at Moore Stephens said: “Too many businesses in the care home sector are heading back to the brink.

The mixture of rising costs, cuts in funding and an ageing population has created a volatile situation, with many companies now showing signs of significant financial stress.

“It’s critical that care home companies receive the funding they require in order to offer the highest standard of care possible.

“Commentators have also speculated that the debate over the post-Brexit free market of labour has already reduced the number of EU staff willing to relocate to the UK to work in the sector.”

The Brexit effect And sure enough those words struck a chord when a week or so later Clayton Recruitment came out with their report claiming that Brexit poses a significant threat to labour availability.

Coupled with fewer nurses entering the profession, they said it could all bring the entire system to a standstill.

Clayton Recruitment say things are further compounded by the recent research in the Lancet (see page ten) which revealed that an extra 71,000 care home places would be needed in England within the next eight years to cope with rising life expectancy.

Samantha Edmonson, senior nursing consultant at Clayton Recruitment, commented: “The care system has long suffered from a talent deficit – the simple fact is that there are not enough nurses to cope with demand. And time after time the government has been called on to put adequate measures in place which focus on getting the right skills into the profession – and crucially, keeping them.

Heavy dependence on foreign labour “Despite this, however, little has been done and we are now faced with a system that is at breaking point. Brexit may already be influencing people’s decision to migrate in and out of the UK which could spell further trouble for a system which relies so heavily on foreign labour.

“This, coupled with fewer nurses entering the profession, as well an ageing population, means that urgent action needs to be taken to safeguard patients both now and in years to come.

“While the mainstream media focuses largely on negative stories about working in the arena, it is an incredibly fulfilling and varied sector and more needs to be done to publicise these aspects. While we need to see initiatives which entice people into the profession, it is arguably just as important that employers focus on keeping nurses through robust talent

retention and wellbeing strategies.”

And it wasn’t just the accountants and the recruitment consultancies doing the shouting. On the eve of his HC-One’s group purchase of 122 care homes from Bupa (see page six) Dr Chai Patel, now the biggest operator of care homes for the elderly in the UK sounded his own alarm.

Patel fears ‘catastrophic failure’ The HC-One chairman told the Times newspaper that care homes are teetering on the edge and a chronic shortage of funding risks catastrophic failure within the National Health Service.

He predicted that six national chains would emerge to dominate the market by benefiting from economies of scale. Yes that looks to be the way the industry is heading – with Dr Patel at the very top of the pile with his latest deal giving HC-One 350 homes with around 22,000 beds.

The Times reported – and it will come as a surprise to no one working in the sector - that the pressure on care homes amid funding cuts and an increase in wage costs meant that some small operators were simply shutting up shop, with 144 care homes closing last year and a loss of about 2,000 beds a year.

And that shortage of capacity means that the number of people in

residential homes has not increased in line with rising longevity, forcing many frail and elderly people to rely on specialist care in their own homes.

And everyone knows what pressure home care is under today.

Dr Patel admitted: “There is no question the sector itself is on the edge. The impact of chronic underfunding of social care will result in catastrophic failure in the NHS.” Care for more complex needs He said his investors were betting on the requirement to care for an ageing population with more complex needs.

“Demographics are showing in the next ten years there is need for almost 70,000 beds and this is not happening.

“When local authorities are trying to work alongside social care providers you can see the challenge of trying to integrate these services. I think larger operators can bridge this gap.”

And that may ultimately prove to be the UK’s best hope. Can we expect an NHS-style national body of care home operators, admittedly mostly in the private sector?

It may come to pass. But losing the small operator of just a few or even a single care home would have a big effect. The country would lose those small operators at its peril.

September/October 2017 | Care Home Management 27

Worcester-based academics chosen to help with dementia services

Need for complete sign up Professor Brooker said: “Personcentred care requires sign-up to working in this way across the whole care provider organisation if it is to be sustained over any length of time.

The education programme that we are working on here supports leadership at all levels and will enable all staff to provide the best quality care for people living with dementia.”

Care UK has earmarked over half a million pounds to further improve the care it offers to residents living with dementia. The majority of this money will be spent on one of the most comprehensive programmes of training and awareness building that the organisation has ever embarked upon.

Care UK has selected the Association for Dementia Studies at the University of Worcester, as its new partner to help it invest further in its provision of care for people living with dementia.

The initial phase of the partnership sees an 18-month contract where the University of Worcester will support Care UK to build consistency, cohesion and continuous improvement into all aspects of dementia care in its 114 homes.

Announcing the launch of the partnership, Care UK’s residential care services managing director Andrew Knight (above) said: “We’re already known for our resourceful, compassionate and innovative approach to caring for people with dementia but we are always striving to be even better. Linking to an academic partner will help us to use the very latest in dementia research to ensure we are at the cutting edge of residential dementia care over the next decade.”

Three strong shortlist Care UK spent four months

evaluating possible academic partners from universities across the UK. After narrowing it down to three, Worcester was chosen for its strong research base and its determination to develop a tailored programme based on a deep understanding of Care UK’s current and future dementia care services.

Andrew Knight continued: “We were particularly impressed by the fact that the Association for Dementia Studies at the University of Worcester wanted to develop a really tailored programme which will make a difference to every member of our team from carers and housekeeping colleagues to my executive team.

“The two organisations also have a lot of shared values around respect, seeing people as unique individuals, and recognising the importance of our teams working closely with the family and friends of residents and other members of the community.”

Professor Dawn Brooker from the University of Worcester will lead the team of academics.

28 Care Home Management | September/October 2017

The implementation will be in two phases: 1, Discovery phase. ADS continue to add to their understanding of Care UK by visiting homes, gauging existing levels of understanding of the latest thinking in dementia care among care home managers and to ensure that proposals are practical in operational terms.

2, Training phase. This will involve building the skills, knowledge and understanding of the 9,000 strong workforce by: ■ Workshops for the executive team on how to drive a dementia-friendly culture ■ Three day courses in leading a team towards excellence in dementia care for all home managers ■ The appointment and coaching of dementia champions for every home ■ Dementia awareness training for every care home employee ■ An ambition for every single person in the organisation to be registered as a dementia friend - including support staff such as accountants and HR specialists.

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Making The Right Impression

A clean and hygienic care home creates a pleasant and safe environment for residents, staff and visitors. It can also help form positive perceptions among potential residents and their families when they are choosing where to live.

Cleaning processes should be prioritised as part of the daily routine.

It is essential to think about the choice of products. These must be effective but they should also be easy to use, readily available and economical.

Diversey Care meets the needs of busy care homes and similar businesses with Pro Formula, its new range of professional-formulation cleaners in familiar and trusted brands. Each of the more than 20 products in the range is designed to give excellent results and value when completing common daily and problem-solving tasks.

