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T H E P U B L I C AT I O N F O R N U R S I N G A N D R E S I D E N T I A L C A R E H O M E S Every Business Has An Unsung Hero

W W W. T H E C A R E R U K . C O M





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Fire Safety

Pressure Care

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Issue 41

See Page 2 for details

Furniture Dementia Property Nurse Call Cleaning Medication Incontinence Food and Laundry and and Care and and and Management Solutions Nutrition Solutions Technology Pages 26-29 Pages 30-31 Hygiene Pages 34-35 Furnishings Training Pages 44 Professional Pages 20-25

Pages 32-33

Pages 36-39

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Court of Appeal Overturns £400m Sleep-in Shift Ruling

The Court of Appeal has reversed an Employment Tribunal judgment which could have cost the care sector £400m in back pay to staff. The ruling relates to social care workers who had been paid a flat rate for shifts where they slept in a patient’s house or at a care home to provide support if necessary, known as “sleep-in shifts”. Mencap and Care England, the representative body for social care providers, went to the Court of Appeal in March to challenge an Employment Tribunal ruling, made in 2016 and upheld at appeal last year. The tribunal rulings, in favour of a sleep-in shift worker, Clare Tomlinson-Blake, found Mencap should have paid her the full minimum wage during sleep-in shifts, and would have led to charities and care providers having to pay back pay and penalties to large numbers of staff, which would cost the sector £400m and result in some organisations going bankrupt. Mencap argued that a previous tribunal decision which compelled care providers to fund six years’ back pay for overnight carers was unaffordable, adding that small-

er employers could be forced out of business by the decision. Care workers who provide care overnight used to be paid a flat fee in the region £30, since they may be sleeping during some of their shifts. However, after employment tribunal rulings involving a Mencap support worker, HM Revenue and Customs said they should be paid at least the minimum wage for every hour overnight, almost doubling the amount. The Court of Appeal ruled earlier this month that care providers had no liability for back pay. Responding to the decision, Mencap said the decision removed uncertainty around the issue and called on the government to ensure that care providers were properly funded in future. Derek Lewis, chair of Mencap, said: “The court’s decision has removed the uncertainty about how the law on the National Living Wage applies to sleep-ins. (CONTINUED ON PAGE 3...)


VIEWPOINT Hello and welcome to the Summer issue of The Carer, and, we are delighted to say we are celebrating our 10thy anniversary! The Carer is 10 years old!


Peter Adams

I would begin by welcoming any new readers to our publication, we have made changes to our distribution database which of course means that some of you may be reading our publication for the first time.

The Carer is a quarterly residential and nursing care home publication in print and online mailed out FREE to residential and nursing care homes throughout England and Wales. We bring news views professional comment products and services, in print, digitally, on our website and in our twice-weekly digital newsletter which you can sign up to via our website. (please do sign up)! I am using our editor’s view on space to tell you about our great 10th anniversary competition. The prize is a luxury weekend away for two in a choice of over 300 hotels for the deserving winner. All you have to do is nominate somebody working in your care/nursing home and has done something any time over the last 10 years you feel deserves recognition. Every home has an “Unsung Hero”, so please nominate yours! No catches no rules, just sending a nomination with a short paragraph on how they have gone that extra mile and we will draw a winner next month! So please get nominating!

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Court of Appeal Overturns £400m Sleep-in Shift Ruling (CONTINUED FROM PAGE 1...) The prospect of having to make large unfunded back payments had threatened to bankrupt many providers, jeopardising the care of vulnerable people and the employment of their carers.” He added that the charity had brought the case because of the “mayhem” that would have been caused otherwise. “Many hardworking care workers were given false expectations of an entitlement to back pay and they must be feeling very disappointed,” he said. “We did not want to bring this case. We had to do so because of the mayhem throughout the sector that would have been caused by previous court decisions and government enforcement action, including serious damage to Mencap’s work in supporting people with learning disabilities.” He said that “care workers deserve a better deal” and should not be among the lowest paid sectors. Alan Lewis, an employment law partner at Irwin Mitchell said: “This is a significant judgment and unless successfully challenged it will save care homes thousands of pounds. The decision provides a clear dividing line between when workers are actually working and are entitled to paid at least the National Minimum Wage, and when they are only available for work and are not entitled to be paid. “Essentially, workers who are required to sleep in at their clients premises, or remain at home on call will only be entitled to be paid if they are called on to perform work during those shifts. “This is much more straightforward and the decision will be welcomed by care homes who have been subjected to changing and conflicting guidance from the

government and HMRC. In 2017 many employers were encouraged to sign up to HMRCs Social Care Compliance scheme to declare how much they had underpaid staff for sleep in shifts in exchange for not receiving stiff penalties of up to £20,000 per worker or being publicly named for underpayment of National Minimum Wage. To be accepted onto the scheme, employers had to repay underpaid NMW to their workers and those that did so, are unlikely to be able to get that money back.” llr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said: “This ruling will come as a relief to care providers and councils because it removes considerable uncertainty and a potential considerable unfunded burden on top of already significant financial pressures on the adult social care sector. “We now need urgent clarity on all enforcement action for back payments when the National Minimum Wage wasn’t paid to ensure that no provider will face further action. “As we said in our submission to the court, we strongly support care workers being paid a fair wage for their valued work, but if this appeal was upheld it would have increased the risk of a sinkhole in adult social care. “However, today’s decision does little to ease the financial crisis facing social care. There is a £3.5 billion funding gap facing adult social care by 2025. This gap needs to be fully funded by government so that providers can plan with more confidence to ensure all people can receive reliable, high quality, personal care and support when and where they need it.”

Social Care Guides Launched to Help Providers Deal with Complaints Better Councils and care providers are being encouraged to adopt a new statement which sets out best practice in receiving and dealing with comments, complaints and feedback about their services. Launched this week by the Local Government and Social Care Ombudsman and Healthwatch England, the new single complaints statement helps adult social care providers set out what service users, their families and representatives can expect when making a complaint. Born out of the Quality Matters initiative, which aims to improve the quality and consistency of adult social care provision across the country, the statement offers a simple bulleted guide for each stage of the complaints process.

‘EasyRead’ version is also available. Michael King, Local Government and Social Care Ombudsman said: “I want to encourage all service providers – whether independent or council run – to adopt the single complaints statements into their own complaints policies, and highlight them in any information they give to service users, their families and representatives. “We know the complaints system can be a real labyrinth for people to navigate, but we also know many councils and care providers have excellent procedures which help guide people through the system, and signpost them to us at the end.

The Government recognised the value of the new single complaints statement in supporting a more consistent understanding of handling of complaints as part of its recent response to the CMA market study on care homes.

“Our investigations have shown the best councils and care providers have open and reflective complaints procedures, with a learning attitude at the heart of them. These new complaints statements should be a useful tool for all providers and their complaints systems.”

Launched alongside the complaints statement is a second document created for service users to help them better understand the complaints process. An accessible

The documents can be downloaded from the Ombudsman’s website at


Home Office Errors: Grounds for Care Homes to Challenge Illegal Working Penalties Care home providers face tough penalties if found to be in breach of their immigration compliance duties. But, as immigration lawyer Anne Morris explains, the Home Office itself has a track record of failing to follow correct procedures, meaning care homes may have grounds to challenge penalties.

of the inspection, and concerned about the gravity of the allegations and the tight timeframes involved, it’s understandable that many business owners just pay any resulting fine.

UK care home providers are required by law to meet certain immigration compliance duties. They must carry out document checks on all employees, confirming their right to work in the UK. In addition, care home providers employing skilled workers such as nurses from outside the EU will have to comply with their duties as a sponsor licence holder.

Did immigration enforcement officials have the relevant and lawful permission and paperwork to enter your premises to detain illegal immigrants?

Where the Home Office alleges a care home has failed in its sponsor licence duties, they have the power to downgrade, suspend or even revoke the licence This will affect the business’ ability to hire foreign nursing staff and curtail any PBS visa holders’ leave to remain. If the Home Office finds the care home has failed to perform its right to work document checks correctly, they can issue a civil penalty for illegal employment for up to £20,000 per illegal worker. There is no cap on the number of fines that can be issued to any one employer. Civil penalties have become a lucrative income stream for the Home Office. In the last quarter of 2017, over £11.5million in fines were issued to UK businesses for illegal working. Employers are clearly struggling to meet their immigration compliance duties, and that the Home Office is poised to profit from those employers that are in breach. Our WACMAT® has been the leading washable carpet protector for Care Homes since 1997. Now it has a rival! Following advances in textile structure technology we have now been able to develop the new WACMAT® ultra, utilising the latest Solution Dyed fibres to ensure an ultra long life, combined with a very high level of liquid retention. To complement this hi-tech surface we have also employed the next generation of nitrile rubber backing, coupled with an ultragrip under-surface texture. This construction ensures maximum resistance to tearing, rippling and ‘creep’, as well as providing a significant reduction in weight.

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Care home providers in particular are a target for immigration enforcement due to the high numbers of foreign workers. Businesses facing a Home Office penalty for illegal working are generally unaware of the full extent of their right to appeal. If you can show valid grounds for complaint against the allegations, you may be able to have your penalty cancelled. How to challenge Home Office sanctions

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But a civil penalty could be an unnecessary and avoidable cost if you can show that the Home Office did not follow the correct procedure during its investigation. Common areas of Home Office failings include: 1. Unlawful entry

For example, a warrant to enter premises under the Licensing Act should not be used for the purposes of detaining illegal immigrants. 2. Officers’ conduct Did the conduct of Home Office officials during the inspection fell below the required standards? For example, were any non-English speaking individuals interviewed with a translator present? 3. Misapplied rules Has the Home Office has misapplied or misinterpreted the rules when making their decision to impose a fine? For example, any unlawful arrests of foreign individuals during a raid could amount to racial discrimination. 4. Insufficient evidence Does the Home Office have insufficient evidence to support their allegations against your business? For example, the Home Office will need to provide evidence that the individual was employed by your business. If you are not the employer of an alleged illegal worker, if they were agency staff or employed by a third party, you are not under a duty to verify their right to work and you will not be liable for a fine. 5. Incorrect data Is the allegation based on up to date information? For example, Home Office systems data may incorrectly show that your foreign nursing staff are without the requisite qualifications.

For care home providers facing Home Office sanctions - either as a civil penalty, a restriction on your sponsor licence or both - your next steps will be critical in determining the outcome of the matter. You will need to act quickly to respond to the Home Office by the deadline.

On the basis of any of these issues, or others that have been identified in your case, if your business can effectively represent to the Home Office that they have failed to meet the required standards during the investigation, you should expect the penalty to be cancelled.

Each case will need to be looked at on its own facts and circumstances. Has there been a factual error being relied on in the grounds that can be challenged with supporting evidence? Can you show that the penalty is disproportionate to the breach?

Given the potential implications of a civil penalty and a revoked or suspended sponsor licence, care homes should consider all options if facing enforcement action by the Home Office to determine quickly how best to proceed and which course of action will result in minimal financial loss and disruption for your business.

An increasing area for challenge is to look at the Home Office itself and how it has conducted its investigation. Site inspections (or ‘raids’) are commonly used by immigration enforcement. They can be hugely stressful, unpleasant and invasive for employers. After the ordeal


Anne Morris is managing director of business immigration solicitors, DavidsonMorris, specialists in all areas of UK immigration including sponsor licences, HR compliance, visa applications and challenging civil penalties.


Unequal Access to Hospice Care Across England Adults with incurable diseases – including dementia, liver failure and stroke – are not being referred to palliative care from hospices early enough during their illness, according to new research.

to benefit fully from this type of care. But hospices have limited control over the referrals they receive from other health services, which can lead to patients being referred late or not at all.

Looking at the numbers of days from when patients were referred to community and inpatient hospice services to when they died, researchers found notable differences depending on their type of disease, age and location – with a clear north-south divide.

Referrals for hospice and palliative care are made by a variety of health and social care professionals including: GPs, hospital consultants, community nurse specialists and social workers.

Funded by the National Institute for Health Research (NIHR), the University of Leeds researchers looked at referrals to hospice care based on data from 64 hospices – approximately a third of the UK’s hospices. The findings, from the first national survey of its kind, examined the records of more than 42,000 people who died in 2015 with a progressive, advanced disease, after receiving community or inpatient palliative care from one of the hospices involved in the study. The study found that cancer patients were referred for hospice care about 53 days prior to death, while for non-cancer patients referral happened at about 27 days prior. It also found that older patients tended to receive less hospice care, with patients aged under 50 years receiving 78 days, compared to 59 days for 50 to 75year-olds and 39 days for patients aged over 75 years. Conducted in collaboration with the national charity for hospice and palliative care, Hospice UK, the study also found significant variations between northern and southern England in referrals for hospice care. In general, patients in the North of England were referred to hospice care around 35 days before death, compared with 55 days for the South of England and 55 days for the Midlands and East. “Our findings suggest we need to find more effective mechanisms to make palliative care accessible for all, so that everyone can be looked after appropriately as they come to the end of their lives.” According to previous clinical trial research, patients with progressive diseases should be referred for palliative care between three and six months before they die

The UK is recognised as an international leader for the quality of its palliative care services. However, this new research shows that many people in the UK are not accessing palliative care early enough, and there are significant differences in when they are referred for care depending on the patient’s disease, where they live, and how old they are. Lead author for the research Dr Matthew Allsop said: “There are misconceptions held by the public and healthcare professionals about what palliative care is, who it is for, and when people can benefit from access to it. “Palliative care is for any person diagnosed with a terminal illness, not just those with cancer. It aims to help patients and their families achieve the best quality of life through treating or managing physical symptoms, and helping with any psychological, social or spiritual needs.


“We know that people have a better quality of life if they are referred for palliative care early, but our findings suggest that this is not happening in a majority of cases. A large number of patients are accessing palliative care in the last weeks of life.


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“Where access is happening, we found that younger patients and those with cancer are receiving the longest duration of care. This is in contrast to an ageing population and the rising number of people with conditions such as dementia who could benefit from palliative care.

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“Our findings suggest we need to find more effective mechanisms to make palliative care accessible for all, so that everyone can be looked after appropriately as they come to the end of their lives.”



Volunteers Wanted For Care Home’s Edible Garden Project AN EDIBLE garden project is calling for volunteers to help tend the latest crop of produce. Lever Edge Care Home won funding from the Bolton Transformation Fund to install the multi-sensory garden – which includes fruit, vegetables and herbs. The home now runs regular gardening sessions with Natural Education, a Bolton-based initiative aiming to improve mental health through outdoor activities. Volunteers are being welcomed to the Monday sessions, running from 10am to 3pm every week.

