Caring Times November 2020 issue

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Staff / recruitment... Property marketplace... Innovation... Expert analysis...

Call for balanced approach to care home visiting Sector shows resilience in face of pandemic

Colten Care: putting care before profit ensures sustainability Management is key to controlling Covid-19

November 2020

Social care business management

A CARER CARED FOR – RHONDA LIVES WELL WITH DEMENTIA

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inside 8

November 2020

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CARE HOME VISITS

National Care Forum joins Age UK in calling for a balanced approach

Putting care before profit ensures sustainability, says Colten Care chief executive MARK AITCHISON

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COLTEN CARE

A CARER CARED-FOR – LIVING WELL WITH DEMENTIA

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INFECTION CONTROL

LATEST NEWS

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COMPLIANCE

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RETIREMENT LIVING

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MARKET ANALYSIS

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SEE PAGE 14

Effective management is key, says ANNE SMITH

Radfield Home Care favours a technology-led approach Rangeford Villages looks for land Knight Frank says sector is resilient in face of Covid-19 pandemic

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news

November 2020

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Govt unveils Winter Plan for care homes Health and social care secretary Matt Hancock has announced an Adult Social Care Winter Plan which aims to curb the spread of Covid-19 infections in care settings throughout the winter months.

As part of the plan, announced in mid-September, people receiving adult social care and care workers will receive free PPE, a new dashboard will monitor care home infections and help local government and providers respond more quickly, and a chief nurse for adult social care will be appointed to represent social care nurses and provide clinical leadership to the workforce.

Care home operators must restrict all but essential movement of staff between settings to reduce transmission.

The government says it will support this with an extra £546 million for the Infection Control Fund, intended to help care providers pay staff full wages and enable staff to work in only one care home.

The extra money brings the total funding for infection control measures in care homes to more Editorial & advertising Investor Publishing Ltd, 1st Floor, Greener House, 66-68 Haymarket, London, SW1Y 4RF Tel: 020 7104 2000 • Fax: 020 7451 7051.

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than £1.1 billion and the government says this underlines its commitment to ensure adult social care has the resources it needs to keep residents and staff safe.

Also as part of the Winter Plan, the government says it is “prepared to strengthen” monitoring and regulation by local authorities and the CQC, including asking them to take strong action where improvement is required or staff movement is not being restricted.

This could include restricting a service’s operation, issuing warning notices or placing conditions on a provider’s registration.

Health and social care secretary Matt Hancock said that, with winter on the

horizon, the UK was entering a critical phase in the fight against coronavirus.

“Our priority over the next six months is to make sure we protect those most vulnerable receiving care and our incredibly hard-working workforce by limiting the spread of the virus and preventing a second spike,” said Mr Hancock.

“This Winter Plan gives providers the certainty they need when it comes to PPE and provides additional support to help care homes to limit the movement of staff, stop the spread of coronavirus and save lives.

“We will be monitoring the implementation of this carefully and will be swift in our actions to protect residents and colleagues across the country.”

Caring Times editor hands-on the baton Caring Times’ editor Geoff and in the professionalism of Hodgson is retiring. After 22 all who work in the care secsuperb years during which tor, despite a political envihe has often been the voice ronment where, he says, a of the sector, Geoff is putting succession of governments the cap on his editorial pen. have given the barest lip-serWe all owe him a great debt. vice to the vitally important Yorkshire-born, Geoff emirole social care has in maingrated as a child with his taining the fabric of a civilised family to Australia in the midsociety.

Geoff Hodgson (left) and Rob Munro 1960s. There he studied Geoff leaves Caring Times music before training as a registered nurse. While in a far stronger position than when he joined it. working as a nurse in His strong moral compass for what is right and fair remote regions he showed early signs of his verrather than what is expedient, plus a very special satility by writing for a regional flair for communicating complex issues simply, has newspaper and was subsequently offered ensured the publication is now recognised as a full-time employment as a journalist. leader in the care sector.

His training as a journalist was “on the job” Geoff has been the first to congratulate our and he progressed to become a sub-editor, incoming editor, Rob Munro, on his appointment and subsequently editor of a weekly and to express the earnest hope that Caring community newspaper.

Times continues to serve today’s committed, proReturning to the UK in the mid-1990s he fessional and resilient base of social care providers worked first as chief sub-editor for a group of for another two decades and beyond because, South London newspapers before moving on to despite all that has been achieved, there is still the editorship of Caring Times. much to be done.

During his time as editor Geoff witnessed and Readers and staff will wish Geoff a long and fulinfluenced the huge improvements that have been filling retirement.

– Dr Richard Hawkins, made in dementia care, in physical environments editor-In chief, Caring Times

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news DIGEST

November 2020

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‘It’s been a breath of fresh air’ says oil exec. turned care home handyman

CAREER CHANGE: former oil & gas executive Paul Law is now handyman at Balhousie Alastrean

From regulating oil exploration in Russia to changing light bulbs in a care home, Paul Law’s career has gone in an extraordinary direction.

The former oil and gas executive says his new job, heading up maintenance at Balhousie Alastrean, is a “breath of fresh air”.

It’s a lot to do with his new job’s location: a former country house and sprawling estate in Tarland, Aberdeenshire. Formerly known as the House of Cromar, the property was built as a country retreat by Lord Aberdeen and then became a retirement home for the RAF. Today it is owned by the RAF Benevolent Fund and managed by the Balhousie Care Group.

Paul, who lives in nearby Banchory, wanted a change of pace after 32 years working all over the world in a job which included Ministry of Defence work. He now loves that he’s a short commute from work, and doesn’t take his job home with him.

But while the pace is slower and the surroundings breathtaking, Paul has his work cut out for him; the expansive property includes 51 en suite rooms and five lounges. Paul readily admits he had “never stepped foot inside a care home” before getting this job.

“Working here has really opened my eyes to the hard work care home staff do,” he said. “The care people are getting here is second to none. And these are paying customers so we all have to make sure they’re getting the best service we can give them.

That includes my daily maintenance checks.”

In his spare time – which, happily, he now has much more of – Paul enjoys his cars: a 1967 MGB GT, a BMW Z4 and a 4×4.

Care Workers Charity launches scheme to support care workers’ mental health

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Research from The Care Workers’ Charity (CWC) report “The Beating Heart of Care: Supporting Care Workers Better” shows that the mental health of care and support workers was suffering before the Covid-19 pandemic. The report found that many care workers were often in in-work poverty and were often suffering from mental health issues due to their low paid and emotionally charged frontline roles as carers.

Since then, social care workers have experienced additional challenges during the covid-19 pandemic. The CWC says the toll on mental health has been and continues to be massive.

A survey conducted during the early months of the pandemic by the Queen’s Nursing Institute recognised that “there are far more beds in care homes with nursing than there are in hospitals in England” and CWC points out that delivering a

high level of care to individuals who need a ‘combination of support for complex physical and cognitive needs’ requires a high level of skill.

In such settings, end of life care is often unavoidable and can be extremely draining on the mental and physical wellbeing of the workforce.

Of the people surveyed, 80% of respondents “reported very negative experiences” of working during March – May 2020. 56% of respondents felt worse or much worse in terms of their physical and mental wellbeing. Other contributing factors to their negative feelings were not being valued, poor terms and conditions of employment, feeling blamed for deaths of service users and a lack of clear guidance.

In response, The Care Workers' Charity is preparing to introduce mental health grants for people working in the social care sector. The charity is also looking at offering sessions of

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therapy or counselling from licensed professionals tailored to the needs of the individual, and is currently running trials to identify partners to deliver this.

The Care Workers’ Charity executive director Karolina Gerlich said the Covid-19 pandemic had shown the resilience and determination of care and support workers as they continued to care for the most vulnerable members of society.

“The toll on the mental health of care and support workers has been great, long before the pandemic,” said Ms Gerlich. “However, Covid-19 has compromised the mental wellbeing of individuals who may have struggled with their mental health previously and people who have never previously struggled with anxiety or depression are now finding their mental health is suffering.

“We are now appealing for support and donations to this fund to help us ensure care workers receive the right type of guidance and support to help them through what has been a very dark period for most.”

■ Donations can be made by following the fundraising link here: thecareworkerscharity. enthuse.com/cf/mental-health-appeal

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news DIGEST

November 2020

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Charity: adding senior care workers to the Shortage Occupation List will not solve recruitment pressure Parliament’s Migration Advisory Committee has, in its latest report, recommended that senior care workers be added to the Shortage Occupation List.

The recommendation has been welcomed by older people’s charity Independent Age. Chief executive Deborah Alsina said professional care workers provided a vital service that had been pushed to the limit during the Covid-19 pandemic, but even in more normal times, professional carers received poor pay and limited recognition for the important and skilled work they do.

“People in later life have shared with us that the shortage of workers in the care sector can have a severe impact on them, with some seeing a different carer on each visit, who is then expected to perform intimate tasks like helping wash and dress,” said Ms Alsina.

“We welcome the Migration Advisory Committee’s recommendation that senior care

workers are placed on the Shortage Occupation List, to enable overseas workers to fulfil some of these roles once freedom of movement ends.

“However, we know that providing an immigration route for senior care workers will do little to tackle workforce pressures in adult social care.

“Latest figures from Skills for Care show that there are nearly ten times as many care workers (865,000) than senior care workers (87,000), yet there is still no planned migratory route for this

much larger proportion of the workforce.

“Independent Age continues to call on the government to establish pathways for care workers to come to the UK to ensure we do not see further workforce shortages. We also welcome and echo the committee’s urgent call for additional funding to enable higher wages to be paid to boost domestic recruitment.

“Action on both of these fronts is essential if the social care workforce is to be equipped to meet the significant challenges ahead.”

DEBORAH ALSINA: Providing an immigration route for senior care workers will do little to tackle workforce pressures in adult social care.

Care homes to get extra £546m Covid-19 funding Government has promised an extra £546 million in funding to bolster infection prevention and control measures in care homes during the winter.

While welcoming the extra funding, the National Care Forum (NCF), which represents not-for-profit care providers, was critical of delays in the announcement of the extension to Infection Control Fund.

NCF executive director Vic Rayner said there had been a series of calls from the sector for the government to make its plans known urgently before the deadline of the initial fund on 30th September.

“This ring-fenced finance has been a vital lifeline for many providers of care to ensure they are able to support staff who are isolating, and to

minimise movement of staff within and between homes,”said Ms Rayner.

“It is imperative that this funding reaches the front line quickly. We welcome the funding, and need urgently the detail to enable understanding of the criteria and timeframe.

“The clock has been ticking on the government around a number of major announcements – the Infection Control funding is

Brendoncare offers trial stays for relatives At its Park Road care home in Winchester, notfor-profit provider Brendoncare is offering a free trial for a relative to move in alongside the new resident, so they can help them settle in to their

Call for reappraisal of remote operational visits A forum of health and social care providers has called for the sector to reevaluate its scepticism for remote operational visits in the wake of the Covid-19 pandemic.

The Health and Social Care Leaders Forum, sponsored by The Access Group, is chaired by Jonathan Vellacott, executive chairman of MiHomecare and The Complete Group, and convenes to discuss the most pressing issues in social care.

The forum says that, while many care providers have previously been sceptical of the effectiveness of remote operational visits and inspections, checking sites remotely could offer a cost effective and efficient solution.

Agincare chief executive Raina Somerson said that in the past, her organisation had

most welcome – but needs to be understood against a wider set of commitments for winter and any second wave.

“The well-documented breakdowns around testing, rising rates of infection and increases in local lock-downs mean that we need these government plans to be shared – preparation is critical and last minute announcements serve no one well.”

been sceptical of how effective remote inspections of their care homes across the UK could be but had found that they were as productive as conducting visits in person.

She added that remote visits were, “in many ways more focused and more meaningful” than in-person visits often were.

The forum also discussed the role of technology in helping the sector respond to the crisis, with the expectation that digital transformation would continue at increased speed over the coming months and years.

Westminster Homecare chief executive Sushil Radia said that he and his team “have learned and moved our tech strategy forward more in the last three months than the last five years.”

new surroundings. The resident and relative will each be given a room so they can isolate together for up to two weeks, to ensure safety for them and their fellow residents. This will also provide the opportunity for them to get to know the staff and work together on their individual needs and preferences.

Brendoncare Park Road home manager Erin Langley said the relative would see kindness and compassion in action and would be able to observe the high standard of care their loved one will receive.