Residents are often frail and vulnerable which makes preventing infections doubly-important. Regular cleaning helps meet this key objective and maintain the appearance of rooms and communal areas. Paying attention to detail in a few select areas can make a big difference.

Linen – residents and guests expect crisp, white towels and bedclothes that are hygienically clean. Until recently,

the only way to do this was to wash whites at near-boiling temperatures to kill any bugs. This takes longer, uses more energy and water, and can even shorten the life of the linen.

All of this adds to running costs.

Modern professional detergents avoid these limitations with formulations that ensure excellent disinfection and whiteness at the much lower temperature of 40oC. Persil Hygiene laundry detergent eliminates 99.999% of bacteria at this temperature.

Kitchens & Dining Areas – preparing and serving food in a clean and safe environment should be a critical objective.

Potentially dangerous food-borne illnesses can arise if cleaning and hygiene standards are allowed to lapse. With good hand hygiene, surface disinfection is the most important cleaning task in kitchens and dining areas because it eliminates and prevents the spread of bugs.

The best professional-class products combine cleaning and disinfection in an easy-touse formulation. They will be effective against a wide range of micro-organisms but will also cut through grease, dirt and dried on food. It is best to use non-

30 Care Home Management | September/October 2017

perfumed products otherwise foods can be tainted and spoilt. Cif 2in1 Kitchen Cleaner Disinfectant is a highly effective product for all surfaces in food premises that meets these criteria.

Toilets – most general soiling is easily removed but conventional, bleach-based toilet cleaners are not very good at getting rid of the unsightly germ-protecting limescale that will build up if untreated. Another enemy in the toilet is mould which always looks bad but also gives off bad smells as these tiny microbes digest the organic residues they live off. Traditional cleaning tasks usually require a different product for each surface but this can be costly and expensive. An alternative is to choose a professional multipurpose washroom cleaner that removes limescale and can be used on a wider range of surfaces than conventional products. Cif Washroom 2in1 offers this performance on almost every surface found in toilets and bathrooms.

Visit www.proformulabydiversey. com for more information.

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September/October 2017 | Care Home Management 31

The importance of recruiting effectively in the care sector It has never been more important to recruit effectively in the care sector. James Parkin, co-founder and operations director of Caresolve, says many care homes find it difficult to find – and keep - high quality care staff.

It is a common problem. Demand for good quality staff far outweighs supply at present in the care home sector.

It means that it has never been more essential to retain your staff once you’ve recruited them. In order to attract the best candidates, and ensure the need to recruit is kept to an absolute minimum, it is important to differentiate yourself from your local competitor homes, to really value your staff, and to show them recognition where it is deserved.

Who do you need?

Assess what you need and understand what the minimum level of experience required is. Think about whether the current staffing structure would allow you to train someone up. It may be that attracting candidates who don’t require specific experience may prove easier.

Delegate where appropriate. The recruitment process, when undertaken effectively, can be a time-consuming task.

Role profile. Ensure it’s clear, concise and provides the job seeker with a good summary of day-to-day responsibilities involved, the minimum requirements of the application and crucially, how to apply. Include phone

numbers on adverts where permitted.

It is absolutely essential to ensure that the person responsible for writing the job advertisement is grammatically sound and has a good standard of written English. First impressions really count.

Publish salary Always, where feasible, publish the salary on offer for the post, even if you advertise it as a salary bracket.

Research suggests that job ads displaying salaries receive a far better response.

Research the best job boards to use and negotiate on price with them in turn. In addition, be creative - utilise recruitment banners on the exterior of your care home(s), place a card in the local shop/post office window, introduce ‘refer a friend’ incentives amongst your existing staff, advertise on your own website, consider overseas recruitment, liaise with local colleges or hold job fairs/open days.

Telephone screening Where possible, telephone-screen shortlisted candidates before inviting them for face-to-face interview. It’s much less time-consuming, you’ll be able to form a good first impression

32 Care Home Management | September/October 2017

and you’ll often be able to weed out potential time-wasters.

Before interviewing, prepare. Have pre-prepared interview questions, which should ideally be competency based (i.e. “can you give me an example of”, “describe an occasion when”).

Where possible interview in pairs and have at least one of you taking notes. You may wish to score candidate responses to each question individually and compare scores at the end – it’s good to have a second opinion.

The second interview Be prepared to go to a second interview if you are unsure about a candidate or more than one candidate impresses you. Taking additional time at this point could save you significantly more time in the long-run.

Once a decision has been made, phone the candidate to tell them.

Share the good news. Assuming a verbal offer is accepted, follow it up with an offer in writing as soon as possible.

Keep in regular touch throughout the checks/offer process. Keep them warm, invite them in to meet the team, invite them on staff nights out.

Plan ahead for any further/future recruitment. If there are no permanent vacancies, then advertise on an ongoing basis for bank staff – it will eliminate agency spend and provide you with a future staff pipeline. www.caresolve.org.uk

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How to secure care homes and residents in the 21st century?

The solution is wireless, user-friendly and already trusted in residences all over Europe

Care homes present many unique security challenges. Above all, a residence needs to feel like an open, welcoming space. It must work for the resident, and provide a pleasant environment to greet family and other visitors.

At the same time, managers must ensure security of the site, including its staff, sensitive data, and areas where medicines are kept. If there has been an unauthorised access attempt, staff need to know as soon as possible.

When residents have dementia or other complex conditions, it is crucial that care workers can find out where they are at any time.

That’s why advanced access control that’s easy for everyone to operate

can have major benefits. A system that can feed back to site managers in real time, for example, can directly impact quality of care, enabling staff to quickly locate residents, respond to incidents or problems as soon as they arise, and organize staff workflows more efficiently.

The solution wireless access control In 2017, old-fashioned mechanical security is not the answer. Managing all those keys puts a huge, unnecessary admin burden on care staff, and finding the right key in a hurry can cause critical delays. In any case, a physical master-key system does not offer the standard of security now required in a modern care home.

34 Care Home Management | September/October 2017

Additionally, spending every night under lock-and-key can carry negative associations for elderly residents. But if care home managers introduce new technology, they must also be certain it is easy to operate. Electronic access control must be intelligent, of course.

It must also offer a user-friendly and affordable step up from traditional keys.

Unfortunately, wired access control and magnetic locks are disruptive and expensive to install, and expensive to run in comparison to wireless solutions.

In contrast, SMARTair battery-powered wireless locks offer modern, easy, costeffective installation, alongside features designed to put care home managers in more control of their premises.

SMARTair intelligent wireless devices provide the easiest upgrade and replacement for mechanical locks — and are just as easy to retrofit to existing premises as to install from scratch on a new-build care home.