Parents and children are invited to participate in the workshop free of charge, when they will be able to plant their own seeds before harvesting later in the year for pizza toppings. Sarah Urmston, from Natural Education, said: “We believe that nature can provide us with the means to improve our own lives through growing your own food. “We work with local authorities, schools, care homes, community groups and more to demystify gardening and reconnect people with the natural environment.”

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CQC Study Reveals Quality Staff Vital for Improvement in Social Care Sector The recruitment and retention of quality staff is vital in turning around failing care homes a CQC report has revealed. The report entitled Driving Improvement is a collection of nine adult social care case studies, and provides an honest insight from a wide range of people – including those who use services, their families and carers, staff, managers, directors, chief executives and other professionals – describing how it felt to be rated as inadequate, what impact this had, the challenges they had to overcome and how they got back on track. Across the country CQC sees over 80% of adult social care services that were originally rated inadequate improve their overall rating and Driving Improvement highlights examples in County Durham, Staffordshire, Shropshire, Hampshire, Suffolk, Essex, Surrey, Kent and Dorset. Commenting on the publication, Andrea Sutcliffe, CQC’s Chief Inspector of Adult Social Care, said: “As the independent quality regulator, we know the devastating impact inadequate adult social care has on people, their families and carers. That’s why it’s vital that the people in charge of providing care tackle the problems our inspections identify so improvement can be achieved. Our Driving Improvement publication shares the experiences of those who have been able to transform the care they deliver to explain how that journey of improvement can happen. My hope is that people running or working in care services rated as inadequate or requires improvement can use these case studies as practical guidance to improve for the benefit of the people they support and care for. “Key lessons we have seen from the case studies include understanding and accepting that problems exist; creating a clear vision to improve and putting that into action; appointing strong leaders who can establish an open and transparent culture where improvement can truly thrive; and focusing on developing a workforce that is valued, well trained and supported to deliver safe, effective person-centred care. “But we’re not saying that improvement is easy. Pressure on resources, increasing demands and workforce shortages mean these are challenging times for adult social care. Providers and their staff have a responsibility to deliver good care – but commissioners, funders and national bodies and the health and care system as a whole has a responsibility to work together to help create the environment that makes this possible.”


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Minister for Care Caroline Dinenage said: “Despite the challenges facing the sector, many social care providers are doing an incredible job, with over 80% rated as good or outstanding by CQC. Those who have turned around their rating should be especially proud and CQC is rightly sharing these lessons with the whole sector so others can improve. I am committed to ensuring social care in England is of high quality, safe

and compassionate and will shortly outline reforms so the sector is sustainable for the future.” Emily Holzhausen OBE, Director of Policy and Public Affairs at Carers UK said: “The impact of good quality care goes far beyond the person needing the care to the wider health and wellbeing of millions of families and friends who care unpaid. Families who rely on good quality support will find it encouraging to see companies demonstrating improvements in care and the practical steps that they took to do this – measures that could be adopted by others. Trusted, well-trained, compassionate, reliable, affordable and appropriate services are highly valued by families and close friends who need them.” Professor Martin Green OBE, Chief Executive of Care England, said: “Providers need the long term stability to sustain the quality of care that they strive to provide. CQC’s report demonstrates that change and innovation are evident throughout the sector. This needs to be both celebrated and replicated; however this is a major challenge given the confines of a poorly resourced sector. It is clear that we need to be able to invest more training and resources in our staff who are our biggest and most valuable resource”. Glen Garrod, President of the Association of Directors of Adult Social Services, said: “ADASS, the voice of social care leaders across the country, has long called for the kind of person-centred, tailored care that doesn’t just provide the support that older people or adults with disabilities need, but that enables people to exercise some choice and control and help them to live fulfilling and independent lives. “These insights into the lives of people receiving support provide exceptional examples of transforming lives – which is what social care can achieve. It will come as no surprise to anyone working in social care that the teams who have been most able to retain and recruit high-quality staff have seen such brilliant results, which is why it’s essential that the upcoming Green Paper for social care delivers a sustainable financial base to deliver great social care for more people, enabling them to retain their place in society and continue to contribute. This is further evidence of the exceptional work dedicated and hard-working social care staff do day in, day out. “We’ve been very clear that sector-led improvement could lead to real care breakthroughs – Quality Matters, which brings regulators, commissioners, providers and service users together, is an example of this working positively. We encourage not just colleagues in social care but those in health and housing services and the wider public sector to look at these examples and see if there’s anything they can learn from them which will help them locally.” Join in the conversation on Twitter using the hashtag #DrivingImprovementASC


Nine In Ten Councils Say National Taxation Key To Solving Adult Social Care Funding Crisis Nine in ten (89 per cent) of councils say national taxation must be part of the solution to securing the longterm financial stability of adult social care. The survey - the first of its kind by the LGA - reveals that 96 per cent believe there is a major national funding problem in adult social care. England's 152 social care authorities have been able to increase council tax in recent years to pay for adult social care. The LGA has warned that extra council tax income cannot be expected to plug growing funding gaps and protect adult social care services from further cutbacks and more than two thirds of councils (70 per cent) responding to the survey agree that increasing council tax is not part of the solution. A separate LGA public poll reveals nearly nine out of 10 people (87 per cent) surveyed believe that councils should be given more government funding to tackle the funding gap in the sector. The LGA said the findings further demonstrate that bold and possibly radical political decisions are urgently needed to provide a long-term and sustainable solution to funding adult social care. In the disappointing absence of the Government’s Green Paper on adult social care, now delayed until the autumn, the LGA also announces that it will publish its own Green Paper on adult social care later in July, complete with consultation and engagement, to kick-start an urgently-needed debate about how as a society we should fund this vital service in the future. There is growing political and public consensus that councils should be given more funding to pay for adult social care. Council leaders say it is essential that national political parties come together to try and build consensus on the way forward, working closely with

councils as a key partner in designing and implementing possible future changes. Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said: “Our surveys show beyond doubt that the overwhelming majority of both our national politicians, and the people they represent, will settle for nothing less than additional funding from Government to help solve the social care funding crisis. “Public polling consistently demonstrates that the British public is proud of the NHS and wants to see funding for it increase, even if that means paying more tax. We are now seeing similar consensus on the need for morfunding for adult social care. “Properly funding social care and prevention services not only helps councils with overly-stretched budgets protect care services for the benefit of those requiring them, it also helps to prevent further crises in the NHS and saves the health service a fortune by keeping people safe and well in their own homes, reducing the number of hospital admissions. “We need an amnesty on the politics of care funding reform. All options should be on the table to solve the funding crisis in adult social care and enable councils to meet growing demand with high quality and safe services that help people live their lives. The longer we wait for long-term reforms, the more likely we will see an unresolvable year-round problem in A&E. “The funding crisis cannot be ignored any longer which is why the LGA is now writing its own Green Paper on adult social care in a bid to engage the public, politicians and the adult social care sector to help shape official legislation to best help people of all ages with care needs access a wide range of reliable and high quality care they deserve.”

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Waltzing Wish Comes True For Dancer Jack, 93 A former gold medal dancer who performed at the iconic Blackpool Tower Ballroom has rekindled some of his moves and steps with help from his Dorset care home. Jack Richardson, 93, told staff at Colten Care’s dementia care home The Aldbury that he would love to dance again. In response, team members arranged a special visit from Poolebased dance school Dance Majic. Founder and teacher Lynda Toohey brought along a troupe of young dancers and readily accepted Jack’s invitation to take to the floor. The pair danced a waltz to the tune of Moon River followed by a foxtrot to Getting To Know You.

Lynda said: “He said he wanted to dance with me and as we got into it very gently, you could tell bit by bit that little things were coming back to him. “It was lovely to see him recalling his old moves and doing the steps again. He was definitely with it.” Among other dances performed by the students from Dance Majic were tangos, cha chas and a Virginia Reel line dance. The Aldbury’s Companionship Team Leader Sarah Ingram said: “We had a lovely afternoon watching and dancing with the pupils. “When Jack started dancing he had a beaming smile on his face. It was an emotional moment for him, his daughter who was there, and all the team."

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1.4 Million Older People “Aren’t Getting the Care and Support They Need” More older people than ever are missing out on the vital care and support they need, and delayed hospital discharges due to a lack of social are costing the NHS a staggering £500 a minute, new analysis by Age UK has highlighted. In just two years, the number of older people living with an unmet care need has risen by 19% to nearly 1 in 7 older people. Of the 1.4 million older people affected, more than 300,000 need help with three or more essential everyday tasks, like getting out of bed, going to the toilet or getting dressed. More than half of these people get no help at all from paid carers, family members or friends. “Our new analysis echoes what we hear all round the country: it is getting ever harder to access care if you need it and increasing numbers of frail, ill older people are being left to manage alone,” says Caroline Abrahams, Age UK’s Charity Director. “If an older person needs social care but can’t get it this is a surefire recipe for them to become weaker and less well. They are at far greater risk of not eating enough and of falling and hurting themselves because of trying to do more than they really should. And it goes without saying that their lives are likely to be diminished and made more miserable. “Is this what we want for our parents and grandparents, husbands

and wives, older neighbours and friends in 2018?” Meanwhile, Age UK’s analysis also found that delayed discharges from hospital due to a lack of social care are now costing the NHS more than £500 a minute. “These numbers show the folly and sheer wastefulness of the Government’s failure to invest anything like enough money in social care,” said Caroline. “We all depend on the NHS so we all lose out if it has less money to spend due to the lack of social care, but there is no doubt that it’s our older population who are paying the highest price of all – with their health, their happiness and sometimes even their lives. “The numbers of delayed discharges due to a lack of social care are actually going down, but lack of social care still costs the NHS an eyewatering £500 every minute – not to mention undermining the chances of older people making a full recovery if they are unnecessarily stuck in hospital for weeks or longer. At a time when the Government says we need to spend public money carefully, it makes no sense to fritter it away in this way. “It’s high time the Government saw Health and Care as one whole system and provided the resources needed by both.”

Dementia Is 'Top Challenge For NHS In Next 70 Years' One in four UK adults say they believe dementia is the biggest health challenge facing the NHS in the next 70 years according to a new survey commissioned by Alzheimer’s Research UK, the UK’s leading dementia research charity. The YouGov poll asked participants to consider the cost to the NHS and the number of people affected in each of eight disease areas, including cancer, heart disease and mental health conditions. A quarter of adults selected dementia, the highest percentage for any disease area. As the NHS marks its 70th birthday this week, Alzheimer’s Research UK is calling on the government and NHS to prioritise three pivotal areas to meet the challenges posed by dementia: Revolutionise dementia diagnosis, ensuring people with the condition today receive a timely and accurate diagnosis while also working to diagnose the diseases that cause dementia 15-20 years earlier than we do today. Foster research and innovation by increasing funding for dementia research, encouraging people to join dementia research, creating channels for global collaborative research, and preparing now for future dementia treatments.

Flower Power

Did you know that receiving flowers can reduce feelings of anxiety and depression, make us be more sociable and compassionate towards others, and even improve our memory! Nostalgic and fragrant British blooms can evoke strong memories of happy times. They can help us to feel close to nature and to keep track of the seasons. Fragrance can immediately take us back to a wonderful childhood memory, such as mint along a footpath, lavender in grandma’s garden, or picking allotment sweet peas. At MeadowSweet, we want to give everyone the chance to enjoy British seasonal blooms. Our experienced florist creates a new seasonal arrangement of

Change the way society thinks of brain health and increase awareness that dementia risk reduction begins in midlife. The findings of this survey come as the National Institute for Health Research (NIHR) announce an additional £215m in funding to develop solutions to major health issues, including those associated with ageing, in the next 10 years. Hilary Evans, Chief Executive at Alzheimer’s Research UK, said, “There are 850,000 people living with dementia in the UK today, a number projected to grow to 1 million in just three years at a cost of £30bn to the UK economy annually. We simply cannot afford to wait any longer to address the challenges presented by dementia or our health system will not be able to cope. “We have seen positive progress in treating people with dementia on the NHS in recent decades, but that progress must not stagnate. The additional funding toward major health issues is a welcome contribution, but we must see greater dedicated financial resource put toward dementia research if we are to diagnose dementia earlier and bring about life-changing treatments.”

flowers each week, full of textures and fragrance. Flower posies are expertly arranged in a vase, ready to display, with information about where the ingredients have come from. Our posies are perfect to bring life, colour and cheer to a bedside table or coffee table. We work with care homes that wish to offer flowers in their rooms, and we provide a gift subscription service for relatives wishing to give regular flowers to their loved ones. Our local delivery service is currently available in Dorset and parts of Hampshire and we have an overnight courier service for the rest of the UK. For weekly posy deliveries along with other products and frequencies please visit our website, email or talk to Sophie or Mark on 07561 531 390. See the advert on page 3 for further details.

Congratulations to The Carer on your 10th Anniversary 21 Church Road, Parkstone Poole, Dorset BH14 8UF Tel: (01202) 730736 Fax: (01202) 730738 E-mail:

Proud to be printers of The Carer for the past 10 years. 01952 585585


Borough Care Residents Get Out And About With Oomph! New Pub Opens At Borough Care’s Bamford Close Home Borough Care, the largest not for profit provider of care for older people in Stockport, has partnered with Oomph! to provide its residents with more day trips out to destinations further afield. Oomph! provides wellbeing and activity programmes specifically designed for older people. Borough Care will work with the Oomph! Out & About service, to offer residents regular visits to places of interest. Oomph! Out & About provides a tailored programme of fully managed excursions, which make it easier to keep elderly residents connected to the people and places that matter to them. Each of Borough Care’s eleven homes will participate in one Oomph! trip each month. Recent trips have included a day at the seaside in Blackpool, a chance to see the animals at Chester Zoo and a visit to Knowsley Safari Park. Commenting on the Oomph! partnership, Sophie Gardiner, Area

Manager at Oomph!, says: “We are excited to partner with Borough Care, to ensure that all residents live a full life for life. Research shows there are proven health and wellbeing benefits of continuing to get outdoors as you get older so we are delighted to be able to provide this service for Borough Care residents.”