“We know how hard it can be to be apart from a loved one at this time and we wanted to be able to help in any way possible,” said Ms Langley.

“We are delighted to be able to offer free rooms for a relative or friend, so they can isolate together. We look forward to welcoming new residents into our lovely home.”

Brendoncare Park Road is run by Winchesterbased charity, The Brendoncare Foundation, and provides nursing, respite and end-of-life care to 40 older people in Winchester. It is located in a tranquil part of Winchester and has attractive mature gardens.

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covid-19 restrictions

November 2020

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Visiting in care homes – pushing for a balanced approach Following the government’s launch of the Social Care Covid-19 Winter Plan in mid-September, which imposes stringent new restrictions on care home visits, VIC RAYNER, executive director of the National Care Forum and CAROLINE ABRAHAMS, charity director of Age UK, have published a joint-blog which argues against a blanket ban on care home visits. The blog is published in part below:

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To deprive people living in care homes of the stimulation and unprecedented pleasure that ‘visiting’ brings creates significant risks, Social care is a holistic service – it is concerned with people’s mental and physical health alongside their spiritual and emotional wellbeing – we lose sense of the balance of all these elements at our peril.

The impact of taking visitors away from people on a prolonged basis has been closely observed all over the country, with people and organisations commenting on the raw reality of residents going downhill fast, giving up hope and ultimately dying sooner than would otherwise be the case.

This is why it matters so very much and why we should think very hard indeed before intervening in a way that severs these connections.

That is not to say that any visit can be taken lightly at this time but the Social Care Covid-19 winter plan, launched by DHSC on Friday 18 September, while not outright banning visiting, gets awfully close to it.

The plan outlines measures already in place which have created a blanket lock-down of those care homes in “areas of intervention”, which on the last count amounted to a geography covering nearly 20% of all care homes in England. This means that residents and their immediate families, amounting to approximately 300,000 people, a population equivalent to Brighton and larger than Newcastle on Tyne, have been effectively split apart from their loved ones without warning, and without consultation. With a blanket ban meaning no visits can take place – no garden visits, window visits or visits inside the home.

This is to say nothing of the many more hundreds of thousands of people impacted by homes being in localised lock-downs through the decision of their Director of Public Health, as a result of being in areas which are on a PHE watchlist.

Of course, it is completely understandable that policymakers want to take every precaution they can when it comes to care homes, given the catastrophic suffering and loss of life earlier in the pandemic and now, with the emergence of a

“second wave”. Declaring a “no visiting” blanket ban, or near ban, may seem to them like the right thing to do against this context – but we seriously question whether it really is, and for a number of important reasons.

Firstly, care homes and residents are all different whereas a blanket ban inappropriately treats everywhere and everyone the same.

Surely, with this as with everything the appropriate way to proceed is by assessing the risk for places and people on an individual basis.

Secondly, it seems perverse, to say the least, for official guidance to say that in certain circumstances a person can be discharged from hospital into a care home without a test showing they are Covid-19 negative, yet carefully managed visits by loved ones should cease. This makes no sense at all.

For older people with dementia there is clear evidence that connection helps to slow down the progress of the disease, whereas its absence helps to accelerate it.

Thirdly, we are not aware of any evidence showing that visits, if carefully managed, have been a significant risk in spreading the infection so far. On the contrary, our understanding is that the evidence points more towards people who come in and out of a care home inevitably being rather more of an ongoing risk, whether they are staff or visiting GPs and district nurses, or indeed CQC inspectors. Unless these incomers are housed on site they live in communities like the rest of us and so are as vulnerable to picking up the infection as we all are.

Finally, the risk of visiting contributing to spreading the infection is not the only risk that has to be managed here, though it’s the one we have the metrics to count. The other risk, which

is very significant for many older people living in care homes, is that their physical and mental health significantly declines as a result of a prolonged lack of connection with those who mean most to them. It is this very delicate balancing act that homes, in partnership with relatives, have been negotiating in recent months.

It is a very human balancing act that centres around people and their needs, and the risks for those living and working within a care home and relatives and friends too. Everyone has their part to play in making this a success: homes need to communicate transparently and often, sharing their thinking and measures to minimise risk as the situation changes; relatives need to ensure they are working with the home to facilitate these mitigations; and everyone needs to keep the focus on what really matters here – the safety and the welfare of the person living in the home.

A polarised debate helps no one.

The public conversation about this is not helped by the term “visiting”, which somehow fails to capture what many relatives and friends often do for people in care homes to supplement the care available from staff. It is not unusual, for example, for the partner of a resident with dementia to spend many hours with them, helping them very slowly to eat and drink sufficiently.

They are also often able to communicate effectively with a person who has dementia or another form of cognitive decline in a way which even the most highly skilled staff cannot manage – love makes all the difference.

Finally, for older people with dementia we understand there is clear evidence that connection helps to slow down the progress of the disease, whereas its absence helps to accelerate it. The very hard reality we must all contemplate is that for many care home residents, they don’t have time for us to get this absolutely right and therefore it is about balance – like every decision we have to take with and for them.

■ The blog in full can be viewed here: nationalcareforum.org.uk/blog-posts/visiting-incare-homes-where-now

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2020 Congratulations to our next winners – Shawn Lowmass, Maintenance Broadwater Lodge, Care UK

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news

November 2020

www.careinfo.org

Regional providers’ associations – their role in challenging times Surrey Care Association chief executive ERICA LOCKHART talks about the role of local care associations in supporting individual care services.

“W

hy join a local care association? What’s in it for me?” As the chief executive of a leading one, these are questions that I’m commonly asked. And while I always answer them as succinctly as I can, during the Covid-19 crisis these questions have been answered a hundredfold – something that helps me enormously when trying to convey the work we do as an association to those who ask.

The events of the last few months have thrown our work into stark relief, but long before the current pandemic, care associations up and down the country have been providing invaluable support and advice for care providers.

It’s just that now, more and more providers are appreciating the significance of our contribution and recognising the benefits of being part of a care association.

Indeed, there’s never been a more important time to be an active part of your local care association.

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You are not alone The number one reason for doing so is that no provider needs to feel alone.

Given the deluge of changing guidelines and rapidly evolving recommendations, it’s very difficult for a lone provider to stay on top of and abreast of the relevant requirements.

It’s not just guidance either – there are myriad other complications to consider.

Where do I go for testing? How do I access PPE? Care associations, and certainly in the case of the Surrey Care Association, have worked as a focal point for all communications – either through helplines, websites, mailings and more. We were and are a constant source of information and clarification, helping providers to decipher and subsequently implement the latest government advice.

The thing with government guidance – in any scenario, not just during Covid-19 – is that, as it’s a centralised voice, it

effectively delivers a one-size-fits-all approach, without taking in to account individual, or even regional requirements.

Of course, rolling things out on a national level makes focusing on any of the minutiae almost impossible to achieve – so, it’s here at the local level where care associations come into their own.

Most local care associations are members of the National Care Association Alliance (of which I am co-chair alongside Melanie Weatherley from Lincolnshire) which has proven to be incredibly helpful in recent months, but again, it’s at the local level where we, at the SCA, help to disseminate the relevant details and ensure care providers understand what’s applicable to them and how to apply it.

Care associations also help to build up advantageous relationships with key services, becoming the conduit between individual providers and larger organisations, such as the NHS or local authorities, and helping to lobby or raise issues, as well as providing general support around any interactions with these bodies. As an association, if any providers come to us, we will speak on their behalf – for instance if a courier doesn’t arrive, or if they need help with securing additional PPE – we will act as their voice, while also simply offering comfort and reassurance in times of stress, assuring them that they are not on their own.

A recent example where our role came to the fore was in the distribution of the Infection Control Grant. Working closely alongside the local authority in Surrey, we worked up ideas around the appropriate guidance as to what providers could and couldn’t spend the money on. The constraints were challenging, so we worked with the local authority to determine a workable plan, and then shared with other local care associations so they could come up with their own strategies thanks to our involvement with the Care Association Alliance, which allows us to share and

collaborate across the UK. We’ve received some much appreciated feedback in recent months – something that helps us recognise the value of what we do, which I thought I’d share. This example is feedback from Charlie Hoare, the managing director of the Huntington & Langham Estate in Hindhead, Surrey.

Charlie said: “I just wanted to say a big thank you for the newsletter; it is absolutely brilliant for so many reasons. Not only does it collate so much vital information in one place, but the signposts to other organisations/initiatives are really useful. It’s so reassuring to have this as a resource, particularly for us, as an independent home with no ‘head office’ feeding us this information – it is often up to me to find this info for myself, and you’ve done so much of the hard work for me, so thank you!”

This feedback encapsulates a central part of what we do. Care providers are busy, with management and senior staff having countless responsibilities to undertake and oversee day-to-day. We help providers by taking the latest guidance and working out what’s needed from them and what they need to do, thereby saving them time and making the process far easier – enabling them to focus more on the process of caring for their residents.

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legal landscape

November 2020

www.careinfo.org

Winter Plan brings cold comfort on the regulatory front A new regulatory approach adopted as part of the Winter Plan for Adult Social Care will place an additional burden on already hard-pressed providers of care services, says LAURA PATON, senior associate solicitor at Ridouts Professional Services.

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n 18 September 2020, the government published its Covid19 Winter Plan 2020 to 2021, setting out the national support for the adult social care sector in England to curb the spread of Covid-19.

The plan contains a number of support measures and is accompanied by a welcome commitment to provide more than £500 million of additional funding to extend the Infection Control Fund to March 2021. However, it may not all be all positive news for providers. The DHSC press release heralding the publication of the Winter Plan states that the Government: “is prepared to strengthen monitoring and regulation by local authorities and the Care Quality Commission (CQC), including asking them to take strong action where improvement is required or staff movement is not being restricted. This can include restricting a service’s operation, issuing warning notices or placing conditions on a provider’s registration.”

Does this spell the end of the supportive role that CQC professed to be playing at the outset of the Covid-19 pandemic?

It certainly appears from this statement that providers should be braced for tighter regulation and increased enforcement action. Just what they need while trying to deal with a second wave of coronavirus.

The plan itself does not contain a huge amount of detail surrounding any strengthening of regulation by CQC. In fact, the specific section of the plan related to the CQC’s involvement is headed “CQC Support”. That section refers to the actions that CQC will take in terms of both regulation and sharing best practice. On CQC regulation specifically the Winter Plan states that: the CQC will: ■ introduce a Transitional Regulatory Approach from October, which will bring

ridout-law.com together existing methodologies with new learning from its Covid-19 response.

This approach will place people who use services at its centre, and will focus on safety, access and leadership: ■ develop a new approach to monitoring which will capture a much broader range of topics, as part of the monitoring process, to present a clearer view of risk and quality; ■ increase the number of physical inspections, focusing on high-risk providers where there are safeguarding concerns, the provider has an overall rating of inadequate, and other factors; ■ continue to inspect any service where people may be at risk of harm and publish a report for each inspection in line with normal procedures; ■ ensure that all inspections of care providers consider how well services are managing infection prevention control, taking swift regulatory action where provider-level performance requires rapid improvement, including adherence to infection prevention and control measures for visitors; and ■ ensure information on additional risks and pressures are raised with national government and relevant system partners.

The roll-out of the Transitional Regulatory Approach has of course been confirmed for 6 October 2020 onwards in adult social care.

The commitment above in the winter plan to “increase the physical number of inspections based on risk” is interesting.

Despite CQC’s position that its “regulatory role did not change” throughout the pandemic, CQC were heavily criticised in some quarters for failing to cross the thresholds of services at the outset of the pandemic. It looks fairly clear from the Winter Plan and CQC’s own Transitional Regulatory approach that

CQC does not intend another pause on inspection during a second wave.

Instead, the language in the Winter Plan and the Transitional Regulatory Approach, focuses on inspection activity that is targeted and on risks and concern including Inadequate services. This is a shift from the previous CQC strategy that promised to focus inspection activity based on risk and improvement. Whilst it will be argued that this approach will focus inspection resources based on risk at a time when there are real threats to service users in the form of the pandemic, it could actually mean increased risks if services which, on the face of it are not presenting immediate concerns, are not inspected as frequently as they should be.

It will also likely mean that services which are rated as Requires Improvement or Good which wish to improve their rating may wait much longer for an inspection visit that will result in a rerating. The focus of increased enforcement action in the Winter Plan appears to largely be around infection prevention and control measures. The plan repeatedly makes reference to the CQC’s enhanced scrutiny of this as part of their Infection Prevention Control inspections and the fact that they will take “swift regulatory action where needed.”