Simply swapping existing locks for wireless cylinders or escutcheons with integrated card readers links a door to the central admin software, freeing care managers from key hassles, making staff workflows more efficient, and instantly upgrading resident security.

With SMARTair lost keys no longer cause a security risk. It takes a few seconds to issue or revoke a keycard, using a computer or a smartphone.

There’s no longer any need to change locks when a key goes missing.

Reprogram a card and you have a new “key” — instantly — saving the time and money usually wasted on replacing compromised locks. It’s easy to use, and offers audit trails and real-time monitoring as standard. It’s also easy to expand at a later date, so an installation can start small, with a limited security budget, then grow later and adapt to changing security needs.

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Unboxing SMARTair SMARTair™ wireless access control is available with different management options for administration. With ‘Offline’ or ‘Update on Card’ administration, users’ access rights are updated via wall or programming devices. It’s straightforward to combine Update on Card and Wireless Online functions within the same installation, giving managers the flexible control they need. So, pharmacies can be monitored in real time, while less sensitive storage areas use offline access management.

SMARTair has devices to fit any opening, including wireless electronic escutcheons, cylinders and locks that can be installed at any exterior or interior door.

Users can open SMARTair-equipped doors with multiple credential types, including tags, bracelets and cards, as well as a mobile app. This makes it easy even for elderly residents with limited dexterity to open their doors or room safes.

SMARTair in action Pamplona, Spain SMARTair is already deployed in residential care settings across Europe. To assist in the care of over 500 residents, Pamplona’s Casa de la Misericordia demanded a new access system that offered real-time control over the premises. The choice was SMARTair Wireless Online.

“In a residence like ours it is critical to have real-time management that allows us to interact with a door at any time,” explains Ernesto Serra, facility manager at Casa de la Misericordia.

The system had to be expandable, so it could be installed in two phases, starting with a new-build before moving on to a 1930s building. Advanced wireless technology suited to retrofitting an old building was a must-have - the older building has walls up to one metre thick.

“A wireless solution that allows us to install access control without wiring up the buildings is a big advantage,” adds Ernesto Serra.

The new system needed to be scalable, so staff could manage access to the 2 buildings from the same control point, amend access rights instantly, and tailor access privileges to the diverse profiles of staff, residents, volunteers, visitors and emergency workers. The 2-stage project is now complete, and includes 650 additional SMARTair™-enabled doors in the old building.

SMARTair in action Skanderborg, Denmark Operated by the Skanderborg Housing Cooperative, Dagmargården is a state-of-the-art care home with 54 accommodation units plus common areas and a spa. The Cooperative sought modern access control suited to every user’s needs.

The team also committed to make their new Dagmargården care home a welcoming, key-free environment, without the negative connotations of key chains and mechanically locked doors.

The site now has wireless SMARTair Offline and Online escutcheons and wall readers, ensuring security managers are kept informed about the status of the premises in real time.

This enables staff to respond quickly, and makes residents more secure in their care.

“SMARTair provides safety and the possibility to tailor the system exactly to

our needs,” says Ole Høi Sørensen at the Skanderborg Housing Cooperative.

“It is practical in daily life, and we can see who has been where and when.”

Everyone at Dagmargården opens doors using standard credentials.

Residents are issued with a tag which automatically opens their apartment door.

“We do not have a problem with lost keys anymore,” adds Ole Høi Sørensen.

There is no access control tradeoff between simplicity and security.

With SMARTair™ wireless locks, care homes can have both, by installing a system that saves staff time, eliminates key management hassles, and makes residents safer and more secure.

For more information on how SMARTair™ access control is helping to protect the care homes of the future, visit www.tesa.es/smartairresidentialcare.

September/October 2017 | Care Home Management 35

Controlling food spend should be ‘basic knife skills’

by Mark Sanders, sales director at Zupa Caternet, a one-stop shop web portal that delivers e-procurement technology to the food and beverage and hospitality sectors.

Food prices are on the rise. For the care home industry the purchasing of food and drink and the knock-on effect of controlling spend places a significant burden on catering staff and management teams.

Sometimes it is easy to overlook the fact that food is money and controlling spend comes down to complete visibility and good oldfashioned processes.

A lack of visibility and control of supplier pricing also exacerbates the issue of overspend because it ultimately means that care homes are unaware of the impact their food purchasing is having on the bottom line budget, until it is too late. This leads to large amounts of overspend and waste.

Where is the money going?

The number one focus for care homes has to be on the level of care they provide on a day to day basis, everything else is secondary. But to run a successful operation you need to understand where your money is going.

Most staff tasked with providing catering services don’t have the inhouse expertise associated with food purchasing and legislative control that is needed to combat spiraling food costs. This is not a criticism, after all, they’ve most likely trained as a cook not an accountant.

Despite this, controlling costs has been identified by care homes as one

of their biggest operational worries in terms of stability and future growth.

Over the years, care homes have attempted to make their finance software work in collaboration with the purchasing of food items.

The truth is this doesn’t work because these outdated systems don’t have the flexibility to deal with weighted items and the difference this makes to the value of goods received nor do they allow food suppliers to amend deliveries with substituted goods (which would be a massive help).

Many suppliers means many invoices Having no central control of food suppliers and product purchases means that care homes usually have large lists of suppliers with a matching heap of invoices. Lack of reconciliations also means invoices can get missed easily and this creates many more hours of admin in compiling, correcting errors and issuing credit notes before payment runs. This is a big time drain for care homes.

36 Care Home Management | September/October 2017

Care homes may also be missing a trick in terms of regaining their negotiating power with food suppliers because lack of control and use of multiple suppliers for the same items could mean some organisations are paying far more for certain products that they need to – which all adds to the overspend issue.

Live price control The answer has to be live price control. Care home managers and catering staff need simple to use ordering templates with real-time prices for that day and they need to be able to make product changes quickly and easily. The care home must be in control of any price changes and be able to reject any costs they believe to be incorrect based on what has been agreed with their suppliers.

Care homes have an important job to provide the best care they possibly can and that should be the key focus on a daily basis. Freeing up timeintensive admin tasks will help make that happen as will taking the right steps to help to regain control of costs. www.caternet.co.uk

Food presentation now vital to a discerning clientele An ageing population, an increasing clamour for better quality and a desire for choice means care homes have a seemingly impossible set of demands to meet. So how can care home managers and owners improve their efforts?

Catering equipment specialist for the care home sector, Victor Manufacturing says that the presentation of food is key to satisfying a growing, discerning and knowledgeable audience.

Counters and food display units are able to present a wide range of choice and have the capacity to keep products hot or cold, maintaining premium condition and visual appeal.