Support at Borough Care, says: “At Borough Care, we believe people should continue to do the things they love and that a person’s life shouldn’t come to a standstill when they move to a care home. We are committed to providing a wide range of activities, to ensure our residents live an enriched life and are able to participate in everything they wish. The link up with Oomph! offers people the chance to get out and about in a safe environment.” Matt Hamblin, Senior Business

The health and wellbeing benefits to Borough Care residents, participating in the Oomph! trips, include the excitement of doing something different; the opportunity to reminisce by revisiting places they may not have visited for many years; improving relationships with fellow residents through shared experiences; and spending more time outdoors in the fresh air, which is beneficial to both a person’s physical and mental health. For more information on Oomph!, please contact Lisa Thomas by email at or by calling 0203 784 7995.

Mainteno Is A Complete, Cost-Effective Solution For Facilities and Maintenance Management Whether it’s managing planned maintenance or dealing with fault repairs, Mainteno simplifies the day-to-day maintenance of almost any organisation. Our award-winning software keeps everyone in the loop and archives all your communication and documentation in one place. For total control of your organisation’s assets, Mainteno also seamlessly incorporates asset management and tracking. Mainteno streamlines every aspect of the maintenance management process, saving your organisation time and money. Usability made affordable Mainteno was designed with practicality in mind. The interface is so intuitive that basic operation can be learned in minutes, and you can be a power user in one afternoon. Elegant usability usually means a hefty price tag. However, our pricing structure means that for small organisations, Mainteno can cost as little as two cups of coffee a month. No set-up fees, no lengthy contracts and a free trial, all mean that the system starts paying for itself straight away. This what Dr Asif Raja, Bsc MBBS Summercare Managing Director had to say about the system.

Facing significant challenges of ever increasing quality and compliance demands upon time and resources as well considerable economic pressures, Summercare, an award winning provider of residential care and housing related support, sought to upgrade their systems for managing the property and environmental aspects of its service delivery

A pub built by Borough Care at its Bamford Close home for older people in Cale Green, Stockport is now open for business. Residents and staff got together at the pub in the home’s grounds to mark its official opening. Borough Care’s Vice Chair, Jean Walker, had the honour of cutting the ribbon to declare the pub open for business. Relatives of residents, along with residents from other Borough Care homes, joined Bamford Close residents and staff for a drink and to look around the new pub. Bamford Close residents have been heavily involved in the design process for the pub and in the choice of items to kit it out. A relative’s friend owns The Union pub in Reddish and kindly provided tables, glasses and a dart board. Borough Care also had lots of items donated by Stockport based Robinsons Brewery and Manchester’s Joseph Holt Brewery.

The pub is not just a place where residents can meet for a drink. It is also somewhere residents and visitors can go for some quiet time, to socialise or to play traditional pub games. The new pub at Bamford Close is the latest in a wide range of activities and facilities Borough Care provides for residents at its homes. Borough Care has ambitions to lead a step change in the approach to care for older people and is continually looking at new ways to engage residents in social activities. Bamford Close is a residential care home for those living with dementia. It offers small group living in four self-contained buildings, each with ten bedrooms and a lounge/dining area. In addition, there is a large central lounge area where residents can meet together to socialise and participate in a wide range of activities.

Care Home Builds Shops For Residents With Dementia MINI SHOPS are to be built inside a Bolton care home following the success of a new sweet stall. Lever Edge Care Home, in Great Lever, is now aiming to build their own newsagents, haberdashery and book stand. The care home residents enjoy popping to the sweet stall for a treat and staff are hoping a full street of shops will prove equally popular.

been a huge hit. “For our residents living with dementia, a trip to the shops can be a very enjoyable experience, as it’s something they remember and are familiar with. “It’s not always possible to take everyone into town, so a street of shops at the home will be a great additional feature that everyone can enjoy.” The home is now appealing for materials to help create the shops, which will be installed in the home’s dementia suite.

Familiar sights and tasks, such as a shopping trip, also provides added benefits for those living with dementia, according to home manager Karen McMahon.

The sweet stall was constructed by Alfred Barnes, Lever Edge Care Home maintenance man, and Dave Edgerton, North West regional decorator for Hill Care, which owns and operates the home.

After an extensive period of investigation and research Mainteno was selected as the platform of choice for the entire organisation based on its ease of use, very short-term contract, quick set up and ongoing support.

She said: “Our residents love a sweet treat, just like everyone. So the sweet stall has

The organisation uses our comprehensive software solution to streamline the management of its property and environment. This has achieved greater efficiency for the company.

Footwear For Residents With Swollen Feet

The Mainteno system was the obvious choice based on it being easy to deploy and operate and with an extensive range of inbuilt processes and reports that meant we could start realising benefits very quickly. We are confident the system will provide us with improved accessibility and communication across the organisation and will improve the efficiency and quality for frontline care services. Dr Asif Raja, Bsc MBBS Summercare Managing Director See the advert on page 6 for details or visit, email: or call 01342 825025.

Do you have residents with swollen feet who can’t find shoes or slippers to fit? Cosyfeet can help. Their footwear for men and women is roomier than anything on the high street. Recommended by over 11,000 health care professionals, it fits a range of swelling as well as bunions, problem toes, bandaging and orthotics. Cosyfeet’s range includes supportive slippers, leather and fabric shoes and summer sandals. They also have a collection of stretchy shoes that won’t put pressure on swelling, bunions or

hammer toes. To complete your residents’ comfort, Cosyfeet offers extra roomy socks and hosiery which are designed to fit swollen legs as well as diabetic-friendly socks that won’t rub vulnerable feet. Cosyfeet’s ‘No Quibble Money Back Guarantee’ and free returns means your residents can order with confidence. They also offer VAT exemption for anyone with a chronic medical condition. Visit or ring 01458 447275 for free catalogues. See the advert on page 13 for details.

The Five Cs of Bill Checking ✔ Consumption

The most common errors we come across relate to consumption information. Whilst you would think that SMART meters or automated meter reading (AMR) devices should have minimised this, it is not always the case. On several occasions over the last twelve months clients have been billed to estimated reads, despite having an AMR device or SMART meter fitted. Equally, we see many occasions on which meter reads are transposed across the time periods, with day being billed as night, and night as day, or, worse, evening and weekends as day units.

YouGov research found that 60% of people find their energy bills confusing. Indeed, energy suppliers were rated the worst offenders of confusing bills, beating water companies, mortgage lenders, councils and phone providers.1 So, how do you know if your bill is right?

Power Direct’s experienced energy consultants check thousands of bills every month for our clients and we find a significant number of them to be wrong. In fact, in the past year we identified errors on 12% of the bills we checked! Each of those wrong bills could potentially have cost our clients money if we hadn’t quickly rectified the error.

What could go wrong with your bill?

In our experience, there are five fundamental aspects to consider when checking if your bill is correct: contract; continuity; consumption; cost; and calculations. Use our

hecking C l il B f o s C e The Fiv ✓ Contract y ✓ C o n t in u it io n ✓ Consumpt ✓ Cost ns ✓ C a lc u la t io

handy checklist to get into the habit of reviewing your bills, so you’ll know what to look for.

✔ Contract

It is relatively common for suppliers to apply the wrong rates to bills, and you might be surprised at just how many times we uncover this issue. Sometimes, we discover rates have changed mid-billing period as a result of a contract change, and it means rates are incorrectly applied across both periods.

In addition, discounts for having direct debits can often be omitted.

✔ Continuity

This is about simply checking that the bill continues correctly from the previous bill. You can easily check that the opening read is the same as the closing read from the previous bill, or that the opening balance reflects the information provided about payment since the last bill was produced. This is especially important when you are transferring from one supplier to another.

Since the P272 regulations came into force in April 2017, more businesses have moved to half-hourly metered. Halfhourly settled meters do tend to provide the most accurate billing information, but they present other issues around the non-energy costs. Many of these will be newly applied to the meter and are included in your energy costs, but are sometimes wrong. These tend to be the most difficult to check. It usually requires a strong knowledge of the contract that has been signed and the level of flexibility that can therefore be applied, as well as the relationship to the consumption information.

Case study:

Correcting transposed reads delivers a refund of £5,250 Challenge

Power Direct identified that meter reads from the owner of Orchard Views Care Home had been incorrectly recorded, and also that the reads had been transposed. It meant that the customer had been charged a day rate on the evening and weekend usage, instead of the lower evening and weekend rate.


Once we had fully investigated and identified the issue and corrected the transposed reads, we were able to ask the supplier to rebill for a period of 18 months. The result was a significant refund of £5,250 for the customer.

“I am delighted by the value that Power Direct continue to deliver to me. They are tireless in their efforts to ensure bills are correct, which means I can concentrate on the key aspects of running my home, and supporting staff in delivering the best care to our residents.”

Mr Mohammad Sharif Owner, Orchard Views Care Home, Barnsley

✔ Cost

Here you are checking that the actual costs have been correctly attributed and that payment plans have been actioned.

A very common issue we face is when direct debit payments have not been applied. It is a simple issue to fix, but in the period before it is spotted, clients can find themselves facing late payment charges, and mounting bills. We regularly find errors surrounding the VAT that is charged. Residential care homes are eligible for 5% VAT, but we have supported claims for many clients who have been charged at 20% VAT over a number of years. Sometimes the numbers just don’t add up!

✔ Calculations

The calculations that are used to derive the figures on your bill are sometimes complex. Since they are mostly computer programmed and will only reflect the information that has been put into the system, you would expect them to be accurate. However, we do come across cases where the calculations are incorrect. Experienced energy consultants will quickly spot where an equation for gas or electricity consumption has been miscalculated. Sometimes, the simplest of errors can have a significant impact on your bill. Gas meters that are showing as imperial meters on your bill when they are metric will create a bill for nearly three times the amount of energy cost you should be charged!

How can an energy procurement service add value?

In addition to the above, there are so many more ways in which an energy bill can be wrong that it is worth reviewing them on a routine basis. For example, a typical error we encounter is when a client’s KVA capacity is set at the wrong value. Legislation means that businesses exceeding their capacity can now be penalised by a cost up to three times more than their standard rate. However, when the KVA is set too high for the business’s consumption, the rate they pay will be considerably higher than it should be.

Power Direct’s invoice validation service is a checking and confirmation service focused on identifying any possible discrepancies in energy bills. From ensuring the numbers are based on accurate usage data, to guaranteeing the correct VAT rates are being applied; we deliver £1000s in savings each year to our clients. We are quickly able to right any mistakes, chase any money owed and then have it returned to our clients.

Call our friendly team if you would like more information about our invoice validation service, or for an informal discussion about anything else we can help you with: 0333 1234 313 yg-archives-con-uswitch-billingenergy-080411.pdf 1





Increase in Families “Stepping In” To Prop Up the Care System Research by the Social Market Foundation has revealed that there are 7.6 million people in the UK over the age of 16 who provide unpaid care for a relative. That is 1 million more than in 2005. Almost 15% of adults now care for a relative. The current social care system is putting pressure on families to step in and provide care for relatives where the state does not. Such family care is an essential element of the overall system of social care yet is not often put at the centre of conversation about the care system. Family carers are doing more care. Among carers, the proportion providing 20 or more hours a week has increased from 24% to 28% between 2005 and 2015. On average family carers provide 19.5 hours per week of care, which is equivalent to 149 million hours of care being provided each week in the UK. That is equal to the work of 4 million full-time paid care-givers. The only occupational social class where the proportion of women providing care rose was management/professionals: 19% of women in professional jobs provide care, up from 18% in 2005. The proportion of women in “routine” occupations providing care fell, from 22% to 21%. The report observes that: • There are more women with caring responsibilities in the profession-

al and managerial occupations. • The number of hours of care that family carers provide is rising overall. • The more hours of care a person provides, the more likely they are to reduce their hours of work or exit the workforce altogether. The SMF report makes a number of recommendations for the Social Care Green Paper, several of which are aimed at “nudging” employers into offering more support for working carers: • Employees should record the number of their staff who have caring responsibilities. • “Care pay gap” reporting could be required, where employers would publicly report the pay rates of staff with caring responsibilities and that of those of comparable staff without caring duties. • Big employers should be required to publish policies for supporting workers who care. Surveys suggest only 40% of large employers have policies setting out how managers should support carers. The paper also suggests much greater use of “care navigators” to help family carers guide elderly relatives through the complex system of public sector bodies likely to be involved in their overall package of care.

Care Home Resident, 99, Relives Passion For Fast Cars A 99-year old, Chichester care home resident, who once drove his car across the Alps, has been reunited with his favourite motor cars.

Other residents from the home also admired the cars and a few even sat inside them and turned on their ignitions. Some of the owners then presented Richard with a framed sketch of his own MG GT.

Richard Garrard, a resident at Colten Care’s Wellington Grange was visited by six, local, MG owners and their pristine vehicles.

Richard said: “This was one of the best days of my life – a really marvellous afternoon. Thank you to everyone.”

Richard has owned three MGs during his life – a VS 180, an MG GT and an MG PC7. He even drove his MGB GT across the Italian Alps and remains a member of the MG Owners’ Club to this day. Emily Hudson, Companionship Team Leader at Wellington Grange, said: “When we asked Richard to name his dearest wish he immediately said he wanted to touch and

Emily added: “Here at Wellington Grange we celebrate all our residents’ passions and we like nothing more than to grant their wishes when we can. hear an MG again. So when he saw all the cars lined up in the car park he was absolutely ecstatic.”

“We are hugely grateful to the local owners who brought their cars in and helped make Richard’s wish come true.”

Alpacas Gloria and Gaynor Visit Care Home Residents ALPACAS Gloria and Gaynor temporarily moved into a care home in North Yorkshire. The metre-tall, 70kg animals were visiting residents at Hazelgrove Court Care Home, in Saltburnby-the-Sea. They immediately made themselves at home, settling in the lounge and sitting down – a sign they feel safe and unthreatened, according to keepers. The pair were brought to the home from Alpaca Alpaca, a family run farm in the Leven Valley, near Yarm. Gloria and Gaynor made immediate friends with

the residents, with many stroking their fleeces and one resident, Walter Frost, even offering a kiss. Sharon Lewis, activities coordinator at Hazelgrove Court Care Home, on Randolph Street, said: “Walter said he didn’t expect them to be quite so big and their fleece to be surprisingly soft. “The residents are really fond of animals. We already have five chickens, which they have raised since the birds hatched a couple of months ago, and a budgie called Sparky. “The residents find it very soothing to have animals in the home.”