The Winter Plan highlights that CQC’s scrutiny in this area will include adherence to infection prevention and control for visitors and again refers to CQC taking swift regulatory action where standards are not being met and provider-level ➤ Continued on next page

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news

November 2020

www.careinfo.org

Report says social care should function as a ‘genuine and fair market’

The social care system in England must be overhauled to function as a genuine and fair market, says the Social Market Foundation (SMF), an independent public policy think-tank.

The SMF says new regulation and rules are needed to help ensure care-users pay the right price for care, and providers supply the levels of care the country needs.

A briefing paper from the SMF, sponsored by Bupa, argues that politicians and officials need to accept that social care in England is provided through a market system, with local councils and self-funded care-users buying care services from providers.

That market needs better regulation, the SMF said, urging ministers to create a new independent body to oversee care, setting rules for the minimum cost of care and identifying areas where an imbalance of demand and supply leads to unfair outcomes.

The SMF paper follows-up on a 2017 market investigation by the Competition and Markets Authority, which recommended the creation of an “independent body” to oversee the care market.

The paper points out that different purchasers of care services pay different prices, partly depending on their bargaining power. On average, wealthier care-users who fund their own care pay much more for care than local authorities who buy care for less wealthy users.

Self-funders pay 41% more for their care per week than local authorities, equivalent to £236.

While the SMF acknowledges there can be good reasons for such differences, including the different services offered to self-funders, it says wide differentials can indicate that local authorities are using a dominant position to drive down prices, raising concerns about the future supply of care.

Over the last five years, the social care sector has become more fragmented and overall, the supply of residential care beds has reduced as some providers leave the market, while demand

➤ From previous page

performance requires rapid improvement.

The language of scrutiny at provider level, rather than at location, means that a problem at one service could lead to scrutiny across all. At Ridouts we are already beginning to see this happen for providers with multiple locations. Provider level enforcement action could have potentially catastrophic consequences for a care business if, for example, CQC took action to de-register the provider rather than individual locations.

We have seen a marked increase over the last month or so in CQC using letters of intent requiring urgent action plans

funders) and sellers. This evidence, says the SMF, would help ensure policymakers considering social care are properly informed.

SMF director James Kirkup said that, while there could be good reasons for differences in the rates paid by local councils and self-funders, if local authorities were in a position to drive prices down, they may end up jeopardising supply by forcing providers out of the market for local-authority funded care.

“Like it or not, care in England is provided in a marketplace, where buyers and sellers agree on the price paid in exchange for a service,” said Mr Kirkup. “Since we have a market for care, National Guidelines: The CQC policymakers should do more to should create national guidelines for ensure that this market works fairly the minimum cost of social care and properly, for the benefit of the services. These should be designed people in it. in a similar way to the NHS national “There is not enough discussion tariff and allow for local variance in about the care system as a market. cost due to unavoidable differences.

Politicians need to do more to develop James Kirkup and implement policies that will make Demand forecasting: The CQC that market work in the long-term should have a duty to provide governinterests of users and the country as a whole.” ment, local authorities and providers of social Bupa Care Services managing director Joan care with forecasts for future demand by need Elliott said the Covid-19 pandemic had and place. emphasised that the long-term sustainability of Cost of care forecasting: CQC should provide the care sector requires a well-funded system. government and local authorities forecasts on how “However, if it is to be truly successful, it also the cost of care delivery may change. This should requires structural changes such as those account for changes in need, wages and other highlighted in this report,” said Ms Elliott. local costs. This would ensure that decisions on “These findings are an important contribution where to allocate social care funding is made to the ongoing debate about social care reform based on the best available evidence. and, if adopted by the government, will help ensure that the needs of residents, carers, Monitor competition: CQC should monitor providers and taxpayers are properly met.” levels of competition and concentration in resi■ The SMF paper – A market for residential care dential care markets at a regional and local level services – is published at smf.co.uk/publications/ and carry out regular assessments of the market market-for-social-care/ power of both buyers (local authorities and selffor care has increased. In its report, the CMA found there was a significant amount of uncertainty among providers about the shape of future policy and the level of local authorities’ fees. This uncertainty, says the SMF, can lead to an absence of investment focused on provision for local authority residents, resulting in a lack of such capacity and, eventually, increased costs for local authorities when procuring care.

The SMF said ministers should act to ensure a better-functioning market for care, by giving the Care Quality Commission new powers to oversee the market, including four new tasks:

and/or the urgent imposition of Section 31 conditions of registration as its means of “swift regulatory action” following inspection. However, when the detail of these is drilled down, they are not always necessary or justified and they can and should be defended by providers where it is appropriate to do so Covid-19 has not changed CQC’s statutory duty to have regard to the need to ensure that enforcement action taken in respect of providers is targeted only where needed and that is proportionate to the risks against which it would afford safeguards. It is important that providers faced with enforcement action take swift advice if they find themselves in that situation. Whilst

responding to such action may seem like an additional burden in the current already very difficult operating climate, the consequences of not responding could have an extremely detrimental effect on care businesses such as restrictions on admissions or worse, closure of locations or de-registration at provider level.

Often the first step will be a robust factual accuracy response which, in some circumstances, might stave off a threat of enforcement action. However, even if it does not, that does not mean it is not possible to successfully defend the enforcement action. In those circumstances, providers should seek early and specialist legal advice to protect their position.

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25 November 2020 | Virtual event| Bookings open soon

Thank you to everyone who submitted nominations for the 22nd National Care Awards. Year after year, we are overwhelmed by the outstanding quality of entries and this year was no exception!

Here at Caring Times we recognise that Covid-19 has had a widespread effect on the care sector.

Despite the challenges that many of you have been, and are still facing, we know that there are incredible teams, staff, managers, homes, and groups out there that deserve recognition to reflect the hard work and achievements of all involved.

The Gala Evening and Awards ceremony on 25th November will be the culmination of a process many months in the making.

We cannot wait to announce our incredible finalists, who will all be contacted in October.

The Awards celebrate the very best people in the long-term care sector, highlighting excellence and rewarding those who work tirelessly to provide consistently outstanding care, and we can’t wait to celebrate this incredible sector with you in November!

We extend a huge thank you to our Sponsors, without whom this celebration would not be possible. Special thanks to our Main Sponsor, Christie & Co for their continued support!

main sponsor

award programme sponsor

category sponsors

Questions or queries contact • events@investorpublishing.co.uk Sponsorship opportunities contact • caroline.bowern@investorpublishing.co.uk

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ct interview

November 2020

www.careinfo.org

Caring Times editor Geoff Hodgson talks to Colten Care chief executive MARK AITCHISON about values, the company’s commitment to nursing care and coping with Covid.

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or more than 30 years, Colten Care has operated as a family-run care home operator in the southern counties of Dorset, Hampshire, Wiltshire and West Sussex.

Putting care before profit ensures

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Today the company operates 21 care homes for a total portfolio size of just over 1100 beds. Seven of those homes are currently rated Outstanding by the Care Quality Commission, with one retaining its rating at a later inspection. The other 13 to be inspected are all rated Good. I asked Colten Care chief executive Mark Aitchison to outline what he thought were the characteristics of a good provider, and I should really have known what his answer would be: “We don’t aspire to be a ‘good provider’ – we aspire to be an outstanding provider.

‘Good’ for us is the norm, but it’s not where we want to be. Everything we do is about being consistently outstanding through a good-to-greater journey of continual improvement.”

Mark Aitchison has been in post as chief executive of Colten Care for just on seven years and after building his senior team, one of the first things the company did was to adopt five core values; Colten Care would be friendly, reassuring, individual, honest and kind.

“These are the foundations that drive what we are about,” said Mark. “They have been embedded in the culture and our approach to care which we call ‘All About Me’ - ‘Me’ being the resident.

“One of the founding principles that has come from the shareholders has been that we put care before profit; that means our focus of attention is around delivering high quality care consistently – if you do that, then you will have a business that is sustainable in the long term, and you build profit. That ethos enables us to

sustainability recruit in line with our values to source the right quality of talent we need in the business. It’s important that we attract the best and we are not afraid of investing for the future; we make long term decisions.”

To have seven out of 21 homes rated Outstanding, one achieving this twice, is an enviable achievement but it took hard work and it didn’t happen quickly.

“We went through two or three years where we struggled to achieve an Outstanding rating,” said Mark. “We felt that CQC had got to a point where they almost had a prejudice against private providers. That all changed after the first inspection of our Kingfishers care home, in New Milton in Hampshire, in 2016. We achieved our first Outstanding rating and since then we have been able to chip away and get to where we are now. That first Outstanding rating showed us that it was possible and gave us confidence.”

Mark says that for a care home to be outstanding, having the right team in place is fundamental; the team has got to feel like a family, and work as a unit and each new member of staff is welcomed with a three-month induction programme.

They also have the support of a central team of quality, clinical, HR and learning and development managers.

“In recent years we have not been recruiting simply for jobs but for careers in care,” said Mark.

“Our recruitment processes are comprehensive and sophisticated and each position has a career path available to it; there is the opportunity to progress via NVQs, so a school-leaver could come in and become a healthcare assistant, progressing to senior care lead and onwards. We have a nurse associate programme which takes a clinical path or the home manager route. We focus on creating career paths with comprehensive training programmes which enable us to identify and nurture that talent. It’s great to see our internal talent grow.

“For those who just want to continue as reliable workers in their role, we are happy for them to do that but fundamentally it is about having the right team in the home.

We find that our highest level of staff turnover is in the first six to 12 months, where people may have been unfamiliar with the care world and who struggle with it. So that’s when staff need to be nurtured and helped to settle in.”

Colten Care was one of the first providers to take on the associate nurse programme, and is now in the second year of a partnership with Solent University, taking senior care leads and healthcare assistants and giving them the opportunity to move into nursing.

“A great deal of work goes into that,” said Mark. “It includes educational input and placements with other providers to

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ct interview gain that depth of experience. But we see the provision of nursing care as a fundamental part of our business. We are excited about developing our own nurses.”

The nursing imperative Which led us to a discussion of whether there was an argument for care home operators to become more flexible in their provision, perhaps developing assisted living models.

“Care homes and retirement living are two very different businesses and two very different business models,” said Mark. “Retirement living is aimed at those people who are entering the next stage of their retirement, who have the ability to look after themselves; who have and want that independence.

“The older persons’ care market then moves into how people can be best looked after, and if you are providing that care, I struggle to see how you can do that if you don’t have the ability to deliver nursing care as part of it. Many operators have moved away from that and are now focusing purely on residential care. For that group, I think the question is very pertinent because how do you then differentiate residential care from retirement living, because actually, when it come to the ability to deliver all the care needs a resident has as they get older and move towards the end of life, you haven’t got those skills in-house – you’re reliant on the community, which doesn’t make it very different from retirement living.”

Community engagement Colten Care has a strong commitment to making all its homes part of their local communities, with most residents coming from within a radius of about five to 10 miles and so strongly identifying with their local area.

Charles Hubberstey, Colten Care’s head gardener, judges entries in the inaugural Colten Village Produce Show last year.

“Working with our companionship teams our homes engage in ways which are mutually beneficial,” said Mark.

Residents enjoy being part of whatever the engagement is. Each of our homes has at least one nominated charity, predominantly a local one, that residents choose to support. Local groups will come into the home to give talks. In turn, we offer the home’s facilities to local groups. Each of our homes, in consultation with their residents, raise funds and then over the course of the year they hold various activities. This was in the pre-Covid world of course.”

Coping with Covid And what of the pandemic, I asked Mark. How has Colten Care coped over the past year?

“I would like to think we have weathered the storm,” he replied. “We were fortunate in making the decision to put our homes into lock-down in early March. Because all our homes are registered for nursing care and our clinical excellence is second to none, we have sound infection control policies; we are used to dealing with issues, such as controlling norovirus. So in some respects, although Covid-19 was an unknown, it was a known in terms of what procedures we needed to put in place. I lead an active ‘Covid team’ which meets weekly to maintain a responsive, well-thought-out approach to the virus. It’s all about making sure our home managers have the right information they need in a timely way to keep residents and staff safe.

“Throughout the pandemic we have tried to stay in front of what is required; making sure we’ve got the PPE we need, putting in place a comprehensive set of policies, and slowly but surely our homes have gained a sense of reassurance that what we are doing is working.”