Victor’s marketing manager, Peter Brewin says: “Food display solutions are essential components for care home caterers looking to improve their meal offerings to residents. It is important that they are presented as high-end, tempting and indicative of the ‘grab and go’ style that consumers have come to expect in all areas of foodservice.”

Working with Smithy Croft retirement village in 2015 to install refrigerated multitier units, Victor gave the bistro inside the complex the ability to display a range of different food products, whether hot or cold,

to help maintain both the ideal temperature and premium appearance for perusing diners. Granite counters were also installed for both durability and aesthetic purposes, as well as a stainless steel deli topper for display flexibility; ideal for popular food-togo applications.

Quality is key In addition to presentation, the issue of quality is always been high on the agenda - and catering is no exception.

In August last year, we reported the CEO of Audley Retirement Village, Nick Sanderson calling for action to be taken on quality offered in care homes. He said: “The government should look at the facts – 86% of the older generation are still living in a family sized home which is often unsuitable to their changing needs, yet 99% don’t want to enter a care home.”

Brewin says: “The need for quality improvements point to a very real and achievable opportunity for care homes to set themselves apart, not only with their menus but with their displays. Counters and displays play a significant role in kitchen equipment which is not just about functionality, it also has the purpose of setting the tone and creating an atmosphere in

homes that is already present on the high street.”

Baby boomer effect Not only are industry leaders pointing out the need for greater quality but the segment of the population who are occupying care homes are quite rightfully demanding improvements too.

According the Office of National Statistics, the UK population grew to 65.1 million in 2015 and is projected to go beyond 70 million by 2026.

The report highlights that the older generation will account for almost a quarter of the population by 2045.

The report states: “This is an important consideration for the provision of health and social care services and pensions.”

Care home residents are understandably discerning with high expectations and this need should be acknowledged as the baby boomer generation continues to take up a large slice of the population.

Brewin concludes: “Nutrition and health continue to play an important role in care home catering innovation; to echo the efforts made in this area, managers should be showcasing their products to residents in the best possible way.”

September/October 2017 | Care Home Management 37

Case Study

Nutrition case study – the Chocolate Works

Ellen Brown, divisional manager apetito care homes has witnessed a great deal of change in the care sector since apetito entered the market in 2008. Recent collaborations with some of the most pioneering care groups have highlighted these changes and an exciting future.

One such development is the increased focus on dining experience. Ellen discusses the reasons behind this trend and points to partner Springfield Healthcare as an illustration of how dining experience can be placed at the centre of the care solution.

Quality, nutritious meals in care homes should be a given. But perhaps less well documented is the role dining experience plays in ensuring the health and well-being of residents.

Often, when people go into care, mealtimes become more of a task than an enjoyment. There are strict times during which residents are fed and they are given a narrow, unimaginative selection of meals.

Frequently these are served in solitary, enclosed dining spaces.

Dining impacts life A pleasant and sociable dining environment can have a significant impact on the life of a resident.

Making mealtimes an enjoyable experience can encourage them to eat well and often, having a positive effect on their health, well-being and weight management.

Recognising this has led many modern care groups to place an increased focus on dining experience.

One such group is Springfield Healthcare.

In May 2017, Springfield Healthcare opened its new care village in York, ‘The Chocolate Works.’

Housed in the former Terrys Chocolate Orange factory, it has been carefully restored to provide exceptional and innovative care facilities. The village is beautifully designed. But there is more to this than just being aesthetically pleasing.

Dispensing with enclosed spaces The centrepiece is the marketplace, a large indoor space which aims to bring the outside in. The space is full of natural daylight, trees and greenery and is home to shops, a café, spa, gym and chocolate shop. The idea - to move away from the enclosed communal spaces found in traditional care homes.

Residents are free to move around the marketplace, feeling like they are outdoors and part of a wider, bustling community. The shops encourage a sense of normality, so when people move in, they can continue living an active lifestyle, undertaking activities they have participated in throughout their lives.

For residents with dementia, the recognisable elements of the marketplace will help to recreate a life

38 Care Home Management | September/October 2017

they know and understand, making the move into a care setting less of an unsettling experience.

These ideologies are very much reflected in the way food and mealtimes are dealt with. Just as the facilities’ layout and design encourages normality, community and social interaction, so does its approach to food.

Variety of locations Each floor has its own kitchen, but, importantly, meals are also served in the café, pub, terrace and other outlets. This means residents have the flexibility to eat what they want, whenever they want, either on their own, or in groups with friends and visitors.

This flexible approach means eating together, relaxing and socialising are cleverly woven into daily life. Residents retain their independence and communal dining allows the natural and enjoyable social aspect of eating to be maintained.

Addressing the dining experience is central to apetito’s approach.

Therefore, working alongside Springfield Healthcare and having the opportunity to design branding, menus and to provide food throughout the development was an extremely exciting opportunity.

‘The Chocolate Works’ exemplifies that as care facilities move forward, the importance of modernising and improving residents’ dining experience should never be overlooked.

Home from home

dining for your residents.

At apetito we are proud to supply meals that are tasty, nutritious, and crafted with care by our chefs using high-quality ingredients.

Our meals don’t just meet dietary needs, they promote well-being by turning an everyday meal occasion into a stand out dining experience. And our market leading customer service means you’ll be supported by us every step of the way.

Book your free tasting experience today at

apetito.co.uk/tasting

Care Homes

September/October 2017 | Care Home Management 39

Risks from an unpredictable rhythm – tracking behaviour in dementia care Palle Stevn, COO at MariCare, stresses the importance of being in step with the daily rhythm of dementia and how it is essential to monitor every resident’s activities to cope with the unpredictable risks the condition provokes.

Advancing age is the greatest risk factor for developing Alzheimer’s disease – the most common form of dementia. Once someone reaches the age of 65, the risk of developing Alzheimer’s doubles every five years.

The front line of dementia care Dementia has a progressive nature which results in patients typically requiring assistance for many years.

Care is initially in the community but usually is carried out in residential care as symptoms worsen.

In addition to the distressing emotional impact, dementia also delivers a huge burden on the health and care system. One in three people over the age of 65 will develop dementia and the total number of people living with the condition is expected to double in the next 30 years.

Care homes are at the front line of how the UK tackles dementia. A state of the nation report from the Department of Health reveals that an estimated one third of people with dementia live in residential care, while approximately two thirds of care home residents are currently estimated to have dementia.

Taking no risks It is crucial for those in the care sector to monitor the high-risk behaviours so typical of the condition.

This makes it a priority to track the unique daily rhythm of dementia and also detect a fall as soon as it happens.

We are all subject to the regular 24-hour sleep/wake patterns. When these deteriorate with age they cause reductions in sleep quality and impairment in cognitive performance.