Adaptawear’s Top Selling Clothes For Carers

Adaptawear recognise the invaluable support and work carers make to their patient’s lives and they can help with the important everyday task of getting dressed and underdressed. They sell a range of adapted clothing to help with both assisted dressing and independent dressing with the aim to make getting dressed easier and less painful for both the wearer and carer. Our adapted clothing are ideal for arthritis, stroke, Parkinson, incontinence and dementia sufferers as well as people of all ages who struggle with buttons and zips. Some of our best-selling clothing suitable for carers: Nightwear & Underwear • Ladies Open Back Nighties – makes toileting more dignified • Men’s Open Back Nightshirts – petal back style to help with dressing in choice of long or short sleeves • Side Opening Underwear with Velcro fastening and Petal

Back Open Vests • Body & Pyjamas with Side Zips – designed to enable carers to dress and undress a person from lying position Daywear

• Tracksuit pants with side zips down both legs • Open back ladies and men’s trousers – aid dressing • CareZips incontinence dignity trousers – front opening from waist to knees • Open back men’s shirts and ladies and men’s open back polo shirts • Back-opening ladies dresses For more information on Adaptawear’s Product Range please visit Carer readers please quote TC141 for 10% discount off your first order or see the advert on page 7.



Sector Continues to See Loss in Beds

The UK care home sector has continued to see a net loss in the number of homes and beds, with the past year seeing a net loss of 117 homes and 388 beds, according to the latest research by leading global property adviser Knight Frank. The annual UK Healthcare Development Opportunities 2018 research report shows that whilst there continues to be a net loss in beds and homes, this figure is much lower than the previous year, at 388 as opposed to 2,612. This is driven by smaller care homes closing whilst larger, more efficient and viable schemes open throughout the UK.

The Knight Frank UK Care Home Development Index identifies which UK locations present the best prospects for investment and development. This year, Greater London leads the hotspots list in England whilst the Central area of Scotland remains in top place for the third consecutive year. Greater London benefits from a projected elderly population growth of 46% in the next 15 years and 38% projected GDP growth in the same period, which is well above the national averages, and the need to replenish the loss of beds. The top five in England and Wales are Greater London, South Glamorgan, Buckinghamshire, Berkshire and Cambridgeshire. Julian Evans, Head of Hotels, Healthcare and Leisure at Knight Frank, said: “The UK healthcare industry is less developed than other sectors and therefore requires

substantial investment in order to keep pace with present demand, let alone the provision that is going to be needed for the future. Whilst the gap closed on the net loss of beds compared to last year, this is still not enough to address the crisis in provision and is likely to be further exacerbated as the next generation ages at a faster rate than new care homes can be developed.

“We estimate that we require in excess of £15 billion to upgrade existing beds in order to future-proof and that approximately 6,500 care homes are at risk of closure over the next 5 years, which equates to 140,000 beds. “Due to the scarcity of stock and a continuing ageing population driving demand, the investment appetite for care home developments remain strong and there are opportunities for both investors and developers across the entire UK, with our Hotspots Index highlighting the range of opportunities nationally.” Evidence suggests that the care homes that are closing are due to a range of factors including the continued impact of the National Living Wage that has further affected an already constrained labour market and ongoing staffing challenges including an acute shortage of qualified nurses. In addition, many buildings are not fit for purpose whilst there is insufficient funding available for reinvestment into existing care homes, combined with building material inflation costs which has served to restrain new care home development.

The PARTY of the Century for the Care Community The Care Show has now faithfully served its profession and the industry for 20 years and the new event organisers, CloserStill Media believe it is time that the show benefited from a fresh injection of energy! So they have done EXACTLY that. The Care Show is celebrating this momentous occasion with Home Care Awards, prizes, acknowledgments, Carer of the Year award, live music, entertainment and to thank everyone who’s been to a Care Show over its history, there will be a party to remember for its BIG BIRTHDAY BASH for all to enjoy, with tantalising treats, delicious drinks and a live band. So what will be different about The Care Show 2018? As well as celebrating 20 years of Care history the organisers will be adding some fresh interest into the show to ensure the entire community comes together as well as just the usual faces! Business: Brimming with practical advice and ideas aimed at care home owners and multi-property operators to cover key business functions such as finance, customer service, marketing and HR. People: Helping operators and homecare service providers navigate their way around key areas such as, recruitment and retention of staff, training and up-skilling, Brexit-impact, managing agencies.

Dementia: Everything from sensory, to technology, this stream is where innovation and inspiration meets to equip care businesses to provide the very best in dementia care. Assets: A series of seminars which will look at the future growth of the care sector from funding and finance, working with investors, effective procurement strategies, design and construction ideas. Regulatory/Compliance: A series of practical seminars and workshops for all operators and service providers need to know to navigate their way through successful CQC inspections, safeguarding and health & safety. Excellence in Care: This stream will share expertise and success stories from some of the UK’s most innovative care home operators and service providers. This series of case studies will cover technology and innovation, personalised care programmes, successful integration with GPs and the rest of the primary care landscape, including medicines management and specialist care programmes. Pick up your free pass to join the sector as they celebrate 20 years of learning, excellence and caring via the website or call the delegate booking line they have set up to support care homes on 0207 013 4688. See the advert on page 8 for details.


'UNSUNG HERO OF THE DECADE' The winner gets a Weekend for Two at a Luxury Hotel See page 2 for details


FIRE SAFETY Fire Safety In Care Facilities Does your care home comply with fire safety regulations, and would you know what to do in the event of a fire? Fire Protection Online have some tips for making fire safety easy. The Regulatory Reform (Fire Safety) Order 2005 requires all workplaces, businesses and public buildings to have a fire risk assessment carried out on their premises which is then reviewed regularly. Unfortunately, there are often cases where care homes are in breach of fire regulations, more-often-than-not unwittingly. Just last year, a care home in Cheshire was fined £50,000, and in 2004, fourteen elderly residents died tragically in their Scottish care home. But it is the events of Grenfell Tower which have brought the issue of preventing and handling a fire to the forefront of a lot of minds, highlighting how important fire safety measures are.

Fire Prevention The first, easiest, and cheapest way of preventing a fire is to keep things which burn well away from things which could start a fire. This means keeping combustibles such as furniture, furnishings, cardboard boxes, medical supplies, cleaning products, and waste well away from heaters, cooking equipment, and naked flames. It’s important to store hazardous items as directed and to have electrical and gas equipment maintained according to the manufacturer’s guidelines. If a fire were to start, you’d need to be able to contain it, helping to reduce the risk

to life and property. This is frequently achieved through design but is often ineffective due to open fire doors. This is why door closers are essentials and holding the door open with a door wedge is unacceptable. However, door retaining systems do exist which hold a door open to provide access but which shut in a fire emergency.

Fire Detection and Warning Having a fire alarm system installed and maintained is the best option. In a care home, this should have L1 coverage which ensures that sounders are loud enough to wake people from their sleep, with detectors in all rooms and escape routes. As an addition, a vibrating pillow alarm can be used to wake those who are hard of hearing, as well as beacons providing a visual warning.

Fire Extinguishing Fire extinguishing equipment is essential, and you must make sure the correct type is located near the applicable risk. Generally, this will consist of various extinguishers throughout with fire blankets in all kitchen areas.

Fire Action Plan Everyone must be aware of what they should do in an emergency, from where the assembly point is, to how to assist those who need help evacuating, and who calls the fire brigade. And part of the plan will be ensuring you have trained fire wardens and staff who have received evacuation training. The best way to then familiarise everyone with your plan is to carry out fire drills. It is also the best way of discovering any issues that may exist with the plan, rather than waiting until it is too late. To find out more information about fire risk assessments and fire safety equipment, visit

Dorgard from Safelincs Do you feel that managing fire safety in your care setting is a bit of a balancing act? How do you adhere to the guidance of the Regulatory Reform (Fire Safety) Order 2005, whilst also promoting and enabling independence of frail and disabled residents?

room, boosting their self-esteem and independence, which in turn has a positive impact on their general health. Dorgard has developed three types of fire door holders for care settings that will solve this age old issue, Dorgard, Dorgard SmartSound and Dorgard Pro. Your type of setting will determine which of the Dorgard fire door retainers is right for you. If you are a small to medium setting with normal or low noise levels, then the original Dorgard will suit your needs. For settings where the noise level is louder you may benefit from the improved sound recognition of the Dorgard SmartSound and for large sites the Dorgard Pro is ideal. Dorgard Pro gives you the possibility of managing up to 500 fire doors in one system and has the option of wiring into your fire alarm panel, it also provides a ‘one glance’ check that the entire system is functioning correctly.

Fire doors are heavy, with a strong closing action, which makes it very difficult for elderly residents to open them. This often results in residents staying in one place for long periods of time, which can lead to feelings of isolation and low self-esteem. Clinicians have proven that these emotions can have a negative impact on the general wellbeing of the elderly and their ability to recover from illness. Finding a safe way of holding your heavy fire doors open gives residents the freedom to move around from room to

For more information call 0800 978 6287 visit or see the advert on page 18.

DB Fire Safety Limited DB Fire Safety Limited is an independent fire safety consultancy supporting businesses and organisations throughout the UK. DB Fire Safety Limited was recently voted The Best Independent Fire Safety Consultancy 2017. When interviewed following that award, the Managing Director, David Black said: `We help our clients by carrying out the necessary fire risk assessments and providing continual updates. We also provide training to staff in general fire safety awareness as well as training any

Fire Marshals that may be required. "We are proud to include a substantial number of residential care homes as clients where we provide owners and managers with the support they require to help them meet their responsibilities laid down by fire safety legislation and ensure that all their staff and residents are as safe as can be reasonably anticipated. Winning this award demonstrates and proves our commitment to ensuring that all the advice we provide our clients is always in their best interests.` Our motto `Your Partner for Fire Safety` accurately describes our mission that has led to our receiving this award.` From our offices in Peterborough we offer a FREE 24hour consultancy service. See the advert on this page for further details.

The Ultimate Door Closer For Care Homes Critically designed to support and maintain the integral passive fire protection within a care home - Exidor’s Guardian door closer is the only electromagnetic closer in the market specifically designed to meet the needs of residential care facilities. Exidor are a proud UK manufacturer based in Cannock, Staffordshire, specialising in the care home market. Already UK market leaders in emergency escape hardware and electromagnetic closers, Exidor are experts in their field of fire door closers as well as escape systems. Exidor’s Guardian electromagnetic door closer is an innovative advancement from traditional swing free closers and has been designed to take into consideration the specific needs of the Care Home environment. It has two unique features aimed to improve both the physical safety of residents and staff as well as the passive fire safety of the care facility itself.

Protection: The swing free mode of a closer can allow a door to slam shut. Whether this is accidental, deliberate or just caused by a draught, it poses a real risk to frail residents and care home workers alike. The Guardian closer has been specifically developed with an anti-slam function which controls and slows the motion of the door. Drift Resistance: Unbalanced doors naturally swing open or closed, or doors can swing with a draught. This can result in residents wedging doors open and invalidating them as fire doors. Exidor's Guardian closer offers a low level control on the door, which stops it from drifting from its open position, at the same time as allowing it to operate freely to the user.

Anti-Slam Finger

As they are linked to the fire alarm system, they only close when you need them to. Please contact Exidor for further information or details of a local distributor, or visit or call 01543 578661.

Kfive Evacuation Kfive are a family run business providing first class evacuation chair equipment since 2004. Whether you are a small business or a large organisation, the safety of your staff and customers is always a priority. KFive offer a full service solution for emergency evacuation chairs to suit your business premises. Providing emergency evacuation chairs for disabled persons and full training modules, as well as servicing and evacuation chair maintenance, our experts can offer advice and support on which model of evacuation chair for stairs and other hazardous mobility areas you may need assessing. Having worked with some of the countries best known brands, we pride ourselves on our customer service, after sales support and the choice and quality of all of our products ensuring customers get the right product for the specific enquiry and our first rate training programmes. So let us help you choose from our range of fire evacuation chairs to find the right one for your business or service and click through to our online store catalogue, or alternatively you can try our new chair finder tool. We pride ourselves on building lasting relationships with our clients Visit for details.

The Most Compliant Way To Hold Open Fire Doors Until now, the reliability of wire-free fire door holding and closing devices has been questioned by fire safety professionals due to false activations and damage caused to soft furnishings. It was in response to these concerns that innovators of fire safety products, Geofire developed its unique Agrippa magnetic fire door holder which uses ‘listen and learn’ technology. This pre-programing means that the devices prerecord the sound of the building’s specific fire alarm and only release the fire door should they hear this particular sound. Geofire’s Agrippa range of wire-free fire door holders and closers have been very popular in environments where minimal disruption is desired such as care homes and schools. The cleverly designed battery-powered units mean that there is no need to re-wire a building’s current fire door activation system. The devices can be fitted in a matter of minutes and are even complete with a handy, step-by-step installation video. Both products are hygienically installed at the top of the door, ensuring there is no damage to floors/carpets or any warping of the fire door. It is often beneficial in such environments to hold open

fire doors to ease access and increase ventilation during busy periods, where as many building facilities managers fall into the trap of wedging open fire doors without realising they could be prosecuted for doing so. The Agrippa fire door holder is a simple solution to holding open internal fire doors. It is competitively priced and easy to install. The holder is particularly useful for holding open fire doors in corridors and there are many accessories available including chain keepers and extension brackets for non-standard installations. The Agrippa fire door closer is a swing-free device which allows the fire door to be held open in any position. It will make the door resistance-free and so it will feel light and easy to move. The closer has been installed into care homes in the UK to reduce isolation for residents in their rooms. The devices come supplied with two C-cell batteries, can be programmed for daily release, have a battery life indicator and both products are approved to EN1155 and CE marked. For more information go to or call 01388 770 360.