Winter worries Along with other operators Mark is concerned about how to maintain residents’ wellbeing over the coming winter months while pandemic-related restrictions remain in place.

“Residents have been in their homes since March and have not been able to get out. We have had a lovely summer and they have been able to enjoy the gardens but now, as we move into winter, with shorter and darker days, I am worried about the psychological effect this will have, and how we will manage that. None

November 2020

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of the guidance suggests that it is remotely appropriate to relax visiting rules and even though we have pushed the boundaries of some of the visiting guidelines, we still have to sociallydistance. I had hoped we might be able to treat care homes as ‘bubbles’ but residents have to socially distance, which means we cannot do minibus trips.

“We are now investing more in our companionship teams and looking at what can be done to help stimulate and engage residents. One of the things we are doing is the Colten Produce Show, which is in fact in its second year. It’s done through our garden teams and our companionship teams. It uses the gardens and there are various judging categories, around vegetables, making jams, and so on. The residents love it and we get tremendous engagement including in our dementia communities – there are so many levels at which they can engage and it is these simple things that can make a big difference to residents’ wellbeing.”

Positive image Mark said one of his big frustrations was that the national media often portrayed the care system in such a way that left people very frightened by the thought of moving into a care home environment.

“This kind of scaremongering in the media has been going on so long that, if we’re not careful, it will destroy the fabric of the social care system. We have people who will think twice about wanting to move into a care home and it is making recruitment still more difficult; who would want to enter a work environment which is portrayed so negatively? I think there will be operators who will not be able to survive coming out of the pandemic.

“We should be doing much more to celebrate the positives; much has been achieved by care homes across the country in keeping residents safe through this time of adversity. Communication with residents and relatives has been key.

“Surveys we have done of residents throughout Covid have given us helpful feedback with people saying they feel relaxed, rested and positive, and that we are responsive to their needs. We are also starting to see increasing recruitment enquiries and applications from staff with and without care home experience wanting to work with us. We know the current situation its far from over but we feel we are in a good place to support families when they need us.”

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moving around in association with

Appointments Two recent appointments have been at Belmont Healthcare Group.

Clare Swan, pictured at right, has been appointed as head of quality and compliance, and Sallyann Briggs (below) as registered care manager. Both bring their considerable elderly care experience to the company after both working for a major care group.

Clare is also a board member for Kent Integrated Care Association and Sallyann is a registered Mental Health Nurse.

Belmont Healthcare operates five care homes in Kent, East Sussex, Somerset and Devon.

Scottish care provider Meallmore has promoted Carol-Anne Foote to the newly created role of commissioning and business development manager.

The new position will see Carol-Anne working with the operations team to develop the company’s portfolio of facilities providing person-centred care and support, while also expanding the offering of high-quality care to people across Scotland in both existing care homes and new developments.

Carol-Anne started her career as a registered mental health nurse and has more than20 years’ experience in the private care sector. She joined Meallmore in 2005 as care home manager for Forthland Lodge in Edinburgh, before becoming area manager for the central east region of Scotland in 2008.

During this time, she gained an SVQ in Management and has completed a Master’s degree in Innovation & Leadership at Letterkenny Institute of Technology in Donegal, Ireland.

Since opening its first care home, Meallmore Lodge in Inverness in 1987, Meallmore has grown to become one of Scotland’s major providers of private residential nursing and dementia care.

The company currently has a network of 23 care homes across Scotland, with a further one due to open in winter 2020.

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Westacre Nursing Home has welcomed Lynne Seymour as the new general manager. Lynne is a qualified mental health nurse who has devoted her working life to healthcare.

Though new to the 50-bed home, Lynne is not a stranger to the Westacre family, coming from her role as Matron at Peartree House Rehabilitation Centre in Southampton, which is under the same ownership as Westacre Nursing Home.

Lynne’s healthcare career extends back to her first job upon leaving school at 16; she began in housekeeping and was promoted to support worker before training as a mental health nurse at Southampton University School of Nursing and Midwifery.

After qualifying in 2005 Lynne worked her way up through the professional ranks, most of her experience over the years being caring for older people.

“This is undoubtedly a challenging time for everyone working in social care, but I feel confident in the team and this beautiful setting,” said Lynne. “We are ready and well-equipped to keep our residents safe and well whilst ensuring they are enjoying life and staying connected with their families and friends.”

November 2020

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Home care provider Candlelight Care has announced a promotion within its “Home First/Discharge to Access (D2A)” service.

Claire Hurford has been promoted to manager from her previous role as team leader. The Home First/D2A service works closely with the NHS to help patients who have been discharged from hospital, and Claire has led the service since Candlelight Care began offering it two years ago. Candlelight Care is a family-run company offering homecare and live-in care services in Dorset, Somerset, Wiltshire and East Sussex.

Specialist care provider Consensus has appointed Deborah Cotton-Soares as its new quality and compliance director.

Deborah brings more than 35 years of health and social care experience to the Consensus senior management team. She joins the group from the Care Quality Commission (CQC) where she has been the head of registration for the last six years.

Established in 2005, Consensus support over 650 individuals in more than 90 different services across the UK and employs over 1,600 colleagues.

Balhousie Dalnaglar care home in Crieff has a new manager with strong connections to the Perthshire town. Michelle Kinmont brings a wealth of care sector and nursing experience to the 37-bedroom home, run by Balhousie Care Group.

Originally from Perth, Michelle used to live in Crieff.

Her previous positions there included nursing at Crieff Cottage Hospital and managing another care home in the town. She returns to Balhousie Care Group having managed the provider’s Pitlochry care home from 2015-17.

Abbotsford Care has introduced a range of new specialist nurse roles, taking into account the specialist nursing skills required to best support those living in their care homes. The new roles include lead nurse practitioners in learning disability, older people, and dementia. The newest recruit to the specialist nursing team is Dolores Jackson who has joined Raith Manor in Kirkcaldy as a dementia nurse specialist.

Emma Bonellie, the manager of the 60-bed care home in Kirkcaldy, said the newly formed dementia ambassador team had already been working on new initiatives.

“It is great to have someone with Dolores’ skills and knowledge join the team,” said Emma. “I am looking forward to supporting them to continue the early success of the programme.”

Luxurycare, which operates five care homes across Bournemouth and Poole in Dorset, has appointed Alicja Wysocka as manager of Birds Hill Nursing Home in Poole which now operates under the new name of Eagles Mount.

Previously providing a mixture of nursing care and care for those with dementia, Eagles Mount, following a £200k refurbishment, will now exclusively offer high end residential care with some provision for those with low-level dementia.

Alicja is relocating from Redhill in Surrey where she was employed as a senior social worker. She has spent her life working in social care after coming to the UK from Poland in 2006, supporting people with a range of needs while training to be a social worker, qualifying in 2013.

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promotion

November 2020

www.careinfo.org

EF Group launches CaterCloud – the secret ingredient for menu management success Menu management software is free to use as catering sector recovers from impact of pandemic Manchester-based EF Group has announced it is offering free for life access to its new cloudbased, menu management platform, CaterCloud, which launched recently.

The easy-to-use, next generation allergen, nutrition, menu planning and costing system offers a wealth of enhanced functionality to help caterers gain significant efficiencies in their operations, to control costs and increase profits.

CaterCloud helps businesses ensure food safety remains a key focus. With food labelling regulations set to change in October 2021, as a result of Natasha’s Law, all England-based businesses working in the food industry will be required to clearly label all foods produced and packed on their premises with a full list of ingredients detailing the full allergen profile.

Designed to help businesses prepare for this upcoming regulation, CaterCloud provides sub-allergen information and tagging; QR Code scanning for live allergen and nutritional information, along with the ability to print Natasha’s Law compliant food labels. CaterCloud also offers customers access to a range of accredited training for allergen awareness and food safety.

CaterCloud’s innovative functionality also boasts many other benefits to enable simple menu management for caterers across the hospitality, healthcare, education and retail

sectors. It offers effective menu planning with dish and menu costings; access to a nutritional database with 1,000s of ingredients and customisable dashboards to record KPIs. Users of CaterCloud can also join the e-foods’ Buyers’ Club and benefit from its substantial buying power. The Buyers’ Club is made up of a network of trusted accredited suppliers across the UK. Users can purchase food and non-food goods from these suppliers with savings of between 5 to 10%.

Paul Mizen, Chief Executive, EF Group

said: “The service industries are moving at pace towards technology to help meet their stock ordering, menu planning and compliance challenges. Our experience shows that there is increasing demand for more advanced dish and menu costing tools, as well as detailed, easy to use product data.

“Catering managers require their menu management software to seamlessly integrate with their ordering systems and demand best value from their food suppliers. With CaterCloud, we will remain at the forefront of delivering the innovative features the industry needs.

“The entire catering industry has been heavily impacted by the Coronavirus pandemic and as businesses work hard to recover, we are providing CaterCloud for free to help maximise efficiencies and reduce costs. This is our way of giving something back to the industry upon which our business is founded.” www.catercloud.com

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TUESDAY 10TH – THURSDAY 12TH NOVEMBER 2020 VIRTUAL EVENT BOOKINGS NOW OPEN – TICKETS £49+VAT Over the last 15 years the UK Dementia Congress, organised by the Journal of Dementia Care, has built a reputation as the single event those working in dementia care do not want to miss – and we don’t want this year to be any different. Recent times have highlighted the passion, commitment and tenacity in the dementia care community. We are going to take as much of this as possible online, with a diverse selection of plenary and themed sessions, and opportunities for conversation and connections. We will come together in November, wherever we all are, to network and share ideas and experiences in a positive and supportive environment and to celebrate the contribution that you all make and will continue to make to the lives of people with dementia and carers.

We are excited to deliver an interactive virtual Congress, where delegates will have access to all plenary and themed sessions at UKDC, the virtual exhibition and poster presentations, plus networking and chat facilities to socialise with fellow attendees, speakers and exhibitors.

Attendees will also be able to view the Dementia Care Awards presentations on the 12th November! Additionally, there will be access to the sessions after the event, so you will be able to revisit the sessions.

WHY SHOULD YOU ATTEND?

PLENARY SPEAKERS

• •

Paola Barbarino, Alzheimer’s Disease International

• • • • • • • •

CPD certified conference programme Plenary sessions, keynote speakers and a wide choice of parallel sessions, symposia and interactive workshops Over 40 sessions to choose from covering the latest in dementia care, research, policy and innovation People with dementia and carers sharing their experiences Large and interactive virtual exhibition Themed and facilitated networking sessions Congress app Poster presentations Panel discussions and audience question time Opportunities to network with like-minded individuals

People living with dementia (DEEP) and carers (tide) Professor Linda Clare, University of Exeter Jackie Pool, Sunrise Senior Living & Gracewell Healthcare Dr James Warner, Imperial College London

careinfo.org/event/uk-dementia-congress

Programme: theresa.ellmers@investorpublishing.co.uk Sponsorship and virtual exhibition opportunities: caroline.bowern@investorpublishing.co.uk Bookings: events@investorpublishing.co.uk

in association with

academic partner

stream partners

satellite symposium sponsor

Association for Dementia Studies

Plenary speakers • Themed sessions • Symposia Interactive workshops • Poster presentations A strong theme will be the way the Covid-19 pandemic has demanded changes in dementia care practice in all settings, the innovative ways challenges have been met and the way ahead.

in association with

academic partner

supporting partner

stream partners

satellite symposium sponsor

Association for Dementia Studies

TUESDAY 10TH – THURSDAY 12TH NOVEMBER 2020

VIRTUAL EVENT

Sessions will include: • Covid-19 – review, reflection and the road forward in dementia care • Innovations and evaluations in staff development, training and education Full • Creative ways to connect through technology programme • Music and music therapy – Individual arts interventions – online Intergenerational arts practice • The ‘uniform’ question • Care homes workshops: Equality Act and Mental Capacity Act • Stress and distress: Non-pharmacological interventions / A review and new guidelines on responding to ‘behaviours that challenge’ • Self-management, peer and early support • Care and support for people with dementia at home • Experience of people with dementia from minority ethnic communities • New dementia service models: Co-producing services – Social prescribing of arts – Housing with care • Best practice in sustaining post-diagnosis support groups • Reducing polypharmacy / Supporting mobility – practical approaches • Younger people with dementia – diagnosis and support, resources from the Angela Project • Carers and Families – caring in lockdown – distance caring – living grief and bereavement • LGBTQ people living with dementia organised by

#UKDC2020

careinfo.org/ukdc

There are also dedicated whole day special interest sessions on: • End-of-life care in all dementia care environments – challenges for care homes, enabling a good death, advance care planning • Dementia care in acute hospitals – Covid-19 workshop, innovation and research, arts and intergenerational practice

organised by

JournalOfDementiaCare

@JDementiaCare

#UKDC2020

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dementia care

November 2020

www.careinfo.org

A carer cared-for – Rhonda lives well with dementia

R

honda Rowe, a resident at Borough Care’s Wellcroft home for older people in Gatley, Greater Manchester, was diagnosed with dementia in 2015.