40 Care Home Management | September/October 2017

With dementia, these symptoms are exaggerated and affect as many as a quarter of dementia patients at some stage.

Interrupted rhythms Patients can experience restlessness, especially at night, when their Circadian rhythms are impaired.

They may pace or wander, increasing the likelihood of injury. In addition to restlessness, a range of disruptive symptoms and behaviours can occur, including: repetitive behaviour, shouting and screaming, walking, sleep disturbance and night-time waking, hiding, hoarding and losing things, accusing, trailing and checking and losing inhibitions.

The possibility of such a wide range of symptoms emphasises the importance of being aware of every movement to ensure patient safety.

Circadian rhythm disturbances are among the major triggers for institutionalisation. They are associated with shorter survival in long-term care residents and are a cause of

physical and psychological burden for caregivers.

Sundowning behaviours Sometimes a person with dementia will exhibit an increase in certain behaviours in the late afternoon or early evening. This agitated, aggressive or confused state is often referred to as ‘sundowning’ and encompasses a wide range of behaviour changes.

There are distinctions to be made.

Using the term ‘sundowning’ may mean that people attribute out-ofcharacter behaviours to dementia while overlooking other factors causing the behaviour, such as someone trying to communicate.

Therefore it is important to look at and address the potential reasons why someone is behaving out of character.

Falling in stages Assessing risk and the subsequent provision of a range of preventative aids and technologies to combat the ever present risk of falls among the elderly, is common practice for care homes.

The three general stages of Alzheimer’s disease create a range of symptoms and behaviour patterns that increase the possibility of falling.

The risk profile for each of the mild, moderate and severe stages (corresponding to the early, middle and late stages of progression) is difficult to predict. Each individual will experience and display their symptoms differently.

When the elderly are admitted to residential homes it is often in the later stages, when care at home becomes too challenging. Associated symptoms of cognitive impairment and loss of balance have serious implications in terms of falls, and in particular for hip fractures.

a particularly high risk of sustaining multiple falls, compared with those without dementia. Other research demonstrates that patients with dementia or cognitive impairment are at an increased risk of fractures compared with patients who are not similarly impaired.

Those patients with dementia or cognitive impairment who experience a hip fracture are more expensive to treat, more likely to be institutionalised and less likely to recover function.

They are also at increased risk of a second hip fracture. For those with end-stage dementia and hip fracture the six month mortality is 55% compared with 12% for cognitively intact residents.

Beneath the surface A smart floor works similarly to a touchpad or a tablet computer, using capacitive and conductance sensing.

The technology is reliable and safe and there is no visible evidence of the system’s presence. This means that residents will be unaware that they’re being monitored and therefore unlikely to have any issues with the surveillance that could potentially cause disruption for staff to deal with.

Installation is easy and quick – similar to that of an underlay – and it is fully protected by any floor surface covering to ensure a long life, which is beneficial given the current financial climate in the sector.

Taking to the floor A smart floor detection system, can help save lives by detecting a fall as and when it happens. This new technology is an all-round system which delivers the tools to eliminate or reduce most major daily risks.

Staff will be able to view significant changes in residents’ behaviour, evaluate, and then act upon this information. Whether their patients are sleeping, or eating; going outside their room, or making a trip to the toilet, staff can receive alarms and build up data to establish patterns.

A reduction in injuries and improvements in the provision of proactive care through faster reaction can result from the installation of a smart floor solution. Staff will be far more effective in planning their tasks based on each individual residents’ symptoms and needs.

Cause and detect Fall prevention strategies and interventions need to take into account that dementia-related falls have a variety of causes that also include the additional effect of certain prescribed drugs.

Consequently, fall prevention strategies and interventions need to take this into account. There are also implications for care staff with likely increases in anxiety, workload and complaints, and the probability of staff requiring extra training.

Anything which can significantly improve fall detection rates, especially in the case of falls initially undetected due to a resident’s unconsciousness or from a panic button being out of reach, is essential. The amount of time spent on the floor following a fall can be crucial to any recovery.

A break in cognition One study on dementia and hip fractures, concludes that patients with dementia have up to an eightfold higher risk of falling, and September/October 2017 | Care Home Management 41

How giving every resident their ‘day’ can transform care Creating and maintaining a care plan shouldn’t just be paperwork. But pressures of time and resources can result in it becoming just another task with little meaning to either residents or staff.

Dan Lipscombe, operations manager for C&C, which runs eight care homes in London, argues making each person in turn ‘Resident of the Day’ can transform their daily care and give satisfaction to staff.

There is little question that care home staff enact care plans for residents every day, assessing their needs, acting on them and planning care to maximise opportunity and minimise anxiety.

However, when it comes to documenting their actions and providing evidence, this can be more challenging because of time constraints, a lack of continuity of staff and the pressure to complete the task of care planning.

Person-centred care, as a concept, was introduced into the healthcare sector in the 1970s, known then as the ‘Nursing Process’, which aimed to establish an holistic attitude to care and not just a medical approach.

This formally introduced the idea of looking at the range of factors influencing a person’s wellbeing and also gave a greater role to nursing staff, where previously doctors had been dominant.

they contain is comprehensive or up to date. That’s down to the individual and the systems a provider has in place to meet the Care Quality Commission’s Regulation nine.

One key factor is when plans are updated, not just how.

The treadmill of updating Updating Many homes will update care plans at the end of the month, setting aside a day to get through everyone’s health checks and care reviews. But how much attention does that afford each person? It can feel like a treadmill for staff, especially in larger homes, and the outcome is

Care planning is now central Care planning is now a core element of nursing and residential care, and homes are offered a range of printed and digital templates to set up and maintain records for residents.

While these are undoubtedly useful, they can’t guarantee the information 42 Care Home Management | September/October 2017

likely to be less than satisfactory for everyone involved.

At C&C we wanted to look at how efficient that was, both in terms of compliance and improving quality of life for our residents.

A little over a year ago we introduced ‘Resident of the Day’ in which care staff at each of our eight homes in and around London focus on one resident per day.

We felt a rolling programme would give more time and space to devote to each individual and turn what had been a ‘task’ into genuine insight into each person’s needs and desires.

This individual focus gives us

a chance to celebrate, not just document, them and their preferences.

Their room is deep cleaned and their photograph is displayed in the home as ‘Resident of the Day’. Each resident knows they matter.

It’s a low impact solution operationally as it removes the need to block out hours or a full day to go through every resident’s details.

Requests are often simple While a one-to-one activity with every resident outside of the home could be difficult, requests are often very simple – kippers for breakfast, films of their choice with a glass of sherry or just the chance to do the washing up.

The important thing is that the ‘Day’ involves something that has meaning to that person. It comes down to two things, as it would for all of us - being given the chance to exercise choice and experiencing what brings them joy.