PRESSURE CARE Getting The Right Mattresses At The Right Time Demand for space within care homes is on the rise and with that comes the problem of being able to plan for the number of beds you may need, as well as the specific mattress type needed for each patient. With the rise in temporary bariatric care in Care Homes being a prime example, being flexible and responsive has never been more important. Renting a mattress gives you the opportunity to cater to all patients at short notice, saving you money and taking away the stress of the unpredictability of patient intake by giving you flexible options. Rental contracts available from Spearhead include a deep clean and maintenance service which mean you no longer need to worry about your mattresses meeting health and safety standards, as well as offering a range

C & S Seating C & S Seating are proud to be the national supplier of 24 hour postural management and control products for over 25 years. Initially developed by the Company founders and a consultant specialist physiotherapist, using on-going feedback from healthcare professionals we now have a wide selection of positioning equipment available. We assemble and supply 9 different sizes of T-Rolls and Log Rolls (ranging from paediatric to adult) in a machine washable wipe-clean Titex or Soft Knit covering as standard. Our Knee supports and width

of mattresses suitable for whatever your market throws at you. Renting with Spearhead includes: • Rapid breakdown response • Work carried out by trained technicians • In-house Spearhead Technicians, you'll always be dealing direct • Transparent and clear reporting of results Ensure your patients are comfortable and provided with the best possible care from their mattress by taking advantage of the rental service with repair contracts provided by Spearhead Health Care. Call 0345 180 1800 to find out more. adjustable APS systems are also available in 2 sizes. Our new popular Soft Knit range of covers in a choice of 5 vibrant colours provide a softer alternative that can be fitted easily over our standard waterproof rolls. Ask our friendly sales team about our inflatable TRolls that are designed for short term use and ideal for holidays and aqua therapy aid. The inflatables also prove a valuable tool for Physio’s and OT’s during the assessment process. All fabrics meet the UK Flammability standards and carry a CE mark. We are also ISO 9001 regulated. Contact us on 01424 853331 or visit us at to download a brochure, pricelist or order form, request an individualised quotation, speak to an advisor or to place an order.

11 Ways to Help with Positioning Discomfort from Medoris The experience of carers, physios and occupational therapists is essential in foreseeing the possibility of ulcer development and pain from discomfort in positioning and pressure care. As a designer and producer of soft micro-bead pressure care products MEDORIS has listed eleven recent issues and the ways they can be alleviated. 1. Fingers closing towards the palm which are painful to lift up for exercise. Try the handgrip M063 or, if more severe, the palm protector/handgrip M113. 2. The hand is closed into a fist and the nails are cutting into the palm or the skin between fingers is deteriorating. Try the palm protector/hand grip M113 or palm protector/finger separator M112.

between the mattress and the raised side. A roll pillow placed down that side will prevent this. 7. With a profiling bed brain injured patients may still thresh their legs and widely available “hardish” cot bumpers are not soft enough to protect against leg damage. Our cot-side bumper plus M221 can prevent this. 8. With traditional wheelchairs feet do not always reach the footrests. Our footrest cushion M102 can fill this gap and be soft and comfortable for painful feet. 9. A leg ramp can be used as an arm support M062 and a 16-chamber cushion M057 can be folded over to give twice the leg ramp height.

3. Two skin surfaces become pink through touching each other. Try the limb protector M182 or knee separator M108.

10.Where the chin rests on the chest there is an alternative to the traditional horseshoe with a soft adjustable chin support M199.

4. Arm dropping to side after a stroke. Try the lap cushion M134 which can reach up to the armpit and across tummy.

11. Head(neck) support may be better with the raised sides of a ‘dogbone’ shape M195 than a conventional pillow, particularly in a recliner.

5. Falling out of bed. Try a roll pillow M096 under the bottom sheet, if necessary on both sides.

The Medoris website is currently being updated, but Medoris are contactable at or by ‘phone 0333 207 9515 or see the advert on page 3.

6. In a raised side bed a hand can become trapped

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TECHNOLOGY AND NURSE CALL Keyboard Specialists Limited-Your “One Stop Shop” Keyboard Specialists Limited (KBS) is a dedicated online retailer of over 2000 keyboards, mice, trackballs, touchpads, smartcard readers, monitors and OEM products. We aim to provide a one stop shop for all your keyboard and accessory requirements – no matter how big, or how small. We aim to provide clear, accurate and comprehensively detailed descriptions for all of our keyboards and accessories and make these available to all of our customers via our website, email and over the telephone. As it becomes easier and more efficient to purchase on-line than on the high street, we hope that our superb range and excellent pricing will save you time and money.

We continually monitor and update our prices to ensure you get the lowest prices possible • Discounted rates for large quantities or special offer items • Offer an availability check and next day delivery on many items • We can dispatch most items within 24 hours of an order being placed • View your Order History/Status and previous orders online • Track your items with our courier tracking service • Online shop open 24 hours • Direct delivery to an address of your choice See the advert on this page for details.

Edison Telecom Falls Systems Between 2008 and 2016 the number of deaths as a result of falls increased by 177% among men over eighty five years of age, while their total population only increased by 19% over that period. - Office of National Statistics, 2017 Edison Telecom can help. Their intelligent devices can detect unsupervised exits from beds and chairs, alerting staff to the potential for a

fall. Their temporary solutions can be deployed rapidly without trailing wires or other potential trip hazards. For more permanent installations, the system can take control of the room lighting, further reducing the risk of a fall. In addition, the logging and auditing functions allow the care management to demonstrate a strong commitment to reducing the risk of falls for those in their care.

KBS has the largest medical IT hardware range in the UK Our medical and infection control keyboards are built to the highest standards with cleanliness at the heart of the project. Cross contamination and infection are a major issue in healthcare settings; our vast range of waterproof, fully cleanable and wipe-able keyboards are key to minimising HCAIs. Fully HTM01-05 compliant and NHS approved.

£4+8VA.T66 JK-1068 Whisper Quiet Cherry Keyboard with IP68 Silicon Cover

Edison have been innovating and adapting a broad portfolio of products to meet the precise needs of their customers, whether NHS, Private hospitals or Care homes, for over thirty years. They continue to offer maintenance and hold spares for legacy call-systems; both wired and wireless, as well as supplying the latest products from a broad range of suppliers.

AccuMed Medical Keyboard (105) and Mouse Bundle (MOUNA-SIL)

9 £11+V9AT.9

For further information please call 01252 330220.

Workforce Scheduling Solutions Now With Face ID Workforce Scheduling Solutions has joined forces with Reliant Care Services (RCS) to deliver Time & Attendance systems worldwide, USA, Europe & Australia, using the latest Face Recognition technology. We has been in the business of Time Management for over 20 years, and has a vast experience in software development. We developed “Face Recognition” as an alternative to card, fingerprint, and key fob systems ensure that each member of staff can only book themselves on and off duty. “Face ID is not expensive and we have many customers using this technology very successfully. It has the advantage of not requiring any interaction by the staff, no cards that can be lost and their face is discreetly recorded each time, so no mistakes!!” DutyHours™ and TimeCap™ are easy to use and will dramatically reduce time and costs to produce staff payroll. It is suitable for a single home or for organisations that have multiple homes and centralized payroll. Last minute changes to employee

schedules are handled fast and efficiently and it will dramatically reduce pay queries. Staff simply clock in/out with their unique PIN and they can look up their time sheets showing work done or work planned in the future.

0 £26+V5AT.0

Purekeys Wireless Medical Keyboard and Mouse Set

We have introduced the concept of “Check Calls” in which employees are required to make regular calls through the night and weekends. During a recent CQC inspection at one of our customers, this feature impressed the inspector as being visual evidence of the actual employee working. The system creates an electronic timesheet of which job, where, when, which department and accurately calculates and controls pay hours including Bank Holidays, Sickness and other absence. It will identify allowances such as overtime, weekend and night shift working and export the hours for your payroll or for your accountant.

Call us on 020 3474 0234 Email

Call Workforce Group on 03333 444 562 for more information and a demonstration of the system.

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DutyHours ™ and TimeCap ™

Control Costs Staff Wages DutyHours Staff Time & Attendance ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

TimeCap is GDPR Compliant. Holiday, sickness and other absence recorded. Booking on with Face ID - accurate and fast. NOW WITH Agency staff proof of attendance. FACE ID! Eliminate paper Time Sheets. ACCURATE Reduce payroll errors. AND FAST Night time & Weekend compliance “Check Calls”. Electronic Visitor Book to automatically record visit details.

SAVING YOU MONEY AND FREEING UP YOUR RESOURCES Contact us on Tel - 03333 444 562 or

49 Station Road, Polegate, East Sussex, BN26 6EA


TECHNOLOGY AND NURSE CALL All Your Data Protection Needs – Covered The GDPR deadline is looming, but compliance need not be a daunting task. ZURI, the mobile, web-based care management solution developed by Care Software Solutions, has got all your GDPR compliance needs covered.

to the record held as required, from anywhere at any time. This allows the indidivual to be informed on the data held about them as well as rectify them if necessary or object to some of the data being held.

The EU General Data Protection Regulation becomes active on the 25th of May 2018, and contains requirements on how businesses process and protect personal information. In the health care industry, protecting sensitive information is nothing new, what is new is that GDPR requires that the organisation must be able to describe how keeping this sensitive information safe is intended before doing so and show how it will remain compliant through policies, procedures and guidelines. This is where Zuri comes in.

Should an individual request that his data held in Zuri® be deleted, they can then make a request and this will be processed. Additionally, if an individual would like the data held to be handed over to be imported across to a different system, this can be provided in various different formats upon request.

The key points in the GDPR 2018: 1) Individual Rights 2) Subject Access Request (SAR) 3) Data Breaches Zuri® takes data protection very seriously and in this vein, this is how Zuri can help your business comply: Individual Rights Under the new GDPR, the person you hold data for has the following rights: - The right to be informed - The right of access - The right to rectification - The right to erasure - The right to data portability - The right to object Zuri® complies with all of the above by giving access

Subject Access Request (SAR) A SARs request that is made directly to Zuri® in writing, will be responded to within 40 days as per the GDPR requirements with no fee if the request is reasonable as per the regulations. Zuri will only supply data after all security conditions have been met so as to safeguard your business and your client’s sensitive data. Data Breaches Zuri® has been designed from the ground-up to be ultra secure. Data is hosted on secure servers, databases are secured and most importantly, data records are encrypted. Zuri has password rules to make sure the passwords used by users are sufficiently secure, twofactor authentication to prevent someone else from accessing a user’s profile with their password, the option to change the password on regular basis, and fingerprint authentication on smartphones and tablets to ensure only your approved users are accessing their profiles. Please visit, or Email: Call: 0800 210 0094 or see the advert on page 24.

Nurse Call Systems from Alarm Radio Monitoring Alarm Radio Monitoring (A.R.M) is a UK based manufacturer of wireless Nurse Call and Staff Alarm systems; offering a comprehensive range of Nurse Call, Staff Alarm, Fire Alarm, and Door Access bespoke systems. With over 30 years experience in the design & development of wireless Nurse Call & Staff Alarm systems, A.R.M has established itself as a key player within the wireless solutions market to the public and private healthcare sectors. Wireless solutions are ideal for environments which do not lend themselves to running cables, for example listed buildings or busy environments. Wireless systems can be fitted while your home remains operational, so you do not have to close rooms off and they offer greater flexibility and ease for future expansion. Care Homes choose A.R.M nurse call systems because they: • Are quick and simple to install.

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• Make it easier for staff to identify the source of calls because they give full text descriptions.

• Give management the tools they need to monitor and control best practice. The system provides a full audit trail of which buttons are pressed and response times. • Failsafe eg alerts you in the event of a system fault or batteries are running low. • Carry a year’s guarantee. • Are supported 24/7, 365 days a year by specialist engineers over the telephone or online. Take the ongoing cost out of your operation with our unique return to base service exchange policy and low cost of ownership along with flexible finance options. No matter how demanding your environment, A.R.M believes everyone – whether you’re a customer in a care home or team member – should be within safe reach. Whether you need a combination of a Nurse Call, Staff Alarm, Fire Alarm, Door Access system, we have a team to help design a package that will meet your requirements. For further details call 01568 610 016 or email


TECHNOLOGY AND NURSE CALL Intelligent Care Software Limited Intelligent Care Software Limited are a company who design and promote intelligent, intuitive, and cost effective solutions for care home and domiciliary care management. We aim to produce applications that are simple and easy use, work seamlessly together, and provide the information and detail that is required to ensure regulatory compliance and a high quality of service. The CAREis suite of apps: Care and Support From enquiry, though assessment and care planning, to care delivery, CAREis helps to develop the care plan and to provide relevant and up to date data for quality assurance purposes. Care planning and provision is person centred and updated in real time. Carers know exactly what is required, and when to deliver support, with simple and detailed recording of any intervention.

ance reviews and monitoring is far more efficient. This app provides audit templates for all areas of regulatory requirement, and ensures important inspections, audits, and actions are addressed in the specified time frame. Analysis and action planning is streamlined and effective in reducing paperwork time and improving quality and compliance. Policy and Procedure We develop the policies and procedures based on the latest regulatory and governmental guidelines to ensure that your practice is up to date, relevant, and compliant in an easy to read format. With a facility for people to record that they have understood the policy, and a clear link to training requirements, knowledge of policy and procedure is improved significantly throughout the organisation. Support • Live UK based customer support 9-5 Monday to Friday • Urgent support by email 24/7 • Regular software updates

Quality Assurance

• Daily data back up

By extracting data from throughout CAREis in real time, quality assur-

See the advert on page 20 for details.

CareDocs: A Cloud Solution Designed for You Do you need access to your care records when you are here, there and everywhere? Wouldn’t it be wonderful if you had a system that you and your staff could all access wherever they needed to, updating point of care records in real time, completing care needs assessments on location, and checking, at a glance, if any details were missing or records needed updating? If that sounds too good to be true, then you need to know about CareDocs. CareDocs has introduced a more intelligent and connected method of managing records in the healthcare sector. The cloud-based system allows complete synchronicity between multiple devices

(including laptops, smart phones and tablets), home or away, meaning that you’re only ever a click away from viewing the most up to date information. CareDocs is a highly innovative care planning and management system that prioritises the needs of individuals in any care setting, ensuring person centred care is delivered. A comprehensive assessment, once answered, is compiled and automatically constructs the most appropriate, effective and personalised care plan. The user-friendly interface ensures efficiency in adding and reviewing care records, saving money and time, which can then be dedicated to further improving the experience for the people you care for.