Rhonda used to work for Borough Care, as a carer at its Lisburne Court home in Offerton. Rhonda cared for residents living with dementia and those who needed the additional support of residential care.

Edward Coverley, activity lifestyle facilitator at Wellcroft, said that, despite her dementia, Rhonda continued to enjoy her favourite things, including spending time with her daughter, gardening, listening to Elvis records and watching King Kong movies.

“Rhonda lives incredibly positively with her dementia,” said Edward. “Her years as a carer at Borough Care are still clear in her interactions with others. Just the other day, a resident with advanced dementia encroached the personal space of another resident; Rhonda instantly recognised these behaviours and how they can cause agitation and distress to those living with dementia. She walked over and gently guided the gentleman away from the other resident to participate in another activity. She is a true inspiration.”

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Rhonda and her daughter Gabby Wright have an incredibly close bond and enjoy trips out together. Even after it became apparent Rhonda’s dementia journey had reached the point where she needed 24-hour care, and she became a resident at Wellcroft, Rhonda and Gabby were still able to go out together and experience new things.

Both ladies are passionate animal lovers and Rhonda’s dementia hasn’t changed this. Gabby Former care worker Rhonda Rowe is now a resident at Borough Care’s took her mum to a Wellcroft care home in Gatley, Greater Manchester.

Meerkat Animal Experience at Chester Zoo and last year, during a holiday together in Cornwall, Rhonda got to stroke a penguin for the first time in her life and feed sea lions at a sanctuary.

Gabby has found the animal experiences have really helped her mum since her dementia diagnosis, bringing out her caring side and helping her find great enjoyment and peace.

“When my mum was diagnosed, she was scared,” said Gabby. “She Rhonda and her daughter Gabby have an incredibly had seen her own mum close bond and enjoy trips out together. go through the same thing and she knew what Borough Care got in touch with Caring to expect. Now mum is Times and told us about Rhonda to mark doing what she wants, on September as World Alzheimer’s Month her terms, before the by celebrating the lives of its inspirational condition really takes residents who are living with dementia. hold. Just as when I was a World Alzheimer’s Month aims to raise child, mum still loves our awareness of the disease and challenge days out together. There the stigma that surrounds it. This year, is still so much of this the focus of the campaign was to get country we want to see people talking about dementia, to help and things we want to do drive change and better support those together. As soon as we living with the condition. are allowed to travel Borough Care says Rhonda is a true again, we will do it. inspiration and proof that, with the right Alzheimer’s won’t stop help and support, people can live well Animal experiences have really helped Rhonda, helping her find great enjoyment and peace. her yet.” with dementia for many years.

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infection control

November 2020

www.careinfo.org

Effective management is key to controlling Covid-19 Management consultant ANNE SMITH looks at infection control through a management lens.

W

24

ho would have thought a year ago that the key management skill for 2021 would be the management of infection prevention and control (IPC)? And in the plethora of information written, where has been the guidance on the management skills and processes needed to ensure Covid-19 precautions are at their best? When CQC published new guidance in August 2020 on IPC it was firmly planted in the “Safe” key line of enquiry (KLOE) with no real reference to “Well led”.

It is the human factor that results in Covid-19 spread and government advice has centred on what we, as humans, need to do to minimise the risk of cross infection. Media coverage would almost have us believe that getting Covid-19 as an individual or within care homes is all but inevitable but this is not the case.

However, it is dependent on every staff member practising impeccable infection prevention and control, making effective management to ensure this happens so important. Each home is only as strong as its weakest link.

Managers may ask themselves “what did I do before Covid-19?” The 80/20 Pareto principle of inputs and outputs seems to apply in some way, with Covid prevention and management taking up the lion’s share of time. To reverse this so that less time is spent on Covid-19, but to greater effect, a really systematic approach is needed which drives continuous improvement.

What are the key management practices to prevent the spread of Covid-19 when it is recognised that faultless hand hygiene, the proper use of PPE, social distancing, testing, barrier nursing (source isolation) and a high standard of cleanliness are pivotal but that the guidelines change frequently?

The manager walk-round is key to checking many of these elements and more; take mask wearing.

During the summer months, when

Covid-19 levels were low, masks worn below the nose or chin seemed to become a fashion statement. Habits are a problem because they become a routine and it is difficult to get back to the desired behaviours needed as the incidence of Covid-19 increases; therefore regular mask checks by management, the frequency dictated by the level of current noncompliance, must be a priority.

Other advantages of a walk-round are the increased opportunity it presents to communicate and explain, to coach and teach, and to observe both residents and staff, their interaction, the social distance kept and the cleanliness and use of the environment and equipment. The walkround however must be carried out safely to protect all concerned.

In regard to hand hygiene, the increased frequency of handwashing does not confer faultless technique; if anything our routines change over time. Therefore, regular detailed and recorded handwashing checks of all staff ensure they retain the knowledge and maintain the skills. The use of a UV forensic torch can introduce a fun element into the serious business of detecting areas of the hands not cleaned effectively and that needs to be addressed.

Barrier nursing needs practice. During the first phase of the pandemic, care homes with recent experience of infections such as norovirus were reported to do better with Covid-19 infections than those which had not had the experience, probably because the former knew what to do. Those homes without this experience would do well to practise and audit their own barrier nursing techniques in readiness for any infectious event that might occur, and so enable staff to take immediate and effective infection control measures in their stride.

The significant advantage of sustained management and training in infection control is that IPC becomes second nature, protecting residents at work but spilling

The significant advantage of sustained management and training is that infection protection and control becomes second nature, protecting residents at work but spilling into staff’s private lives too. into staff’s private lives too.

In addition to managing the main infection prevention principles, Covid-19 management keeps getting more detailed and nuanced with the ever increasing and changing guidelines. A high quality, up-todate audit can help manage this effectively and efficiently. It should be regularly repeated whilst the risk is high. The advantage of a well-executed audit is the identification of the chinks that could let Covid in, it recognises good practice as well as the work still required. That work must be looked at through a management lens, which takes the opportunity to set standards, develop and engage staff, ensure improvements are sustained and that Covid-19 is actively managed.

■

Anne Smith – management consultant – brilliantcaresolutions.co.uk

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promotion

November 2020

www.careinfo.org

CQC praises Wavewash hand washing timer in review of coronavirus preparedness The Wavewash contactless 20-second hand washing timer has been highlighted as an example of good practice by the Care Quality Commission (CQC) as part of a thematic review in response to the COVID-19 pandemic.

The CQC has carried out targeted inspections of 300 care homes in England to gather information on their experiences and preparedness for future spikes of coronavirus.

The review aims to learn about the strengths of care services across the country and to identify any gaps or concerns around infection prevention and control practice.

While the initial findings of the review have now been published online, individual inspection reports have also been shared with each of the 300 care homes across the country. A full report was expected to be published in October 2020.

One of the care homes to be inspected was The Lodge care home in Essex, which provides accommodation and personal care for up to 36 older people, including people living with dementia.

The CQC’s inspection report of The Lodge identified Wavewash as an example of good practice, alongside measures such as clear signage, thermal scanners, hand gel, plastic screens and face masks.

As a result, the inspectors were assured that the provider was: • Preventing visitors from catching and spreading infections • Meeting shielding and distancing rules • Admitting people safely to the service • Using PPE effectively and safely • Accessing testing for people using the service and staff • Promoting safety through the layout and hygiene practices of the premises • Making sure infection outbreaks can be effectively prevented or managed • Maintaining an up to date infection prevention and control policy Made in East Anglia, Wavewash was created by a team of British engineers as a practical and simple device to aid and encourage better hand washing habits. Launched this summer, the device is now being used in offices, care homes, hospices, schools, food production kitchens, cafes and in households.

Wavewash uses LED lights and sounds to help a user wash their hands with soap and water for the recommended 20 seconds in order to remove almost all microorganisms from their hands - including COVID-19 coronavirus.

Explaining the background of the inspection, the CQC inspectors said: “This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

“As part of CQC's response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

“This inspection took place on 20 August 2020 and was announced. The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.”

As well as Wavewash, the inspectors also singled out a newly installed electronic blind which will enable residents to have indoor visits with relatives in future, with the blind acting as a plastic screen between them which can be cleaned and rolled up after each visit.

The care home was also praised for its plans to facilitate a range of visiting options for family members, including the use of a garden window, virtual visits and drive-through visits.

Tom Lyons, Managing Director of Black Swan Care Group, which owns The Lodge as well as 19 other care homes in Norfolk, Cambridgeshire, Essex and Lincolnshire, said: “Hand washing is a vital component in our approach to reducing infection and supporting overall hygiene and cleanliness. We’re really impressed with Wavewash which we now use in all of our care homes to help staff and residents wash their hands thoroughly.

“While things have certainly improved across the country since Spring, our whole sector is bracing itself for the second spike that’s expected in the coming months so we’re taking every precaution.

Of course, washing your hands is one of the easiest and more effective ways of preventing the spread of germs and viruses so helping people to wash their hands thoroughly enough is crucial.

“We’re proud of the steps we’ve taken to protect our residents and staff from coronavirus and we’re really pleased that these have given the CQC the assurance they were looking for.

“One day, we’d love for families to hug one another as they used to and hopefully that won’t be too far away. But first, we need to look after the health and wellbeing of our residents by doing what we can to protect them from COVID-19.”

Care providers in England are currently responsible for decisions regarding the circumstances, times and frequency of visits to care homes. These decisions must be in line with advice from local directors of public health who will be developing local ‘dynamic risk assessments’ based on principles outlined in the government’s guidance.

While some care homes have begun opening up

the ability of family members to visit care homes, it is being controlled based on the risk assessments and it is subject to the specific circumstances of each care home and those living and working within it. As a result, the frequency of visits, their duration and format will be limited and/or controlled for some time.

With the rising number of cases across the UK and fears that the country is now experiencing a second wave of COVID-19, it has become crucial for care homes across the country to take appropriate measures to improve hygiene and cleanliness in their premises, with devices such as Wavewash proving to be simple and effective in aiding good hand hygiene.

In their inspection summary of The Lodge care home, the CQC inspectors noted: “We found the following examples of good practice.

“The service had a clear process in place for visitors. Signage on the door alerted people to the current restrictions on visitors and a free standing thermal scanner was in place to check people's temperature on entry. Sanitising hand gel and masks were provided.

“The provider had installed ‘Wavewash’ timers in areas where staff washed their hands. The timers use lights as a visual aid to count down the time needed to effectively wash hands.

“People were supported to stay in regular contact with their families. The provider had created an easy to read guide for families and friends explaining the different options for visiting including use of the garden, window or drivethrough visits and virtual visits through the use of technology.

“The provider had recently installed an electronic blind in a designated area of the lounge to enable people to have indoor visits with relatives in the future. When lowered the blind created a plastic screen between the person and their visitor. After each visit the screen could be cleaned and rolled back up to the ceiling.”

Martin Hurworth, co-founder of Wavewash said: “When we created Wavewash during the lockdown in Spring, we knew that it could play a vital role in care homes which do their utmost to protect the vulnerable people they look after.

Washing your hands is a simple and effective way to prevent the spread of coronavirus, and everyone can do it. We’re delighted that patients and staff at The Lodge have taken to Wavewash so well and we’re really pleased that the CQC has recognised the role it can play.

“We’re anxious about the situation we’re facing at the moment, but I hope that with steps like those which are being taken at The Lodge and across Black Swan Care Group, we’re much more prepared for this second wave of the pandemic and we’ll be able to protect our loved ones from the virus.” www.wavewash.co.uk

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technology in care

November 2020

www.careinfo.org

JESSICA JENKINSON, governance and operations manager at Radfield Home Care, looks at how providers can use technology to ensure compliance and deliver a higher standard of care.

A tech-led approach to

compliance A

26

ny care provider who strives for excellence wants to see their hard work reflected in their latest CQC report. Yet every inspection inevitably brings with it a mountain of paperwork, a last-minute rush and, no matter how diligent the provider is, there is the worry that something important has been missed.