For example, one resident decided to visit the local supermarket on her ‘Day’ to choose her favourite foods, some of which she’d forgotten about because she didn’t shop anymore and didn’t see them. Not only did she revel in the freedom and control her ‘Day’ gave her, our staff learned she had a love of blue cheese which they wouldn’t have otherwise known.

Another woman had a lifelong love

of horses. Having visited a local stable regularly, limits to her mobility meant she couldn’t make the journey anymore so staff arranged for a horse to visit her.

It was powerful reminiscence for this resident with dementia – the smell and the feel of the animal unlocked memories that staff had not previously heard, giving them new insight into who she was, and is. And the thrill of the visit stayed with her for many days afterwards, visibly reducing her levels of anxiety.

regularly asked about their needs and desires gives them a sense of control and enhances their feeling of personhood. And where health issues make communication difficult, families are closely involved which has led to stronger relationships with staff.

As with any new initiative, buy-in from home managers and staff teams is essential for success. Here are our key learnings: ■ Be clear about the changes you’re making, their intended outcomes and what success looks like ■ Establish a reporting process so home managers and clinical leads can monitor activity each week and make sure every resident has been involved ■ Be clear on what triggers a red flag – it’s unlikely every resident wants to do the same thing or that one person wants to do a favoured activity each and every month ■ Share success. Communicate inspiring examples internally to maintain motivation and share ideas - residents may need prompting because of their health or changes in mood.

Ultimately, ‘Resident of the Day’ is about creating an effective way of continuously updating our knowledge base about residents and improving their quality of life.

Impact on staff too The benefits to residents have been clear but it has also had quite an impact on the homes and the staff.

We have seen real results in the standards of record-keeping, both in terms of how often they are updated and the quality of the information they contain.

As these examples show, staff now have a better understanding of individuals. There is more meaningful interaction between staff and residents and greater satisfaction among the care teams who have the opportunity to be creative, proactive and feel less task focused.

Another of the key benefits of ‘Resident of the Day’ is that it puts residents at the heart of decisionmaking about their care. Being September/October 2017 | Care Home Management 43

Reliable and cost-effective energy supply key for rural homes

by Rob Shuttleworth, chief executive of UKLPG, the trade association for the liquefied petroleum gas industry

Care homes face many challenges but those located off the mains gas grid face the additional challenge of sourcing a suitable heating and fuel solution that will meet the needs of staff and residents whilst offering a cost-effective solution.

Current Pressures In such a competitive market, with around 20,000 care homes registered in the UK, owners understand that it’s not just the level of care that attracts residents, but also the location in which the home is situated.

Picturesque spots near the sea or in the countryside can be as much of a pull as the staff qualifications and price of the care.

However, with these idyllic locations often comes the problem of being off the mains gas grid. In a residential home, extreme temperatures should not usually be a concern. No care home owner wants an unreliable heating system that may give out in the depths of winter, so a trustworthy fuel source is fundamental to the health of both residents and the business.

For residential homes without access to natural gas central heating due to their location, low carbon LPG can and does deliver the same reliable and convenient benefits as natural gas, however remote their position.

Consistent performance LPG offers almost the exactly the same functionality as natural gas, and yields 12% less CO2 than oil. Indeed, it performs well when compared to other traditional off-gas grid fuels, emitting 35% less CO2 than coal, almost no black carbon, low particle and NOx (nitrogen oxide) emissions and low sulphur content. In addition, providing immediate and consistent heat, LPG ensures that ambient temperatures are quickly achieved and maintained.

LPG works well with some of the most advanced energy efficiency technology available. Replacing old, inefficient and unreliable heating systems with a new LPG system enables managers to make a real impact on cost and carbon savings without compromising on the comfort of residents.

Cooking on gas has always been the preferred choice for establishments that need to cater for large numbers of people and LPG gives this choice to establishments located off the gas grid.

Installation options Bulk LPG tanks come in a variety of sizes that can be installed above

44 Care Home Management | September/October 2017

or below ground to suit owners’ requirements. With telemetry systems that alert the supplier when fuel needs replenishing, LPG offers a convenient, straightforward and reliable low carbon fuel source. These benefits have given LPG a proven track record in sectors that have intensive high energy needs throughout the year.

One care home in Lincolnshire can show the benefits of using LPG. Acknowledging the importance of consistent and reliable heat coupled with a cost-effective solution, it uses LPG for both its green credentials as well as the added value received from its supplier. With an annual usage of 24,000 litres from its above ground tanks, this home found the use of LPG provided a very similar experience to natural gas, and the customer service and assistance from the supplier meant that energy was one thing they didn’t have to worry about.

For rural care homes, LPG’s low carbon properties help to improve green credentials, while at the same time, it is an instant and clean fuel supply can greatly reduce running costs.

For more information on LPG and to find your local supplier visit www.uklpg.org

Lighting for care homes – could LEDs help with wellbeing?

In a care home environment, good lighting is vital to help residents find their way around, recognise the faces of their friends and carers, and generally ensure their safety and comfort at all times.

However, as well as the wellbeing of residents and staff, an important consideration for the management team is how the lighting impacts the running costs and energy efficiency of the property. Here are some key lighting considerations for care home managers.

Being kind on ageing eyes Eyesight gradually deteriorates with age and older individuals typically require a higher level of lighting in order to carry out everyday tasks such as reading, preparing food and getting dressed in the morning. Studies show that people aged 75 years and above actually need twice as much light as the normal lighting standards recommend, and nearly four times as much light as the average 20 year old.

Lighting consistency is also a factor that needs careful consideration.

Dramatic changes in lighting from room-to-room can cause serious issues for those with poor eyesight as it can take their eyes a long time

to adjust to the different levels of brightness. Unfortunately, this can significantly increase the chance of a resident tripping and falling.

In addition to having adequate light levels, care homes should also ensure that glare is reduced on windows and shiny surfaces, and that contrast and colour definition remain consistent throughout the building.

Energy efficiency and cost reduction With the shorter - and colder - days of autumn and winter fast approaching, energy consumption and costs will inevitably start to increase. In order to reduce expenditure in these areas, it pays to seek out lighting solutions that offer a fast return on any initial investment, as well as ongoing savings for the future.

LED lighting, for example, is extremely energy efficient when compared to traditional lighting solutions such as halogen or fluorescent bulbs. LEDs use up to 90% less energy than incandescent lighting and up to 60% less when compared to fluorescent lighting.

In addition, LEDs typically have a lifespan of up to 50,000 hours - far greater than traditional bulbs. As a result, LED bulbs don’t need to be changed as frequently, further reducing maintenance costs and

creating less disruption to residents.