Southern Care Maintenance Ltd With so much equipment now requiring routine testing and servicing, it is increasingly difficult to have all the paperwork, inspection certificates, LOLER certificates etc up-to date and readily available when needed. It is all too easy for these to become lost, or filed away in the wrong place. Two years ago, SCM, Southern Care Maintenance Ltd introduced a new on-line and secure customer portal, mySCM, which has been providing a real benefit to their customers. This provides, free of charge to all customers who have a service contract, a central repository which is available 24/7 and stores all this information together in one place. Copies of job sheets, certificates and invoices can easily be retrieved and printed out again should the originals become misplaced providing peace of mind. Continuing with the technological advancements of the modern day,

"CareDocs is arguably one of the best investments the home has made, and I would not hesitate to recommend it to anyone thinking of changing from paperwork to a computer management system" – Abbas Abeadli, Deputy Manager “Our manager has gone from a computer newbie to a true professional and has taken to operating the CareDocs system with ease. I don't know how we managed before CareDocs came along!” – Joan Evans, Care Home Owner Find out more about how CareDocs can benefit you, contact us on 0330 056 3333, or email

it is now possible to upgrade an old Fire Alarm System and Nurse Call System in under a week. Gone are the days of engineers installing cables and being present on site for a number of weeks as, with the new Radio Nurse Call, a call point can be fitted in a resident’s room within a matter of minutes. Flexibility is a real benefit with the new Radio Nurse Call as units can easily be repositioned when necessary, and multiple displays can be positioned around the care home to ensure staff never miss a call which further improves efficiency. SCM have two divisions which between them cover a huge range of equipment and systems for both supply and servicing, from Hoists, Fire Alarm Systems and Nurse Call. They operate throughout the south-east, including Kent, East and West Sussex, Surrey, Essex and South London postcodes. For more information follow the link to mySCM from . You can also use the Live Chat there or ring 01580 890089.

Lotus Care Technology The NurseAlert pressure mat has been one of the most successful floor pressure mats due to it being non slip and carpeted which makes it feel very natural under a residents foot. Lotus Care Technology Ltd have many other fall saving devices that can give you peace of mind whilst caring for this at risk of falls.  Having many years of experience in fitting and maintaining Nurse Call

Systems helps the guys at Lotus Care Technology understand that every home is different and has different needs. They can specify not only the best system for the enviromental factors in the home but also take into consideration the best products that will make your carers and nurses jobs that little bit easier. For a site consultation or friendly advice call them free on 0800 8499 121 or local 01822 613258.




TECHNOLOGY AND NURSE CALL Installing Landline Phones In Your Resident’s Room Is A Pain…Right? Getting BT or some other provider to install a line needs organising, staff have to be around to show the engineer where the line needs to go not to mention the risks of potential damage to the décor… Sure, they could have a mobile phone but they need charging up and a contract or even worse, topping up. Oh, and guess what? mobiles phones get misplaced and the Care Home staff spend valuable time trying to track them down.

• No Set-Up Charge • No Long Term Contract • Fixed Monthly Rental – Calls


You can also use facility to call residents loved ones, as it's free to call! NO MORE HUNTING EACH FAMILY MEMBERS NUMBER TO CALL, THEY ALL CAN BE ACCESSED VIA THEIR ONE CALL NUMBER • Emergency, Single Number Access To Resident’s Contacts – One Call Connects Them All!!

We wanted to make life easier. Now residential Care Establishments with our help can offer hassle free landline phone and number in the residents rooms - almost instantly. You could also make some additional recurring revenue in the process or create a residents welfare fund. Without lifting a finger!

Your resident gets their own, number to call and receive calls via dedicated telephone numbers, which their family pays a monthly rental. which includes all the calls inbound and outbound! – We handle all the support so you don’t have to.

It’s so easy you can actually market this to potential customers!

Interested? Visit or call 0800 0210182

Saving Care Staff One Hour Per Day Quinton House is a nursing home near Stratfordupon-Avon. The staff here work hard to ensure residents are cared for to a high standard. To support their staff the best way possible, they have invested in digital care planning. An investment that has now returned manifold. Better information sharing and evidencing By using the Sekoia tablets for digital care planning staff can access and deliver relevant information quicker and easier than before – on paper. All information is in the same place. And staff have their own log of events, which automatically time stamps every part of care delivery. Giving the best prerequisites for providing even better care. “You have the screens, you know where to access the paperwork you don’t have to go to different places to find them and everything is clear, everything is legible so information sharing is a lot better and there’s an audit trail -everything is time-stamped,” nurse and Deputy Manager, Kate Pascual, explains.

Medpage Limited Medpage Limited have manufactured quality affordable caring technologies for over 30 years. We specialise in providing bespoke design and development solutions for patient care. We were challenged recently to develop an alarm solution for a wandering resident in a care home on a limited budget. The alarm was to operate independently from the house nurse call system and required to send notifications to the carer mobile phone with time and

Efficient and cost saving For Quinton House, the decision to implement Sekoia was based on several factors. Printing 30,000 sheets of paper each month is not cost-efficient and the large amount of paperwork was a real burden to the staff. “From doing something which originally took us five to ten minutes: Two minutes, and it’s done. And rather than being with paperwork, you’re with the resident”, Kate Pascual explains. This new and improved way of working has resulted in a significant decrease in the time spend on recording and documentation. The first analysis shows that care assistants use more than one hour less per day on their documentation. Managing Director Bill Mehta elaborates: "It’s not all about the cost-saving, it’s about freeing up the staff, freeing up the nurses working day, freeing up the carers to spend more time with the residents and their families." For further information, call (0)20 7751 4010 or email dated incident reports. This we did with 100% success. The alarm is now a mainstream product sold nationally. Reassurance and confidence in a supplier is paramount to a successful business relationship, especially where healthcare is concerned. You can rest assured that when you buy and use our products you are connected with a company with backbone and a passion to offer care technologies that deliver performance and quality. Visit our website for further information about our products or Telephone 01536 264869 to request our new catalogue. See the advert on page 2 for details.

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FOOD AND NUTRITION Oral nutritional supplements – are they always being prescribed appropriately? Ayela Spiro is Nutrition Science Manager at the British Nutrition Foundation , a charity providing evidence-based information on food and nutrition. Malnutrition, characterised by low body weight and weight loss is both a cause and consequence of poor health and older people are particularly vulnerable. Oral nutritional supplements (ONS) can improve energy and nutrient intake (including protein intake), improve weight (or lessen weight loss) and be of clinical benefit and cost-effective as a treatment when prescribed appropriately. However ONS may represent a significant waste of resources if they are inappropriately prescribed or poorly monitored. ONS (sometimes referred to as sip feeds) are designated as foods for special medical purposes, and as such are regu¬lated by European legislation and must comply with com-positional standards. They can supplement a normal diet to help provide the essential nutrients individuals need when food alone is insufficient to meet daily requirements. There are a wide range of ONS styles (milk, juice, yo¬gurt, savoury), formats (liquid, powder, pudding, pre-thickened), and types (high protein, fibre containing, low volume) available to suit a wide range of needs, and most provide a full range of vitamins and minerals per serving. ONS should usually be taken between meals, and not as a meal replacement, to avoid spoiling appetite. Additionally, Initial offerings could include a range of products to establish individual preferences, improve compliance and reduce waste. It is though important to recognise that good nutrition care encompasses far more than the provision of ONS alone. It starts with ensuring that people have access to and/or are supported to consume food that not only meets nu¬tritional, but also cultural and religious needs and prefer¬ences. Good nutritional care also includes ensuring that people who are malnourished or at risk of malnutrition are promptly identified through screening, that action is taken to en¬sure that they receive appropriate and timely nutritional support, and that nutrition care is regularly monitored ONS then are only one of a spectrum of nutritional support strategies that can be used to tackle malnutrition. Food should be first-line treatment for those at low to medium risk of malnutrition However a lack of adequate training, historical patterns of use and inconsistent messages may promote care home staff to regard ONS as the panacea for malnutrition. Thus, ONS can be pre-

scribed in care homes without ade¬quate assessment, goals or treatment plans defined, and before other recommended first-line methods, such as di¬etary counselling and simple food fortification, have been tried. The use of ONS in dementia may be of particular in¬terest to those involved in nursing home care. Limited research indicates some improvement in weight and cognition with ONS although not in function or mortality. Research has also highlighted that although ONS may be prescribed with good intentions – such as dealing with challenging food behaviours like food refusal, or simply to be acting positively to help nutrition care – this may not always be appropriate and highlights the importance of involving dietetic expertise in nutrition care where necessary.

Dysphagia - Concern for Dieticians Estimating the prevalence of dysphagia is a difficult task says Helen Willis dietician at social care food specialists apetito. A secondary condition, dysphagia is a common symptom of a huge number of disorders and diseases and can occur at varying severities, and is caused by neurological conditions such as dementia, stroke and moat in your own congenital and development conditions such as cerebral palsy, muscular conditions and learning difficulties, or by obstructions resulting from cancers or GORD. This makes calculating the number of cases a challenge, but it is clear dysphagia is a common problem which can affect people of any age.

Helen said “apetito are committed to providing great food and great service, so that everybody can look forward to a delicious meal that supports their health and well-being. With menus featuring flavoursome home comforts including traditional Sunday roasts and fish Fridays, there is something for everyone to enjoy. We cater for diets influenced by illness, culture, religion, ethical choice, or personal preference. Our chefs prepare recipes alongside our dietician and nutritionist to ensure that everyone can enjoy the food they need.” “We understand that enjoying a tasty meal with good

company and conversation is one of life’s simple pleasures. That’s why we work with each care home in partnership to create a tailored programme which best suits the needs of its residents and provide an exceptional dining experience every day of the year.” Malnutrition is recognised as a significant burden on the NHS and in the community, says Vitaflo® International Ltd, a medical nutrition company dedicated to developing specialised clinical nutrition products, and is estimated to affect over 1.3million people over the age of 65, and the huge majority of these people are those living in the community, either at home or in residential care/ nursing homes1. Vitaflo have two great products which can help support those with malnutrition: - Pro-Cal shot® is a highenergy, low volume liquid oral nutrition supplement. It is an ideal choice to get a quick boost of energy and protein. 30ml provides 100kcal and 2g protein. It is a great way to “top up in a shot”, adding calories and protein to a patients daily nutritional intake in a simple, palatable way. Pro-Cal shot is available in 3 flavours which include neutral, strawberry and banana. Pro-Cal shot can be added to a range of food and drinks, including custard, porridge, milk, for an alternative way to take the product and get extra calories in. Pro-Cal shot is in a low volume compact 120ml bottle. - Pro-Cal® powder is a powdered, neutral tasting food fortifier. It is a blend of protein, fat and carbohydrate which can be added to a variety of food and drink. It enhances the energy and protein content with minimal effect on taste, volume and texture. Pro-Cal powder is available in boxes of single serve 15g sachets, and also in tubs. The 12.5kg or 1.5kg tubs are ideal for use in catering facilities such as care/nursing homes or hospital kitchens. One 15g sachet or one 15g scoop provides 100kcal and 2g of protein. Vitaflo dietitians alongside our in-house chef work hard to develop a range of supporting items to help with the use of these products. These include “Handy hints” providing quick and easy tips on how to add these products to food and drink. We also have more detailed recipe books to give further support for making meals, desserts, snacks, and smoothies. We are currently developing a Pro-Cal powder catering recipe book which we hope to launch later this year to further sup-

port the use of this product in care/ nursing homes or hospital catering. HotmixHome The affordable ‘Essential’ in every Caring kitchen flavour is a re-occurring theme when providing safe and nutritious meals, and no care home once patients missing out, or see their chefs struggling when producing therapeutic and texture modified diets, maintaining appetising flavour and colour of fresh ingredients therefore it is vital An essential piece of blending kit suitable for care catering environments is the HotmixHOME is the junior model of the celebrated HotmixPRO range of professional thermal blenders. It offers the most advanced cooking system designed for every kitchen! Equipment specialists Barbel believe that the HotmixHome, with its numerous functions cooking is made simple, safe and hassle free. All you have to do is choose the recipe, set it and enjoy, all the hard work is done for you. Thanks to its diverse functions and to the 398 stored delicious recipes it certainly suits every generation’s taste buds and preferred texture. It maximises flavours and goodness and wastes nothing. • Safe -The 2 litre heavy usage mixing bowl sits within a fully insulated stainless steel casing • Easy to Clean – Dishwasher proof mixing bowl • Self-Sterilising – Temperature range from 25° - 145° • Easy to Use - Operates exactly to programme at a touch of a finger • Efficient -Speed range from 0 -12’500 rpm allows blending, small and large amounts, to just the right texture • Financial Benefits – Precise temperature setting dramatically reduces waste by maximising nutritional values • Speedy Recovery – Vitamin rich, tasty food helps your residents to regain strength and sustain their best health levels HotmixHome is the essential support for every conscientious dietician or cook Limited Space or Limited Budget? HotmixHome will be YOUR answer – just ask! See the advert on page 15 for further details.


LAUNDRY SOLUTIONS 5 Reasons Why You Should Choose LaundryTec Chester based LaundryTec since its foundation in early 2016 has become one of Alliance Internationals major UK distributers. Founded by Jeremy Hartigan, the team of industry professionals with the backing of the Alliance Lavamac brand and supported by its service partner PDS Laundry based in Nuneaton. They supply a significant number of the UK’s leading health care operators with equipment, installation and after sale support. The LaundryTec designs offer not only washing, drying and ironing equipment but a full range of handling, distribution, folding and identification systems, to create a fully functioning laundry complete with all items necessary for efficient operation. Every LaundryTec machine includes full installation options, including the removal and disposal of an existing machine. A training program and a minimum of 24 months part and labour warranty.

The environment is at the forefront of every operator’s mind. Standard specification on a Lavamac machine includes functions that automatically weigh and control the energy input into the machine and store the data in the machines memory. Our LS range of electric heat pump dryers require no ventilation or gas services and operates at 3kw per hour.

5 REASONS WHY YOU SHOULD CHOOSE LAUNDRYTEC 1. Cost 2. Efficiency 3. Service 4. Design 5. Innovation Telephone 0151 317 3127 Web www..laundrytec.con

An Expert Laundry Solution, from CAD Designs to Installation Forbes Professional understands that specifying and designing a commercial laundry function is a complicated process and we work closely with clients through planning and design stages. For newbuild or renovation projects, we conduct early site- surveys so as to advise upon all the practical and logistical considerations for the space available. The physical layout, access and processing requirements will impact heavily upon the equipment choices. We can deliver CAD designs detailing the proposed layout as well as the electrical, plumbing and ventilation requirements. We also advise upon ducting, ventilation and water and

power supplies. Design fundamentals such as sink locations, storage area, sorting areas and flooring all need to be considered in the construction phases. Full compliance with CQC and WRAS stipulations is essential and best practice requires provision of clean and dirty areas so as to avoid any cross-contamination. This can necessitate a separate access

Hughes Pro Hughes Pro is a specialist provider of commercial laundry and dishwashing equipment plus manufacturer authorised aftercare. Laundry experts are on hand to assist with machine selection, offering outright purchase, lease and popular rental options. Detergent auto dosing is also a speciality. With stocks held in branch, expect high quality competitive installations and swift repairs by enthusiastic fully Miele trained engineers. Hughes Pro is one of the fastest growing Miele

for dirty laundry and exit for clean laundry as well as a distinct storage area for clean washing. Forbes Professional advises on the necessary compliance issues and provides all of the guidance, resources and support needed. We offer a wide range of commercial laundry appliances from Miele and Primus for adherence with stringent hygiene stipulations. Our engineers fully install and commission all equipment as well as providing user training and a same/next day engineer response service. For further information, visit call 0345 070 2335 or email info@forbes-professional.