Compliance is non-negotiable – but we all know the time it takes to fill in forms and find information in a complex system of spreadsheets and paperwork which diverts valuable resources away from delivering quality care. And, whether they realise it or not, manual processes give managers few insights to inform effective decisions.

Until recently, we were in the same boat as many care providers with a paper-based system that was timeconsuming to manage and made us vulnerable to mistakes. But technology is changing how the sector operates; helping to reduce administration, standardise processes and maintain compliance.

Simply having a central system that allows us to view all information in one place is a huge bonus and will enable us to plan better for upcoming inspections. I no longer have to check multiple systems or spend time downloading reports because everything I need to track trends is already there.

Simply having a central system that allows us to view all information in one place is a huge bonus and will enable us to plan better for upcoming inspections.

We can expand the business further, confident that everyone will be using the same standard system and we won’t be taking on an unmanageable amount of work.

Importantly, we have been able to set clear and consistent standards across the business, so nobody inadvertently fills in an old form or paperwork. We use the system to store and access information securely, so I don’t undertake as many face-to-face visits to find out about potential issues. I know about them already and can take action to make sure compliance doesn’t slip.

Internal auditing has also become easier and more effective since adopting new technologies. We have full control of the audit content and frequency, so I’ll write them to align with what I need to report for our monthly quality improvement meetings.

This process means that any problems flagged-up in an audit must be addressed as part of a clear action plan. We’re able to allocate tasks to the right members of staff and a breadcrumb trail is created to ensure accountability. As well as enabling management to monitor progress, it means we have all the relevant information to show to the CQC if asked.

With all audits stored electronically, we have reduced the number of files locked away in offices to support our goal to become a paper-light organisation.

Managers elsewhere in the business have full visibility of their service and can highlight areas for improvement, helping us to drive up standards. They’re also able to submit evidence of lessons learned from any accidents, incidents or

complaints to demonstrate to the CQC that we’re continually striving for the best outcomes for clients and staff.

Radfield Home Care has grown a lot in the past year or so and today we have 14 branches covering areas around the UK. As new partners came on board, each with their own IT systems and inspections to prepare for, accessing information eventually took up too much time. Not only that, it exposed us to risk and non-compliance as we were tracking data in so many spreadsheets.

We are now in a position where we can expand the business further, confident that everyone will be using the same standard system and we won’t be taking on an unmanageable amount of work.

A CQC inspection invariably brings a sleepless night or two but good preparation should alleviate that. Unlike the old days, when providers had no choice but to spend hours on paperwork, digital systems should allow the establishment of the right processes and access to information. This means providers are able to address any concerns, no matter how minor they seem, so there are no nasty surprises when the rating is received.

Since technology is capable of doing much of the heavy lifting, we’re able to concentrate on the areas of the job that deliver value and ultimately improve compliance no matter how much the business grows.

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building with care

November 2020

www.careinfo.org

Country Court builds nursing home in Camberwell Development of a new nursing home in Camberwell, Southwark is well underway, bringing hundreds of jobs to the area and addressing the high demand for nursing care in the borough. The new home which will offer nursing, residential, dementia and short-term respite care for up to 99 people.The care home has yet to be named and operators Country Court Care are asking for suggestions from people in the local area.

Country Court managing director Alykhan Kachra said the project had been developed in partnership with WGP Architects and Horizon Building Contractors.

“Our aim with this project is to create an environment that promotes healthy living and apply that to the design of our care home,” said Mr Kachra.

“By choosing to work with architects that have not worked on a care home before we have been able to approach the project from a completely new angle, while still reflecting our usual family and community-led approach to care.”

Mr Kachra said the result is a thoughtfully considered mixture of “fabric first” interior, with careful use of natural materials and good light –

Illustrative view of Country Court Care’s yet-to-be-named nursing home now being built in Camberwell, Southwark.

both natural and artificial. The building plan features a central common space with atria linking between floors to give a sense of community.

The home’s designers say the interiors will represent a marked departure from most care

homes with careful positioning of mini-atria between compatible floors, using a penthouse level for either pre-bookable private dining spaces in addition to a ‘club house’ that can serve either as an additional activity space or refined social space.

L&G donates £5m to Newcastle care project Legal & General and Newcastle City Council have announced a £5 million charitable partnership to enhance elderly care in the city.

Legal & General’s £5 million gift to the city will be used in two distinct projects. Initially and with immediate effect, it will help fund additional independent living facilities for older residents within the Future Homes Alliance project at

Newcastle Helix, managed by the City Council’s housing partner, Karbon Homes.

The second, larger component of the donation will provide core funding for a 20-25-bed “new model” residential care home. This project, for which Newcastle City Council will identify a site, will be a prototype which moves away from the traditional large-scale care home to a more

The Future Homes Alliance project at Newcastle Helix, managed by the City Council’s housing partner, Karbon Homes.

domestic, clustered, communal setting. Its design and operation will incorporate key lessons learned from the Covid-19 pandemic, including on infection control and operation of lock-downs and “support bubbles”, helping to minimise negative effects on residents, particularly those living with dementia.

The care home’s construction will be led by the City Council who will also own and operate the facility.

For Legal & General, funding these facilities forms a further component part of the company’s “Let’s Care for Britain” programme.

This already includes a £20m, seven-year investment in research into future elderly care by Edinburgh University, which is already working on this in partnership with Newcastle University. This support has already “crowded in” an additional £20m of funding from other sources.

Legal & General chief executive Nigel Wilson said elderly care was already a major issue for the group and many of its customers, and that Covid19 had been a tragic blow for many in the care sector – including in the North East.

“We have to find better ways to care for older people, and these prototypes will accelerate the process, demonstrate what can be done and what is viable, and complement the academic work we already sponsor,” said Mr Wilson.

“Doing this here, alongside brilliant partners, cements Newcastle’s position as a national leader in care.”

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building with care

November 2020

www.careinfo.org

Later living village proposed for Inverness A later living village is being proposed in the Milton of Leys area of Inverness. The courtyard development of 11 two bedroom homes will form part of a new multi-million pound care hub planned

by Grantown-based Parklands Care Homes.

The single storey properties will offer double and single bedrooms, living room with bay windows, kitchen/dining room, sun room, bathroom and storage. Each property will have a semi private garden area and a parking space.

Within the courtyard development, a central open area will be created with stone dykes, seats, grass and decorative shrub planting. Communal areas will be landscaped with native species plants, trees and hedgerows and will be maintained by Parklands Care Homes. The site will also offer visitor parking.

The homes will include high levels of thermal insulation to maximise heat retention and LED lighting throughout to reduce energy use.

The proposed village would form an integral part

of the new care hub envisaged by Parklands that would also include a 59-bed care home, already granted planning permission.

Work on the care home is likely to begin in early 2021 once a preferred contractor is selected. If approved, it is hoped the village project will be built in tandem with the care home or shortly after. A playgroup for local children also forms part of the care hub vision.

Parklands Care Homes managing director Ron Taylor said the proposed village development was designed to act as a bridge between independent living and the care home sector, with residents being able to access the range of social activities, cleaning, laundry and catering services offered by the care home, while leading otherwise independent lives.

“Since we were initially granted planning consent for the Milton of Leys site in 2018, our plans have evolved and we believe this new mix of care home provision and independent living better

Illustrative view of Parklands care Homes assisted living development at Inverness

reflects the care needs of the local community,” said Mr Taylor.

“Our homes will be aimed at older people who, while able to lead relatively independent lives, feel they might benefit from the additional support of a professional care team. For those who ultimately require full time care support, the village will act as a stepping stone to our new care home.

“If successful, this is a model that we would like to roll out to other areas. More of us are living longer and fuller lives and the way we provide care for older people needs to be more flexible. Not only does this new model ensure older people can continue to live largely independent lives, it will help to release housing stock as the older generation downsizes.

“This is a relatively new concept for the Highlands, not least because our care hub will also include a playgroup for local children. We think it will be hugely beneficial for the city and wider region.”

A planning application for the later living village has now been submitted to The Highland Council.

Parklands currently operates eight care homes in Tain, Muir of Ord, Grantown, Aberlour, Keith and Buckie. The company also operates Aberlour Pharmacy.

Parklands is also currently building a £5.5 million care home in Fortrose. Originally planned to open this summer, the project is now likely to be completed at the end of this year because of the Covid-19 related construction shut down and continuing supply chain difficulties.

Work begins on £60m Inspired Villages scheme in Bedfordshire 28

Legal & General’s later living business, Inspired Villages, has started construction at Elderswell, a £60 million later living scheme in Turvey, Bedfordshire.

The project is part of a development pipeline, with Inspired Villages to deliver more than 2,500 specialist homes for over-65s in the next six years.

Together, these planned schemes will create around 1,000 construction jobs per annum, and up to 640 permanent jobs once the retirement communities are complete and operational.

Once complete, Elderswell will offer 130 ageappropriate homes, as well as facilities in the village centre, including a restaurant, café, wellness centre (featuring a fitness studio, gym and Jacuzzi pool), and library for both the residents and the local community. Phase One will see 76 homes and the village centre built by mid-2022.

Elderswell is the second Inspired Villages scheme in Bedfordshire. The following deals have been achieved by Inspired Villages during the coronavirus lock-down period: ■ Planning permission for a 270-home, £215 million scheme in Kingswood, Surrey, which will

be one the biggest retirement villages in the UK once complete.

■ Planning permission for a 146-home, £100 million scheme in Tunbridge Wells, Kent.

■ A site acquired with outline planning permission for a 200-home, £120 million retirement village in Caddington, Bedfordshire.

■ Planning permission for Phase 2 of development at Inspired Villages’ seven-acre Ledian Gardens scheme in Kent, which adds an additional 50 apartments to the existing works.

Inspired Villages development director Neal Dale said that in 2020, the company had achieved planning permission to deliver 806 much needed age-specific homes across the UK. “Construction at Elderswell marks a significant milestone for Inspired Villages and the development team, demonstrating our ability to move swiftly from planning to starting works,” said Mr Dale.

“We have an important role to play in providing high quality later living housing across the UK; helping to address the social and economic

issues that come as a result of an increasing ageing population.”

Phil Bayliss, chief executive of Later Living at Legal & General and chairman of Inspired Villages,said retirement communities such as Inspired Villages had been proven to positively impact loneliness; reducing the negative effects of self-isolation.

“As much of the younger generation start to settle back in to life as lock-down restrictions have eased, for our older members of society it is a different story,” said Mr Bayliss. “For many, their ‘new normal’ is extended isolation, with the risks still at the forefront of their minds. For elderly people who live alone, which is estimated at around 2.2 million over 75s in the UK, the prospect of indefinite isolation is likely to see a sharp rise in the number of lonely people in this demographic.

“Inspired Villages has capital commitments of half a billion pounds across its villages, and a pipeline to deliver more than 2,500 homes over the next six years. Elderswell represents just one of a number of key milestones already achieved this year; I look forward to maintaining this momentum and progressing with an active construction pipeline.”

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November/December 2019 Volume 18 Number 6

NURSERY MANAGEMENT TODAY

w F w Ch ollow w ec us .n k m ou @nm t- t o m u r tm a g ag w az az eb ine in site e. co .u k

Your hearing How to protect it

Selling up?

How to do it Main Sponsor

MEET THE FINALISTS Inside this issue LAST CALL FOR TICKETS!

Your food budget Balancing cost and nutrition

Chasing success

SCAN ME

Asking those who know www.nmt-magazine.co.uk

Offering nursery managers the complete administration solution

To subscribe to any of our titles please contact: +44 (0)20 7104 2000 subscriptions@investorpublishing.co.uk

EducationInvestor Global

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building with care

November 2020

www.careinfo.org

New wing opens at veteran care village

30

Residents of Broughton House veteran care village in Salford, Greater Manchester, moved into their new accommodation in September following the completion of the first stage of a £15 million redevelopment.

Military veterans moved into the three-storey building which has been named The Stoller Wing in honour of north west businessman and philanthropist Sir Norman Stoller, whose charitable trust has provided substantial financial backing for the scheme.

The building features residential care and nursing care accommodation, with a total of 32 beds over two floors. Each floor of accommodation has an activity room, a lounge, a kitchen and a balcony.

The nursing care suite is named after Col Sir William Coates, who founded Broughton House in 1916 to care for soldiers and sailors injured during the First World War. The residential care suite is named after Charlie Fox, the first Broughton House resident.