The initial investment of LED lights can sometimes be a little off-putting for those care home managers looking to convert to LEDs, but their increased lifespan and reduced energy consumption mean that this one-off investment will be quickly repaid.

Light, health and wellbeing Lighting has a profound impact on health, wellbeing, and mood and to reduce the chance of any adverse health issues, rooms should be adequately lit and maximise natural daylight wherever possible. This not only applies to both residents’ rooms and social areas, but also to the rooms used by care home staff for both operational and relaxation purposes, as well as general reception areas.

Although it isn’t always obvious to the naked eye, fluorescent lights are constantly flickering in order to keep their illumination. This flickering can lead to migraines, eye strain, and even increased stress or anxiety. An absence of this ‘flickering effect’ is one of the main health benefits that can be realised for both residents and staff when switching from fluorescent lights to LEDs. For more information, visit https://www.lyco.co.uk/

September/October 2017 | Care Home Management 45

Why taking care to get business partnerships right is crucial

by Rory Conwill, an associate in hlw Keeble Hawson’s corporate department

Many care home partnerships set off without formal arrangements - often initially founded on verbal agreements and assumed understandings.

Sharing a common purpose and the first flush of enthusiasm for a new commercial venture, partners can understandably often imagine they will never fall out. Subsequently, long hours managing and running a demanding business can take precedence over attending to legal administration.

Unfortunately, disagreements can, and do, arise - even among the closest of partners. And when they do, our experience is that it’s far easier to resolve when the parties have agreed in advance just what will happen in such an event.

While it’s true to say that the law will generally step in to provide a limited level of governance in circumstances when parties have no formal Partnership Agreement (courtesy of the provisions of the Partnership Act 1890), it is important

to recognise that the Act applies a broad brush approach which is not suitable for all partnerships.

Get off on the right foot The precise terms of any Partnership Agreement will of course depend very much on the nature of the care home and the individual circumstances of its partners. However, there are a number of important considerations that are usually relevant.

The first is to decide at the outset what will happen if a party wishes to leave the partnership. This is something that’s often overlooked, but it is far better to put in place a mechanism for dealing with it at the start (at a point where the partners are on good terms), rather than waiting until somebody wants to go particularly as it may be contrary to the wishes of the other partners, or as a result of a dispute with them.

The Partnership Agreement should, then, clearly spell out whether or not the partnership will continue with the

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remaining partner(s). For example, how much will he or she be paid for their share? When will they be paid it? Without the protection of a Partnership Agreement, the Partnership may be forced to dissolve, which could potentially lead to the loss of important lucrative contracts.

Forced ending The second is to set out any circumstances in which a care home partner can be forced by the other parties to leave the partnership. For example, if his or her performance falls below a certain level.

Thirdly, the majority of an active partner’s day is occupied with the home. It is therefore important to set out how it will be run and managed around them. Many care homes, for example, will have partners of varying experience and seniority and each individual is likely to want to take a difference approach to the day-to-day running of the business. It will help to identify early what is expected of each partner, such as how much capital is to be contributed and what happens financially if one partner is required to devote more time to the business than the others.

These are just a few of the many potential pitfalls of a failed practice partnership, so our advice is to seek help early and set firm foundations in place that will serve all parties in the event of a partnership coming to an end.

For further information, contact Rory Conwill, hlw Keeble Hawson, on 0114 252 1411 or roryconwill@ hlwkeeblehawson.co.uk

Can I charge Top Ups on my care home fees?

Philippa Doyle, of Hempsons examines the issue.

The simple answer is - sometimes!

Make sure you know the rules.

Apply them individually to each new client you are looking to accept from either a local authority or CCG commissioner.

What are the rules?

The Care Act 2014 is accompanied by the Care and Support Statutory guidance. Annex A sets out clear rules

on when top ups may be charged, and when a higher fee is the responsibility of the local authority.

When an individual is placed by a local authority, the person has a right to choose between different accommodation. The local authority must ensure that at least one option is available - preferably more than one.

If no suitable accommodation is available within the defined budget, then the local authority must arrange care in a more expensive setting and adjust the budget accordingly so that the person does not have to contribute a top up.

If, however, a person expresses a preference for more expensive accommodation then a top up payment may sought from the individual or their family.

What about clients who are CHC? The CCG is required to fund all of an individual’s assessed care needs,

including their accommodation.

Topping up NHS care must be considered very carefully.

Any top ups sought must be for divisible elements of service.

For example • A larger room or a room with a view • Sky TV packages • Hair and beauty services • Befriending services Some services may form part of a person’s assessed needs – e.g. podiatry services for diabetic residents.

The NHS will meet the cost of this service. For other residents it may be chargeable.

Where someone has chosen to live in a more expensive home than would usually be commissioned, prior to becoming eligible for CHC, the resident may be required to move.

The CCG can and do review whether a person can be safely moved to an alternative provider.

Care Management Home Free Legal Advice Line 01423 724056 Care Home Management and specialist health and social care law firm, Hempsons, offer a free advice line for Care Home Management readers. Simply call 01423 724056 quoting ‘Care Home Management Advice Line’ or email socialcare@hempsons.co.uk The Legal Advice Line is open between 9.00am and 5.00pm, Monday to Friday and offers up to 20 minutes of valuable preliminary advice on a range of issues faced by social care providers.

Charity law | Commercial property | Company law | Contracts | Corporate law CQC regulatory | Data protection | Disputes and litigation | Employment law Fundraising | Governance and constitutional reviews | Health and safety Information law | Inquests and coroners | Judicial review | Mental health law Primary care contracting and community law | Safeguarding | Tendering

Legal advice provided by Hempsons.

Leading Health and Social Care Lawyers LONDON | MANCHESTER | HARROGATE | NEWCASTLE

Events and Appointments

Events line-up 10-11 October 2017 Care and Dementia Show

NEC Birmingham www.caredementiashow.com/ 17 October 2017 Care Roadshow Cardiff

Cardiff City Stadium http://www.careroadshows.co.uk/ 14 November 2017

Appointments Former minister new SCIE chair Paul Burstow, former minister of state for social care, has been appointed as chair of the national improvement agency and independent charity, the Social Care Institute An MP from 1997 to 2015, he was Minister of State at the Department of Health from 2010-12, and architect of the thinking and discussions which led to the Care Act.operating officer.

Care Roadshow London

Epsom Downs Racecourse http://www.careroadshows.co.uk/ 16 November 2017 Care England Conference ‘Shaping Tomorrow’

Church House, Westminster, London http://www.careengland.org.uk 30 November 2017 NAPA Conference: How to connect to your community and volunteers Bristol

http://www.napa-activities.com/ events/conference

2018 25-26 April 2018 Dementia Care and Nursing Expo

NEC Birmingham http://www.carehomeexpo.co.uk/ 27-28 June 2018 Health + Care

ExCel, London http://www.healthpluscare.co.uk/

Heathcotes appoints director of quality & compliance Chesterfield-based care provider, Heathcotes Group, has appointed Tracy Johnson as director of quality & compliance.