Professional dealers since 2012, providing services for Miele and their national customers in 14 postcode areas and are now main dealer for Alliance, the world’s favourite commercial laundry products. All work is fully guaranteed and undertaken by well trained, well equipped engineers to the highest standard. Engineers are proficient in the well-known brands Miele, Amazon, Schulthess, IPSO, ADC, Primus, Huebsch, Electrolux, Maidaid, Hobart and others. Hughes Pro are holders of multiple contracts and agreements including ESPO framework 24. Domestic electrical products are also available via sister company Hughes Trade. Tel: 0800 052 0555 Email: Web:

Please mention THE CARER when responding to advertising

0151 317 3127


Washer Extractors

Tumble Dryers

Cost Quality Service Design Innovation

Flatwork Ironers

Other Equipment


CLEANING AND HYGIENE Maintaining High Hygiene Standards In Care Homes Paul Casson, Technical Field Manager, Rentokil Specialist Hygiene & Dr Peter Barratt, Technical Manager, Initial Washroom Hygiene For both managers and employees in healthcare environments, it’s of paramount importance to maintain the highest possible standards of hygiene. Failure to comply with health and safety regulations can lead to outbreaks of potentially harmful diseases such as Norovirus, resulting in increased risk to patient’s health, employee absenteeism, and consequent disruption to treatment plans and residents’ day to day lives. A large number of people pass through the doors of a care home on a daily basis, so keeping the environment clean and sanitised can under-

standably be a challenge for staff. So how can care workers ensure they are providing a sanitised care facility, while at the same time minimising disruption to residents?

The care cleaning routine When it comes to cleaning, little steps can make a big difference. With most bacteria and viruses transmissible through touch, maintaining surface hygiene goes a long way. A regular cleaning regime should be the cornerstone of your hygiene strategy, as it is a crucial step in helping to prevent outbreaks. It’s essential that cleaning is carried out in the care home both proactively and reactively Proactive cleaning involves the routine disinfection of shared contact points – such as door handles, surface tops – and communal areas. Reactive cleaning occurs as necessary, for example during an outbreak of illness, or when a known transmissible infection is presented by an individual. In this case, all areas inhabited by the individual should be thoroughly disinfected. Alongside routine cleaning, your regime should include regular thorough deep cleans where all furniture is moved away from walls, to ensure all areas of the facility can be reached. Ideally, additional deep cleans should be carried out at least twice yearly by a professional cleaning company. They will have access to specialist multi-purpose biocidal cleaners which can decontaminate surfaces by killing bacteria, fungi, spores, yeasts and viruses. Care home managers may also consider having a “Hygiene Healthcheck” consultation, which can analyse the contamination levels present (via a heatmap) and the cleaning strategy in place for all areas of the facility’. This will help to determine an appropriate cleaning regime, with a clear focus on contamination prone areas. It will also help specify the required frequency of deep cleaning, tailored to your facility, and how specialist disinfection should be implemented to enhance everyday infection

DiffX Does It DiffX is a powerful non-chlorine disinfection system which eliminates ALL surface contamination including spores, bacteria, viruses and pathogenic organisms. The patent protected formulation of disinfection represents a new generation of disinfection. It is not deactivated by soiling, it worksthrough the dirt. The powder is contained within a water soluble sachet, which when dissolved in warm water creates a disinfecting agent which outperforms chlorine based disinfectants, especially under the most extreme conditions.

control measures.

Sanitising hard-to-reach areas Ultra Low Volume (ULV) disinfectant fogging is a method of disinfection, carried out by a specialist, which enables the treatment of large areas in a short space of time. An extremely fast and efficient process, fogging has a fast-drying time and can significantly reduce the number of pathogens present when compared to manual surface cleaning alone. It can also be used in conjunction with routine and deep cleaning, to ensure all areas are fully sanitised.

Keep your employees in-the-know It’s essential for care managers to encourage employees to take sufficient care of their own personal health and hygiene to prevent the spread of illness. Continuous training and development for both management and staff, helps to ensure high standards of hygiene are maintained alongside operational efficiency. This can also help prevent unnecessary downtime in the facility. Above all, don’t neglect the basics of personal hygiene: particularly hand hygiene. Some diseases, like Norovirus, are transmissible for several days and can live on hard surfaces such as door handles and walls. To minimise the spread of bacteria and viruses, hands should be washed thoroughly for 20–30 seconds using soap and water, and then dried properly. If an outbreak does occur, it’s important that a professional deep clean and disinfectant fogging treatment is carried out. What’s more, employees should not become complacent following a deep clean and ensure standards of cleanliness are kept high. Employee training and constant reinforcement of hygiene best practice is essential.

Final thoughts Maintaining hygienic and resident-friendly premises extends beyond the use of specialist cleaners and the latest cleaning technologies. It also requires the support of staff in taking personal responsibility for their own hygiene as well as being aware of, and following, infection control procedures. By taking these precautions, care homes can ensure they are meeting the standards required both by UK legislation, and those expected by their residents and their loved ones.

DiffX kills MRSA and viruses, C diff spores 100%, TB and Mycobacteria, and CRE/CRO • It is non chlorine and non Quat based • Has a corrosion inhibitor and is pH neutral • Is low risk – COSHH • Effective against C. diff, MRSA and Norovirus • Cleans and disinfects in one at the same time • Improves cleaning standards • Patient, staff and visitor friendly • Safe in the environment. • All relevant EN Tests passed, through UKCAS accredited Labs DiffX saves money by keeping wards clean, disinfected and infection free. It also maximis-

es the use of materials being non-corrosive saving money on replacement cloths, mops, floors and equipment. We have a just launched our DiffX Dry Wipes, manufactured and packaged entirely in the UK. They have been tested to and passed the EN13704 standard which means they reach the required log reduction within 2 minutes under dirty conditions. The nonwoven material can be macerated and contains surfactants, so cleans and disinfects at the same time. For further information, call MTP Innovations on 01484 505615 or Visit or



Safe Management Of Waste A wide range of waste is produced in nursing and residential care homes. Managing it safely is the responsibility of every healthcare professional. The right type of container must be used for each type of waste, including various colour coded sacks for infectious waste, for instance.

hazardous, sanitary or general waste – should have been independently tested to prove its effectiveness and safety. Buyers in the healthcare industry should look for recognised quality standards such as the CHSA Refuse Sack Standard and EN standards, such as EN13592, alongside ISO quality management principles.

All waste needs to be dealt with effectively, not only for infection control and prevention, but also to make the best use of our resources. By ensuring waste management is a key focus in nursing and residential care homes, staff can ensure they are playing their part in a sustainable future, whilst maintaining a high standard of care and health and safety for residents, visitors and staff.

Cromwell Polythene is a major supplier of waste management solutions to the healthcare sector and an active member of the Sanitary Medical Disposal Services Association. We offer a full range of sacks for clinical waste management, from ultra-strong sacks with very high tear resistance to economically priced sacks with a high recycled content.

Any liner used in a healthcare setting – whether for

Visit or see the advert on this page.

Air-Freshening Solutions for Care Homes FRAGRANCE DELIVERY Technologies Ltd (FDT), one of the leading players in air-freshening industry, with presence in 50 countries, has pioneered in odour eliminating and neutralizing products. The Oxy-gen Powered range is designed to counter the unpleasant tough odours that can present themselves despite a thorough cleaning regime. They are effective for odour elimination, yet safe for health. FDT very well understands the sensitivities and challenges associated with the caring business, especially when it comes to providing a clean, safe and odourless environment for their valuable members. A wide range is available for Care homes to choose from, for example, the VIVA!e air-freshener, the programmable Oxygen-Pro (30/60/90 days) or the tamper-proof SHIELD model. The Oxy-gen® Powered products use patented medical grade technology to provide a consistent, continuous odour control without particu-

lates, propellants or solvents. Unlike aerosols, Oxy-gen Powered system releases fresh fragrance oil continuously for round the clock freshness. FDT’s Oxy-gen® Powered products are available in ‘Non-Fragrant’ and ‘Fragrant’ odour control cartridges that contain proprietary odour neutralising agent, Neutra-Lox, which eliminates malodours instead of masking odours. The Fragrant odour control cartridges eliminate malodour, while emanating clean, fresh-smelling fragrances into the air. Visir

Angloplas Dispensers Help Reduce the Risk of Cross Infection Angloplas are a UK manufacturer who specialise in producing dispensers for the health and hygiene industry. Although these are designed to keep the workplace tidy and uncluttered they are, more importantly, built knowing the control of healthcare-associated infections (HCAIs) are a priority for healthcare providers, and who are employing a combination of infection prevention and control strategies, including hand hygiene, cleaning, training and the adoption of new technologies, to tackle the problem. As a result, a wide range of infection control products and technologies are emerging on the market, including antimicrobial technology. Angloplas’ range of dispensers are produced in the world’s first proven Antimicrobial PVC with silver ion technology and which is exclusive to Angloplas. This helps reduce the risk of cross infection

Chiltern Water & Environment Chiltern Water & Environment was established in 1991 by Robert Hunt after gaining 25 years' experience as an operational and analytical scientist in the water supply industry. The company gained engineering and further management knowledge when David Hunt joined in 2012. Since then, other water industry professionals have added to the breadth of knowledge and experience within the company. We have always provided high-quality consultancy, testing and remedial services in a professional but personable manner. Our

by stopping the growth of bacteria and mould and works continuously for the lifetime of the product, reducing levels of bacteria such as MRSA, E Coli, Legionella, Salmonella and mould by up to 99.99%. For non-clinical environments Angloplas has recently launched its new Budget Range of products which are made to the same exacting standards as the antimicrobial protected ones but with lower price tags. You can order Angloplas products directly from its website by going to and clicking Hospital, Health and Hygiene or by using the Quick Response code. There you can use the easy online shopping system, or alternatively if you are NHS or an account customer, via an emailed or faxed purchase order. You can also view and/or download the latest catalogue and price list. steady growth has reflected our clients' trust in our services. Our current clients include large housing associations, pharmaceutical companies and facilities management companies, as well as individual landlords and small businesses. We ensure all our customers receive the same level of care and attention to detail. We have clients throughout the South East, London and the Midlands, and carry out water tests nationally and internationally. We currently provide regular water sampling and testing for over 500 sites. See the advert on this page for further information.

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INCONTINENCE SOLUTIONS Incontinence and Dementia Early Recognition

There has in recent years been rapid expansion in residential and nursing home care for elderly people, and many of the residents are likely to have some degree of incontinence or dysfunction. Incontinence is often accepted as an unavoidable part of ageing. Although highly prevalent in Europe, the US and Canada, incontinence remains a largely “stigmatised and untreated condition” (Tannenbaum et al, 2013), and can be challenging even for the most experienced of carers and taking a compassionate and understanding approach is vital. Incontinence however should not be viewed as inevitable. In the first instance, with good management it may be preventable. Incontinence is a symptom of underlying problems which with assessment and investigation, can be identified and treated. Even when a cure is not achievable, optimum methods of incontinence management can produce 'social continence', alleviate embarrassment of preserve patient dignity. People with dementia often experience difficulties with using the toilet. Accidents and incontinence can also cause problems, particularly as their condition progresses. This can be upsetting for the person and for those around them. This can be a sensitive topic for many people, but talking about it can help to deal with the problem. Incontinence can range from mild leaking to unintentional urination. Less commonly, it also refers to unintentional bowel movements, or fecal incontinence. This includes the occasional leakage of stool before a bowel movement or a total loss of bowel control. Incontinence is a symptom that develops in the later stages of dementia. About 60 to 70 percent of people with Alzheimer’s develop incontinence. But it’s not a defining trait. Not all people who have dementia have or will develop incontinence. Chris Knifton, Jayne Brown and Katie Bell (De Montfort University) examine continence and dementia

DEMENTIA Understanding Dementia Over 850,000 people in the United Kingdom (UK) are living with a suspected diagnosis of dementia (Alzheimer’s Society, 2014), whilst worldwide this is estimated at 44 million (Alzheimer’s Disease International, 2014). Dementia is in fact an umbrella term that is used to describe a group of progressive neuro-cognitive disorders characterised by a global cognitive impairment that represents a decline from previous levels of pre-morbid

functioning and leads to an eventual terminal illness. There are over 200 different conditions (sometimes known as dementia sub-types) that may lead to dementia (Ashton, 2016; Stephan and Brayne, 2010) although the most common sub-types seen in the UK are: • Alzheimer’s disease (Major or Mild Neurocognitive Disorder due to Alzheimer’s Disease1) • Vascular Dementia (Major or Mild Vascular Neurocognitive Disorder1) • Dementia with Lewy Bodies (Major or Mild Neurocognitive Disorder with Lewy Bodies1) • Frontotemporal degeneration (Major or Mild Frontotemporal Neurocognitive Disorder1)

Dementia is not an inevitable part of ageing and any concerns about a person’s cognitive deficits or unexplained behavioural and psychological symptoms, regardless of age, ought to be brought to the attention of the General Practitioner (GP). There are numerous conditions that mimic many of the symptoms dementia (known as differential diagnosis) but may in fact be treatable (i.e. delirium states, depression, hypothyroidism, vitamin deficiencies, metabolic disorders) and these need to be carefully assessed for and treated, or ruled out before a diagnosis of dementia is made. Clinical assessments would then normally include history taking, physical examination, mental state examination, cognitive testing, blood tests, and structural or functional brain imaging.