On the ground floor is a café for residents and their families, staff and the general public, along with the Broughton House museum, a reception area, hair salon, physiotherapy and treatment room, conference facilities and, for the time being, the Armed Forces Support Hub. The hub will be relocated after the next stage of works, and the space it currently occupies will become a gymnasium.

Work on the next stage of the scheme was due to begin in October and will see the construction of The Jellicoe Wing, which will provide another 32 residential care and residential dementia care beds and six independent living apartments alongside the Armed Forces Support Hub. The redevelopment of the two-acre The Stoller Wing at Broughton House veteran care village site is being carried out in phases to minimise the disruption to the veterans living at Broughton House. It will create the UK’s Charitable Trust had come from the Greater first veteran care village at the only home in the Manchester Combined Authority, the Garfield north west for ex-servicemen and women.

Weston Foundation, The Band Trust, Lord Outdoor features of the redevelopment will include Glendonbrook and from LIBOR funding, a memorial gardens, a bandstand, landscaped government initiative created to redistribute the gardens and a bowling green. proceeds of banking fines.

So far, Broughton House has raised £11.5 “The Stoller Wing at the Veteran Care Village will million towards the total cost of the scheme. be an iconic building where our veterans and Tom O’Brien, chairman of the Broughton families will receive the care and service they richly House Executive Committee, said significant deserve,” said Mr O’Brien. funds in addition to those given by the Stoller “We could not have achieved this important

milestone without support from a variety of sources, and we are extremely grateful for the commitment of all those organisations and individuals who have contributed and for the belief they have shown in the concept to help bring our vision to reality.”

Broughton House is running a Buy-a-Brick appeal to raise further funds.

Eric Wright Group is the main contractor for the project, which is being managed by Dooley Associates. Levitt Bernstein is the architect.

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building with care

November 2020

www.careinfo.org

Heathcotes to open new service in Bradford Chesterfield-based care provider Heathcotes Group is redeveloping an independent supported living near Bradford which is scheduled to open later this year.

Heathcotes, which specialises in services for adults with learning disabilities and complex mental health needs will redevelop an existing property in Clayton to create Horton View, featuring 14 spacious apartments providing enhanced supported living for individuals who are stepping down from a hospital or full-time residential care setting. Designed to help service users to develop their independent living skills, each property offers self-contained accommodation with its own lounge, bedroom, bathroom and kitchen area. The service will include an on-site office and a team of around 30 staff providing 24-hour care support when needed.

Horton View has been designed by Heathcotes’ in-house architectural consultancy, JDS Design, with internal reconstruction and external improvements carried out across two phases by contractors John Ryan Developments Ltd. Open from November, Phase 1 will feature 4,069 sq ft of single person accommodation including six apartments alongside laundry facilities and office space. Phase 2 will total 6,415 sq ft including eight apartments as well as a communal lounge, laundry facilities, staff break-out space and additional office space.

Heathcotes’ director of business development Natalia Lysiuk said independent supported living was a care model that Heathcotes have developed over the last two years, to complement the organisation’s full-time residential care services, offering the next step in the care pathway towards full independence for service users.

NATALIA LYSIUK: A real sense of community has developed amongst service users, fostering social inclusion to complement their increasing independence.

“It has been exceptionally successful and we have introduced a range of supported living properties across Yorkshire, Lincolnshire and Northamptonshire,” said Natalia.

“Last year we opened our largest supported living service in Leeds, which has been hugely successful. We worked in partnership with LCC

and are pleased to see the service at full occupancy, having only opened in January 2020. A real sense of community has developed amongst the service users, fostering social inclusion to complement their increasing independence.

“Horton View is even larger, with enhanced provision for service users and staff. It follows our established model, offering a spacious, homely environment which is ideal for service users seeking to develop their daily living skills.

Alternatively, these apartments are also suitable for individuals who require a single-person service due to their complexity and inability to live with others.”

With a head office in Chesterfield, Heathcotes Group has 72 residential care services nationwide and has partnered with more than 50 local authorities and Clinical Commissioning Groups since 2004.

Inspired Villages to build second retirement community in Hampshire Inspired Villages, Legal & General’s later living business, has acquired a 10-acre site in Chandlers Ford, Hampshire, with outline planning permission to develop 151 new specialist age-appropriate homes as part of a new retirement community.

The scheme will include a wellness centre (comprising a fitness studio, gym and swimming pool), which will be available to local qualifying residents on a membership basis. Works are expected to start on site early next year, creating 110 construction jobs per annum over a four year period,

and more than 35 permanent jobs once complete.

Chandlers Ford will be Inspired Villages’ second later living community in Hampshire, joining Bramshott Place near Liphook. Inspired Villages development director Neal Dale said the acquisition of the Chandlers Ford site highlighted the company’s ambitions and outstanding momentum, while also emphasising the growing demand for specialist age-appropriate housing in the local area.

“I am proud of, and look forward to seeing, the vast and significant socio-economic benefits that

Computer image of Inspired Villages’ retirement village planned for Chandlers Ford

will come as a result of our upcoming Chandlers Ford community,” said Mr Dale. “There is a need to provide a greater support to our older people within society; Covid has shown us that ensuring the health and wellbeing of our older people, whilst supporting our NHS and social care services, is paramount.”

Phil Bayliss, chief executive of Later Living at Legal & General and chairman of Inspired Villages, said Legal & General invests for the long-term in socially and economically useful assets, making the later living sector an exceptional match for the company’s capital.

“We need to advance and accelerate the UK’s delivery of age-appropriate homes to meet our rapidly ageing population,” said Mr Bayliss. “This is not only crucial for wellbeing, but also for helping our overburdened NHS and social care services.

“Inspired Villages is committed to addressing the social and economic issues linked to the UK’s ageing population. The acquisition of our second site in Hampshire is yet another positive milestone for Inspired Villages and testament to its vision and commitment to the sector.”

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business & property

November 2020

www.careinfo.org

Rangeford Villages is looking for land Later living property specialist Rangeford Villages is looking to purchase new land to develop further contemporary communities for the over-60s. The developer has already committed £90 million to acquiring land during the lock-down period, with plans underway on two upcoming villages in Cirencester and Essex.

This expansion plan follows the success of two existing developments, later living villages Wadswick Green in Wiltshire and Mickle Hill in North Yorkshire. The search for land is primarily focused on the home counties to complement the recent acquisition in Essex, seeking sites capable of accommodating over 100 units that are located in, or on the edges of, towns. Sites need to be close to transport links and local amenities and have a mid to high ageing population demographic. As part of its dedication to create beautiful villages, sites need to have the ‘village’ potential with space for a range of central facilities, landscaped gardens and parking.

Rangeford Villages also secured a new site located in Essex, with contracts exchanged during the summer 2020 lock-down.

Each Rangeford Villages’ development features a “pavilion” as a hub of social activity and on site amenities at the heart of each village, including restaurant, fitness and activity facilities. There is a regular social events calendar for residents to promote a community lifestyle and their wellbeing.

Homes are carefully built for the over 60s market and feature walk-in showers, wide

corridors, and open plan living for ease of mobility.

With modern designs, they are sold on a “lock up and leave” basis, attracting retirees keen to live just as before and retain their independence whilst having the comfort of knowing assistance is available as required.

In addition to a concierge team to assist with day-to-day enquiries and services, personalised care and support packages are also available for assistance on daily tasks, housekeeping and laundry services, or simple companionship.

2022 target for Cirencester project Rangeford Villages has committed to their Siddington Park Village in Cirencester by signing the construction contract with Rydon at the beginning of the lock-down period. Building work started shortly after, in compliance with government advice, and is now progressing smoothly. The development is targeted to be completed in summer 2022 and will offer 123 two and three bed retirement apartments.

Impression of Rangeford Villages’ Siddington Park Village in Cirencester, now under construction.

Look Ahead acquires Kingswood Care Services Specialist care provider Look Ahead has acquired Kingswood Care Services Ltd. Established in 1998, Kingswood specialises in supporting people with learning disabilities in Essex, operating five residential care services in and around Basildon. In total, 32 people are

32

supported by Kingswood’s services and the company employs 99 people.

Look Ahead provides specialist care, support and accommodation services to people with a variety of needs across London and the South East. A charitable housing association, they have

Hicare sold to Kirklands Care Specialist business property adviser Christie & Co has announced the sale of Hicare Ltd, a residential care home operator based in Leicester.

Hicare, which comprises the residential care homes Spencefield Grange and Meadow's Court, was founded in 1989 by Leicester businessman, Mr Satnam Nanuwa, in conjunction with his wife Sukhjit. After 30 successful years in the care sector, the Nanuwa family has decided to retire and sell the company.

“Hicare Ltd has been the biggest part of our lives, and our main priority, for many years,” said Satnam. “My wife, Sukhjit, and my two

daughters, Rupinder and Surinder, have worked extremely hard to build the company and establish successful care homes. The decision to sell the homes was not taken lightly.

“My wife and I need to prioritise our health, and so the time has come to retire. We all wish the new owners of Spencefield Grange and Meadow’s Court all the success for the future.”

The Nanuwa family appointed Christie & Co to find a new business owner who shares the same principles and family values as theirs, so that they can build on what the company has already achieved.

Hicare has been purchased by experienced and expanding operator, Kirklands Care.

been delivering services for more than 45 years and currently support more than 6,500 individuals every year. Look Ahead currently delivers more than 20 specialist services for people with learning disabilities, including those with high and complex needs. This includes residential care, supporting living and community based services.

Look Ahead chief executive Chris Hampson said Kingswood Care Services was the second acquisition that Look Ahead had made in the learning disabilities sector within the last 12 months and its ongoing acquisition strategy was designed to complement its organic growth in the sector, and enable the organisation to continue to expand its learning disabilities and complex needs services across London and the South East.

“The acquisition of Kingswood is a key part of Look Ahead’s long term growth strategy which will allow us to support more people across London and the South East,” said Mr Hampson.

“There is a clear fit between Look Ahead and Kingswood in terms of client group, service ethos and crucially, our values. Essex is a new geographical area for Look Ahead for the provision of learning disability services and we look forward to developing close relationships with customers, their families and commissioners.”

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REPUTATION

DISCRETION

To Buy: 0844 7011 821 To Sell: 0844 3877 498

Redwoods Dowling Kerr

KNOWLEDGE

www.redwoodsdk.com/healthcare

@RedwoodsDK

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BUSINESSES ON THE MARKET Former Care Home, Suffolk

Care Home, Surrey

Project Rosa, Somerset

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Freehold Ref No: 45710

Freehold Ref No: 47444

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£1,599,950

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Project Joseph, Bedfordshire

Project Lily, Cornwall

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Homecare agency, providing quality care, from simple support to high quality & dependable personal care Fee income of £2.8m (y/e 2019) with an adjusted EBITDA of £428k

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Leasehold Ref No: 47548

Offers Invited

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business & property

November 2020

www.careinfo.org

UK care home sector shows resilience despite Covid-19 The UK care home sector was beginning to recover following the impact of Covid-19 in the second quarter of 2020, with occupancy measuring 80.2% and a steadily increasing admission rate, as confidence in the sector begins to be restored, according to the latest research from global property adviser Knight Frank.

The Covid-19 care home occupancy tracking survey by Knight Frank surveys 21 operators managing 1,391 care homes and 79,848 registered beds and encompasses about 15% of the UK care home market.

It has found that overall occupancy as of midAugust 2020 measured 80.2% which, while 8% below the pre-pandemic level, has been increasing robustly since July.

property sector, having accelerated trends that will lead to closures of care homes that are no longer fit for purpose, resulting in a significant national shortfall of bed provision.

Knight Frank’s research identifies a potential 6,500 care homes at risk of closure over the next five years, equating to 140,000 beds and estimates that the UK needs more than £15 billion to upgrade existing beds in order to future-proof for its ageing population.

Julian Evans, head of healthcare at Knight Frank, said this came as the proportion of people over the age of 80 was expected to surge in the next 30 years, with one in ten adults set to be over 80 by 2050, compared to one in 20 currently.

Care home operators have also been devising and implementing new procedures to ensure that they are best prepared in case of resurgence of the virus in the winter months, with barrier nursing and isolation measures being crucial steps to maintain infection control.

This follows Knight Frank’s findings that the Covid-19 pandemic highlighted the need for investment and innovation in the UK healthcare

“The Covid-19 pandemic has shown the very best of the UK’s healthcare sector, with outstanding collaboration between the private sector, social care sector and NHS at this time of need, and the strength in controlling infection levels,” said Mr Evans.