Tracy joined Heathcotes ten years ago as a registered manager before progressing through various roles to become head of quality & compliance.

She has been promoted to the board in recognition of her contribution to the group’s outstanding results in learning and development and quality auditing.

New head of Healthcare at NatWest NatWest has appointed Barrie Davison as the new head of healthcare.

Barrie, who has been with the bank for over 20 years, will oversee the 30 strong team, based across the UK. He brings with him experience from across the business including business management, structured finance and credit.

New Care make flagship appointment New Care has appointed Yana Whitehouse as registered manager for its flagship care home, The Grand in Nottingham.

In her new role, Yana takes responsibility for the 82-bed facility, its 82 residents and 100-strong employee team. Having worked within the industry for more than 30 years.

48 Care Home Management | September/October 2017

Heckmondwike offers complete flooring solution for care & sheltered housing Heckmondwike, one of the UK’s leading fibre bonded carpet and carpet tile manufacturers, is now offering a complete solution for the care sector through its Pure Care and Total Care ranges.

Pure Care and Total Care, both available in eighth colour options, are ideally suited to healthcare environments or sheltered housing, whether that be communal areas, corridors or bedrooms. Both types of carpet feature an impervious backing and are highly resistant to staining and bleach and are extremely durable. They are manufactured to meet all relevant flammability tests with antistatic properties. Available in 4m widths, these carpets are very easy to fit and offer low installation costs.

Jeremy Broadhead, Commercial Manager for Heckmondwike, said: “Demand is strong for our high performance, stain resistant carpets for care homes and sheltered housing. With a wide choice of colours within each range, there is something to suit all tastes and applications.”

Heckmondwike also offers a range of entrance products, which are suitable for care homes and sheltered housing. This includes Vanquisher, with its alternative rib and velour surface pattern. Vanquisher is ideal for protecting carpets from outside soiling and moisture. It also offers thermal and acoustic properties and low maintenance.

Sample cards are available on request by calling 01924 406161 or visiting www. heckmondwike-fb.co.uk.

Forbo Announces DSDC accredited products As age-related changes and impairments can often make it more difficult for people to understand and navigate a building, Forbo Flooring Systems has partnered with The University of Stirling’s Dementia Services Development Centre (DSDC) to review over 1000 floor finishes; assessing their suitability for use in dementia-friendly environments.

Following this, the flooring manufacturer is pleased to confirm that it now offers a selection of independently accredited products that are ideal for use in dementia supportive settings.

Impairments such as sensory, mobility or cognitive (or sometimes a combination of all three) can have a serious impact on older people and those with dementia.

Functioning, behaviour, independence and, ultimately, quality of life can all be compromised, but appropriately designed environments can help keep them safe from dangers, such as falls.

Recognising the need to identify products that can help achieve this aim, DSDC developed its rigorous accreditation scheme,

as Chief Architect Lesley Palmer explains: “We’ve had significant demand from clients, specifiers, designers and manufacturers looking for greater clarity on dementia design principles and how they can adapt, modify and apply their products to make an environment more suitable for somebody with dementia. The accreditation scheme seeks to clarify existing information and promote the use of products that have gone through the accreditation process.”

Forbo will be launching its new DSDC accredited floor coverings on stand J30 at the Care Show at the Birmingham NEC on the 10/11 October.

For more information please visit www. forbo-flooring.co.uk/agedcare

New to the Market – Dynamic Hybrid Mattress Solution from Carilex The Carilex DualFlex is a dynamic replacement mattress system, combining both

high performance static foam, and active alternating air cell technology for exceptional patient comfort and healing.

Specifically developed for patients at ‘High Risk’ of developing pressure ulcers, this flexible step-up mattress, provides cost-effective pressure ulcer prevention and healing in one excellent system.

The high-performance foam layer features a zonal area design, including; GELTEX® inside technology, to provide effective redistribution of pressure on the sacrum,

head, shoulder blades and heel areas.

Alternating therapy can be quickly and easily applied by connecting the ultra-quiet pump, whilst still providing a peaceful sleeping environment.

UK Distributors for Carilex : Agecare Eastern Ltd offering FREE Next Day Delivery Contact : 0845 241 2281 – www. agecareeastern.co.uk

September/October 2017 | Care Home Management 49

In/Out “Staff on Duty” display board

As an official reseller of Find dementia products, ABM Trade (UK) Ltd are delighted to offer the brand new In/

Out Staff on Duty board - a permanent and professional display which effortlessly communicates who is, and who isn’t on duty. Using Find’s unique, anti-glare, anti-bacterial surface, the dry-wipe board is a high quality, professional display for any care home.

Customised and branded, if required, each board may show the name of the home, the logo and corporate colours and, of course, the requisite number of places for staff photos to give a professional and organised impression.

This provides valuable information for staff and visitors alike to know who is in the building, and what people look like, especially welcoming when visiting a home for the first time.

Available as off-the-shelf sizes for 12, 18, 24 or 30 member of staff with photos at 70 x 50mm or as a bespoke design specific to your requirements.

Contact ABM Trade (UK) Ltd Tel: 01706 872114 Email: sales@abmtradeuk.com

Polysafe flooring offers sustainable slip resistance at Stockmoor Lodge care home

Safety flooring from UK manufacturer Polyflor was chosen to help create a safe yet homely interior design scheme for Somerset Care’s latest care home, Stockmoor Lodge in Bridgwater.

Three safety flooring collections featuring sustainable wet slip resistance were used throughout communal areas and bathrooms within the care home – Polysafe Wood fx PUR wood effect flooring, Polysafe Hydro Evolve flooring for continually wet areas and Expona

Control PUR luxury vinyl tiles.

Diana Cellela, Director of The Drawing Room Interiors Ltd commented, “These Polyflor safety flooring products were ideal for creating a safe yet non-clinical living environment for Stockmoor Lodge’s residents which was in line with the dementiafriendly design principles we work to. We have used a range of Polyflor’s flooring products on various care home projects and are continually impressed with the

50 Care Home Management | September/October 2017

variety of beautiful designs offered and the performance delivered once installed.”

Safety flooring samples can be ordered free of charge on the Polyflor website or by calling the Polyflor Samples Direct Hotline on 0161 767 2551.

More information about dementia friendly flooring can be found in Polyflor’s “Specialist Care” brochure, available at www.polyflor.com.

Tel: 0161 767 1111

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