“Having scrambled exceptionally well given the lack of government support, the operators are now much more prepared for the potentially imminent

34

risk of the second wave of the virus, with new procedures in place and higher volumes of PPE at their disposal.”

Need for crisis funding

“Despite the fantastic work of the UK healthcare sector, the pandemic has also unfortunately highlighted the lack of investment by successive governments into the sector, and therefore the urgent need to prioritise preventative and crisis funding.

“Covid-19 has merely accelerated trends to scrutinise those buildings that are not fit for purpose whilst emphasising the insufficient funding available for reinvestment into existing care homes, which has therefore expedited the number of potential care home closures. We are at a vital crossroads where we face a national bed crisis unless significant inward investment in the UK care home sector is made immediately.”

The Knight Frank report said Covid-19 pandemic had placed additional pressures on the care home market which had already seen closures due to a range of factors.

These included the continued impact JULIAN EVANS: of the National Living Wage affecting We are at a vital crossroads an already constrained labour market and ongoing staffing challenges, with where we face a national an acute shortage of qualified nurses, combined with restrained care home bed crisis unless significant development owing to building inward investment in the material inflation costs.

Knight Frank expects that care UK care home sector is home operators will adapt care home design to meet future virus made immediately. experience and that care homes will develop their operational procedures post Covid-19, including an increased use of telemedicine.

An accelerated closure of tertiary assets is likely and, because of increased smart specifications necessary for future new build care homes, the cost of raw materials will further increase.

Other care home property market articles can be found at

www.careinfo.org Caring Times’ official website

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November 2020

www.careinfo.org

Hallmark creates new assisted living brand Santhem Residences’ first retirement village in Essex: creation and ethos were ‘decades in the making’ Major provider Hallmark Care Homes has created a new retirement living brand called Santhem Residences.

Their first project is “Santhem Residences Shenfield”, a luxury retirement living village in Shenfield, Essex with 55 one and two-bedroom apartments shortly to be released for sale, the apartments are scheduled to open in spring 2021.

Facilities at this £20 million project will include a restaurant and bar with a highly trained chef, a cinema, café, gym with a range of classes tailored to over 65s and a beauty salon. There will also be landscaped gardens and private outdoor space in the form of patios, balconies and roof terraces.

The Essex-based company will be overseen by Avnish Goyal as chief executive, running alongside his role as chief executive of Savista Developments and chair of Hallmark Care Homes.

Santhem Residences will work closely with its sister company, Savista Developments to source land, obtain planning permission and build and fit out Santhem’s assisted living projects into the next decade.

“I am pleased to launch our first retirement village scheme Santhem Residences, which has been named after our wonderful parents, Santosh and Hemraj,” said Avnish Goyal.

“This exclusive retirement village in Essex is the first of its kind but its creation and ethos have been decades in the making. It began with myself and my brothers and our aspiration for our parents to have the retirement lifestyle they deserved.

“Santhem Residences will give residents the freedom to live the life they desire, with equal opportunities for socialising and peaceful privacy, so should the resident wish to spend more time on existing hobbies or discover new passions, there will always be an abundance of events, trips, clubs and activities for them to get involved in at their leisure.”

Impact Healthcare REIT buys nine care homes in Scotland Specialist business property adviser Christie & Co has facilitated the sale and leaseback of a portfolio of nine care homes in Scotland on behalf of Holmes Care Group.

The nine care homes, situated throughout Scotland, have been purchased

by Impact Healthcare REIT. The net purchase price before transaction costs is £47.5 million and the initial rent £3.5 million, reflecting a yield of 7.4%. A deferred payment structure has been agreed with the vendors under which Impact will pay up to £3 million based on the trading performance of the nine homes, in exchange for an annual rent increase of up to £225,000. The initial rent cover on the portfolio is in excess of two times.

The portfolio was previously owned by family-run Holmes Care Group, which pursued a sale and leaseback route as it allowed the owners Mr Shiraz and Mrs Indumati Lakhani to retire whilst allowing their daughter to continue to operate and grow the business.

Holmes Care Group managing director Sharifa Lakhani said the deal would allow the group to continuously invest in its homes across Scotland while maintaining it as a family-run business.

“This long-term arrangement will see us continue to operate all of the homes, and is great news for residents, their families and our team,” said Ms Lakhani.

Martin Daw, senior director at Christie & Co, who handled the portfolio, said the deal was the largest care home transaction to happen in Scotland in more than 15 years.

“For the deal to be agreed and concluded, during this very difficult time we find ourselves in, goes to show the confidence in the Scottish care home sector and our client’s quality of operation,” said Mr Daw.

To advertise in Caring Times please contact caroline.bowern@ investorpublishing.co.uk or tel 07974 643292

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care businesses sold

November 2020

www.careinfo.org

PROPERTIES AND BUSINESSES RECENTLY SOLD IN THE CARE SECTOR Former Ty Gwyn Location

Leicester

Registration

previously registered for 12

Asking price:

£495,000 Freehold

Agent

Christie & Co

Tel

0115 9483100

Former care centre Location

Orchard House Location

Registration Bexhill-on-Sea, East Sussex

Registration

32 elderly

Agent

Christie & Co

Tel

Asking price: Agent Tel

Nottingham previously registered for 32 £695,000 Freehold Christie & Co 0115 9483100

Registration Asking price: Agent Tel

01622 656000

Glasgow

Cradley Heath, West Midlands

Registration

35 elderly

Agent

NGA Care

Tel

07943 107 887

Kingswood Care Services

28 elderly

Location

£695,000 Freehold

Basildon, Essex

Registration

Christie & Co

25-plus – group of five

Learning Disability Homes in South East Essex

01315243406

■ Information appearing in “Care Businesses Sold” is published in good faith that the information is accurate and cleared for publication. The onus for accuracy is on the property agent. Caring Times will not publish, in a subsequent issue, corrections or alterations to information supplied.

Agents, please note that items cannot be withdrawn once the copy deadline has passed.

We advise readers to confirm any details with the property agent concerned.

Location

The purpose built all en suite care home was sold through a highly confidential marketing process to a regional operator.

Rowandale Nursing Home Location

Trinity House

Buyer

Look Ahead Care & Support Ltd

Seller

Donna Higby, Deana Higby & Kim Nash

Agent

Christie & Co

Tel

01473 234904

Former Whitchurch Nursing Home Location Registration Buyer Agent Tel

Whitchurch, Bristol previously registered for 50 elderly Genie Care Homes Christie & Co 01179 468500

Meadow House Location Registration Agent Tel

Swansea Reg 27 bedrooms (vacant care home) Christie & Co 07702 809198

Pandemic brings new buyers to the care market

36

In the first edition of its Buyer Registration Index, specialist business property adviser Christie & Co points to an increase of 58 percent in new buyer registration figures for the care sector, which has evolved during the UK Covid-19 lock-down period.

The index, which indicates buyer sentiment across eight industry sectors, including care, shows a general trajectory of increased activity which Christie & co expects to be maintained, particularly as banks begin to focus more actively on new lending.

Michael Hodges, managing director of healthcare consultancy at Christie & Co, said the most active buyers for operational care businesses were generally existing operators and market participants who are already well known to Christie & Co. “It is therefore extremely positive that new buyers, registering for the first time with us, are taking such an interest in the sector and we expect this trend to continue as bank lending activity for new business increases,” said Mr Hodges.

“Along with many businesses across the UK, we have had to evolve the way we operate due to the pandemic. For example, access restrictions

to care homes have led to the creation of virtual tours MICHAEL HODGES: and similar innovations which have been well We expect market received by operators and activity to steadily purchasers alike.

“Positively, across increase as banks our wider healthcare begin to actively focus transactional business, and despite the challenges of on new lending again. gaining access to care homes for buyers and valuers, activity has been certainly be a positive development for the sector. encouraging, with our team receiving “As we enter the autumn, activity levels are 113 offers and agreeing 50 deals during the lockcertainly good and, from an operational down period. perspective, it is encouraging to see a number of “With many banks focusing on supporting our operator clients reporting a gradual increase in existing customers and administering the carefully managed new resident admissions. government’s support schemes over recent Clearly, we remain in a challenging environment, months, most of these deals have been agreed to but my colleagues and I are continually inspired by well-funded buyers who are able to proceed on a the incredible efforts made by operators and their cash basis. Moving forward, we expect market staff to provide the best care possible to residents activity to steadily increase as banks begin to in these most difficult times.” actively focus on new lending again which will

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building with care

November 2020

www.careinfo.org

Hamberley agrees forward sale to Aedifica Luxury care home developer Hamberley Development, backed by Patron Capital, has agreed a forward commitment to sell its next new build care home to European Healthcare REIT Aedifica.

The forward purchase agreement is the second deal between the Hamberley Development team and Aedifica in as many months.

The 60-bed home in Hailsham, East Sussex, is due to be completed in the first quarter of 2021 and will welcome its first residents in the spring.

The deal will see Hamberley’s operating company, Hamberley Care Homes, lease back the building from Aedifica over a 25-year period.

The luxury home is in keeping with Hamberley Care Homes’ premium style and includes en-suite bedrooms throughout, a cinema, an elegant Café, a bar area, a hair and beauty salon (with a nail bar), luxurious lounges and landscaped gardens.

Hamberley says the home has also been designed with the highest safety standards in mind, in light of the Covid-19 pandemic. Additional features include a bespoke Covid-secure visitation suite, in-built thermal imaging technology in the entrance lobby (to ensure all visitors to the home, including staff, have their temperature taken on a daily basis) and an optimised ventilation system which ensures air in public spaces is fully replaced every 15 minutes.

The home will also have hand washing and hand sanitising stations throughout for staff, residents and visitors.

The new development will mark the opening of the twelfth home in the Hamberley Care Homes group which, in 2019 was named Residential Care Provider of the Year by HealthInvestor Magazine.

In addition to Hailsham the group has a development pipeline of sites in Basingstoke, Bedford, Brampton, Bristol, Bromsgrove, Camberley, Cambridge, Dorking, Eastleigh, Enfield, Edwalton, Keynsham, Southampton and West Byfleet. The group is also actively acquiring

land and existing operating businesses and has more than £180 million of equity capital allocated for healthcare investment.

In August, Hamberley Development sold its newest care home, the 69-bed Richmond House, in Ampthill, Bedfordshire, to Aedifica in a sale and leaseback transaction.

Hamberley Development director Tim Street said the forward purchase Hamberley Developments’ new 60-bed care home n Hailsham, agreement for the Hailsham East Sussex, will include built-in thermal imaging technology. development showed the strength of Hamberley’s reputation for delivering Breslauer said the deal would free-up funds to high quality care environments, on time and invest in further opportunities that were actively on budget. being sought out.

“The Hailsham home will meet the very highest “We aim for our investments not just to deliver standards for safety and infection control and sets strong returns but also to have a positive impact on a new benchmark for Covid-secure care settings,” communities and individuals,” said Mr Breslauer. said Mr Street.

“With an ageing population and an increased “We are proud to be able to deliver both luxury focus on safeguarding older and more vulnerable and safety, without compromising on either front. people in society following the recent pandemic We believe that this is what sets us apart as an outbreak, our investments in the later living sector award-winning healthcare development business.” enable us to do just that.”

Patron Capital, managing director Keith

Complete Care buys London operator Complete Care Holdings, a subsidiary of MC Care Holdings, backed by healthcare specialist private equity investor Apposite Capital has acquired Amegreen Complex Homecare Ltd. The combined business provides complex homecare services to both adults and children with long term spinal injury, acquired brain injury, respiratory and other neurological conditions.

The acquisition expands the geographical reach of Complete Care, adding services in the home counties and London. Complete Care’s

current focus of operations is in the Midlands, North West and Wales.

MC Care Holdings consists of Complete Care Holdings Ltd, a national provider of nurse led complex care at home, Noble, a livein provider and MiHomecare, a domiciliary care provider.

Amegreen Complex Homecare was advised by MSNI Consultancy and Spratt Endicott Solicitors. Complete Care Holdings were advised by Anthony Collins Solicitors.

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Despite the challenging times during the current crisis, buyer demand remains strong in the Care sector.

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Nine care homes in Scotland on behalf of Holmes Care Group • Sold to Impact Healthcare REIT plc • Sale price £47.5m

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Ashley House, Surrey

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Saxlingham & Walcott Manor, Norfolk

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