Behavioural Aggression Agitation Apathy Disinhibition Sexual disinhibition

Short term memory loss Retrograde amnesia Episodic memory loss Semantic memory loss Visuospatial memory loss Working memory loss Language difficulties and other associated

Psychological Anxiety Delusions Depression Hallucinations Personality changes

communication problems Orientation problems Sequencing difficulties

Biological Appetite changes Dysphagia Epileptic seizures Incontinence Increased risk of infection Sleep problems Visuo-spatial difficulties (i.e. depth perception)

• Accessible clothing for the user • Cover or remove mirrors (particularly where prosopagnosia is noted) • Prompting On some occasions a continence pad may be considered the best option. The best style of continence pad however for the individual with dementia needs careful consideration. In a recent funded study by Essity (Knifton et al. 2018) the qualities of a continence pad for use with people with mild to major dementia were considered:

(Simpson, 2000) • Discreetness and odour control (Chartier-Kastler et al, 2011) • Absorbency (Clarke-O’Neil et al, 2004) • Storage, ease of application and removal of pad (Fader et al, 2003)

Table 1: Some symptoms of dementia

Anterograde amnesia

• Visual signs and clear identification of the toilet area

• Good fit and comfort and easily disposed of

The symptoms of dementia are sometimes characterised as ‘cognitive’ and ‘non-cognitive’ (see Table 1), although presentation will vary depending on both type of dementia and stage or progression of the condition.

Non-Cognitive Symptoms

• Environmental design/modification of the toilet area

• Supports skin integrity (Trowbridge et al, 2016)

1 importantly DSM-5 (APA, 2013) notes that although the term dementia is used for degenerative disorders that affect older adults, the term neurocognitive disorder is widely being used

Cognitive Symptoms

Following continence assessment, a range of strategies to promote continence may be considered, such as:

Supporting carers with symptom management – continence One example of symptom management options that ought to be discussed with carers and people with a diagnosis is continence. Symptoms of incontinence are common in people with dementia due to deteriorating mental and physical abilities (Wai et al, 2010) and can be a significant cause of distress to carers. Poorly managed continence problems could also lead to untimely care home admissions. Continence problems for people with dementia may include: • Memory problems with forgetting to go to the toilet • Executive problems in not knowing how to use the toilet or adjusting clothing • Communication problems in articulating need • Difficulties in recognising the toilet It is important to note that continence problems may not be related to the person’s dementia. Rather a host of other conditions may be attributed to the cause, including infection, enlarged prostrate, constipation, etc. A carefully considered continence assessment is therefore always essential and ideally referral to a continence nurse.

• Can be used with other products such as barrier creams (Vinson and Proch, 1998) This was used to inform a small study of continence products with people with dementia in care homes. Carers who responded (n=72) indicated that pull-up pant style products were useful for people with mild dementia as they promoted a greater sense of independence and were viewed as discreet. Conversely this type of pad was seen as unsuitable for people with more advanced dementia. Continence products are likely to need to be changed more often and pull up style products may increase distress for the person with dementia and prove more labour intensive for the carer. The use of a wrap-around continence product in this situation was considered more appropriate. Financial consideration often limits the range of continence products available for use with individuals, however from both a financial (staff time) and patient centred perspective having the appropriate continence product available for people with dementia is essential.

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INCONTINENCE SOLUTIONS (...Continued from previous page) Because everyone has different needs and preferences and because some days you may require more security than others, our range of TENA pads and TENA pants is available in a variety of sizes and absorbency levels for women, men and children.

Hygiene should be a priority Jason Whitbourne of CLH Healthcare says : “When providing care to residents who are living with incontinence, it’s crucial to provide them with adequate levels of hygiene. It’s important that not only are residents living with incontinence kept clean but also that hygienic practices are in place when dealing with accidents. Carers should always wear disposable gloves when dealing with an accident to prevent contamination. They should use antibacterial spray or disinfectant to clean areas that bodily waste has come into contact with, and should place all soiled materials into a biohazard bag. It’s also important that hands are washed after dealing with an accident, even when disposable gloves have been worn.” “As we get older, we become more prone to problems with incontinence, which is why so many people in care homes suffer from this issue. While incontinence can be embarrassing for residents, by taking note of the tips above you can make dealing with accidents less awkward and upsetting.”

Personal Hygiene Solutions Ontex, leading international producer of disposable personal hygiene solutions offers a comprehensive range of continence products, supported by a dedicated team of professionals providing leading levels of customer service. A spkokesperson said “Recognising the importance of face-to face contact with customers, we

have invested in a large team of qualified nurses who offer and training and support (on their iD and Lille branded products) to Care Homes and the NHS. We are a key supplier to over 300 NHS organisations and currently NHS Scotland’s preferred supplier

Preserving Dignity Preserving patient dignity, confidence and comfort is vital says medical equipment supplier Win Health, who provide CareZips™ , a new adaptive trouser garment that preserves dignity of incontinent people and aids carers in delivering better care. Fitted with unique 3-zip fastening system, the CareZips™ make changing of personal incontinence products more dignified and comfortable for the wearers and easier and faster for the carers.

can cause concern and distress and have a major impact on your life, say Incontinence UK, but, they say, it needn’t be that way. With the right information and support, by using products designed to meet specific needs, active steps can be taken to manage the issue of continence effectively and remove the worry. Alongside the wide range of incontinence products that Incontinence UK sell; they also offer a great selection of incontinence accessories that can help. From wipes, gloves to skincare range we have it all. Some of our best-selling accessories include: • Moist Patient Wipes gentle, fragranced moist wipes are ideal when quick cleansing is required. They lift soiling quickly and easily. Dermatologically tested. • TENA 3 in 1 Skincare Range TENA Wash Mousse, Wash Cream and Wet Wipes are the perfect replacement for soap and water in addition to skin conditioning products.

CareZips™ feature 3 strategically positioned zips, 2 of which run from the waist to the knees on both sides of the body and the 3rd zip from inside of one knee all the way up and down to the inside of the other knee. The 3-zip system makes access to the abdomen and crotch during diaper changes fast and easy. There is no need to undress or pull the CareZips™ down. CareZips™ are unisex and available in 7 sizes for good fit. Made in popular colours, CareZips™ fabric is soft and wrinkle resistant with stretch for extra comfort. Washable and non-iron, the CareZips™ are perfect for wearing every day. When worn over hip protectors for incontinent people (i.e. HipSaver QuickChange, HipSaver OpenBottom, HipSaver EasyFit), the CareZips™ improve dignity and comfort and help to prevent fall-related hip fractures.

Positive Steps Bladder weakness and continence problems

• Gloves – powder and latex free vinyl gloves. • Urinals - Male and female urinals with a 1 litre capacity. • IncoStress - medically designed for women, to combat stress incontinence. Worn internally, its shape supports the bladder, strengthening the pelvic floor muscles. Sangenic Easiseal Pad Disposal Unit - This bin is the most convenient way to dispose of incontinence products. The system individually wraps and seals each incontinence pad in a fragranced, anti-bacterial film locking away germs and odours in a hygienic way. Tel 01392 823233 • Tel 01835 864866 • 01582 677400 • 01536 269744 • 0800 068 3625 •

esemtan® Cleansing Foam for Gentle Skin Cleaning esemtan® cleansing foam offers quick and effective skin cleaning particularly for residents who are incontinent and those who are predominantly bedbound. The easy to use foam ensures gentle skin cleansing. After shaking thoroughly, the foam is sprayed directly onto the skin area, left for a short period of time, then removed with a disposable cloth. It can be used for residents with urinary incontinence, loose stools or diarrhoea. esemtan has an odour-neutralising discreet, fresh scent and works through the use of mild surfactants. Contact: schülke UK Ltd, Cygnet House, 1 Jenkin Road, Meadowhall, Sheffield S9 1AT 0114 254 3500 /

Committed to Care

CLH Healthcare is a family business which has been supplying a vast range of products & services into the healthcare sector since 1975.

The foundation for our steady growth over 40 years has been our strong business ethics and values, of integrity, trust, and long-term relationships with our customers, suppliers, and all we work with. CARE HOME SUPPLIES • Incontinence Products • Full Range of Medical Grade Gloves • Medical Equipment • Moving & Handling • Nursing Equipment • Janitorial Products • Laundry • Dynamic Mattresses • Bed Linen & Towels Online ordering available from an easy-to-use website

01392 823233



FRANKLITE LIMITED have been known for their quality of product and service in the decorative lighting market for over 40 years and, over recent years, the Company has built an astonishing reputation for quality LED lighting. Recently, Anovocare’s Cloghran Nursing Home in Dublin asked Franklite to create a design that would incorporate as much LED as possible whilst avoiding glare problems that can be created by some poorly designed downlights. Franklite’s range of quality recessed downlights offer a modern, simple lighting scheme with clean lines and

an unobtrusive way to illuminate spaces.

The chosen LED lighting for the nursing home was well positioned to provide ambient lighting and more focused task lighting. As intended, the results were magnificent and can be viewed on our website. Franklite have a team of professional and knowledgeable personnel who can demonstrate Frankled technology and discuss individual requirements. Call 01908 691818, email, visit or See the advert on the facing page for details.

New Exotic Print by Skopos

be new waterproof antimicrobial upholstery fabrics, one with a linen feel and the other a sumptuous velvet.

LAUNCHING AT this year’s Care Show in October, the new exquisite print from Skopos will be based on a faraway island theme.

Skopos launch new collections each year for contract interiors and manage the refurbishments of key Care Home groups and independents, delivering both fabric only and full service: including design, site measure, cushions, drapes and bedding and installation.

Using a mix of illustration and hand painting, the collection has been created to inspire a dreamy faraway island feel, perfect for creating an uplifted mood. The collection will be the launch platform for a new Skopos soft linen-look FR base cloth and will be shown across furniture, drapes and bedding alongside wallcoverings from Muraspec. Launching alongside the new print will

Renray Healthcare Renray Healthcare has been producing high quality furniture for over 50 years and is one of the UK’s largest and leading suppliers to the healthcare sector. Whether you require a fast efficient delivery of quality furniture or a full room installation and fitting service, we have the experience and resources to handle your contract. We manufacture and assemble our products in our own purpose built factories in Cheshire and Europe to British Standards. Hence we are able to ensure your furniture is produced to the highest quality, working with you to plan and meet your projects time schedule and budget. We understand you are purchasing furniture that is fit for purpose, stylish and will continue to perform well into the future, which is why we design and build our furniture with you in mind. Telephone: +44 (0)1606 593456, Email:, or see the advert on page 3 for details.

All our products are tested to comply with FR contract standards. Skopos is an ISO9001 accredited company and has over 45 year’s specialist experience in the design and manufacture of high performance FR fabrics and furnishings for the care, hospitality,cruise and leisure sectors. Visit for further details.

Christopher Guy Interiors Christopher Guy Interiors is one of the largest independent suppliers of nursing home furniture, residential home furniture and dementia care furniture in the country today. We are a family run business and the owners have been involved in the manufacture of furniture for over 40 years. We are constantly expanding in the field of nursing home furniture, residential care home furniture and special needs furniture. We have one of the best ranges of exclusive contract fabrics and are proud of our quality and the excellent value of our products. We deliver throughout the country and always put the customer first and endeavour to meet their requests. We constantly have special offers on on clearance fabric and vinyl furniture. Spectacular Clearance Offer.

Up to 950 chairs available with up to 100 clearance fabrics variations of your choice. Queen Anne clearance deals 500 available £119 + VAT Jemma Clearance Deals 350 available £124.99 + VAT Florence clearance deals 100 available £139.99 + VAT Nowhere else in the country can these chairs be bought at this price. Free delivery on orders of 10 or more chairs. Competitive prices keep Christopher Guy Interiors ahead of all their competitors and our turnkey packages cannot be beaten for price, quality and value for money. Reader enquiries - Tel: 01274 660123 or visit

Kilworth Flooring & Furnishing Company Ltd contract and commercial flooring across a broad market sector. We offer a vast selection of carpets and carpet tiles, sheet vinyl & safety flooring and specialist design lead flooring products, dealing with the UK’s major manufacturers and wholesalers.

Located centrally in Leicestershire, we are a family run business specializing in contract commercial flooring, furniture and soft furnishings. We provide a complete and comprehensive service to our customers including bespoke interior design services, the selection and sourcing of the best available products, installation by professional fitters and tradespeople, and ongoing management of assets and installations.

We have successfully grown over the past 10 years, providing flooring, furnishing and facilities services into diverse commercial market sectors.  Operating from our Leicestershire Head Office, we service our customer's requirements throughout the UK.  Our 5,000sq/ft headquarters incorporates offices, showroom, fabric design studio and substantial warehousing for our Rapid Response services. Our Flooring Division specialize in

Freephone: 0800 917 7943

Our fitting teams have a wealth of experience and expertise, with many years in this industry the quality of installation is second to none.  Our customer base includes many types of establishment within Healthcare, Education, Hotel & Leisure, Motor Trades and the general commercial market place. It has been challenging and exciting to work with such a diverse group of customers to the successful conclusion of many projects.

INTERIOR DESIGN - The finished article and its impact on the customer and their clients is of extreme importance. With this in mind our experienced design team take an active role, working very closely with our customers to create full designs,

colour schemes, fabric selections and furniture choices to help create the visions that our client imagines. PROJECT MANAGEMENT - As a project reaches its conclusion the volume of work for a client increases dramatically. We recognise this and our onsite project team are in place to take on the full site management - receiving deliveries, organising full room placement, unpacking boxes and wrapping, disposing of all rubbish and assembling equipment – we will handle this full project management for you and take on these time consuming requirements. NEW BUILD & REFURBISHMENT - Our services and supply base lend themselves perfectly to the completion of full turnkey new build fit outs or refurbishments, whether in the Healthcare sector, Hotels or smaller projects in Education and Leisure. At Kilworth we are able to assist with furnishing all areas of the building, from Soft Furnishings and Curtains, Cabinet Furniture, Chairs, Seating & Tables through to Linens, Office Furniture & Specialist Equipment. Telephone: 0116 259 9848 E-mail: Web:



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SING FOR YOUR LIFE Announces 50% PRICE REDUCTION By developing the new tablet based Silver Song Music Box System the cost has been reduced by 50% to £750!! There are now over 300 Silver Song Music Box systems in use in residential care homes, dementia units, day care centres and by community groups. The improved system is easier to use and by improving technology we have been able to reduce the cost to support the care sector struggling to meet increasing demand when budgets are under great pressure.

THE SILVER SONG MUSIC BOX system has been developed by Sing For Your Life to enable Day Care Centres, Residential Care Homes and Hospitals to provide participatory singing sessions for older people. Singing brings people together and The Silver Song Music Box provides an inclusive activity that delivers excellent cognitive stimulation therapy and an effective reminiscence experience.

BENEFITS Research has revealed that singing stimulates the release of endorphins which restores memory and comprehension; it helps restore balance and strengthens the facial muscles of those who have Parkinson’s Disease or are affected by stroke, and it helps those who have respiratory diseases (COPD). But above all it is an enjoyable activity which fights social isolation and loneliness.

Supporting the recommendations of The National Institute for Health & Care Excellence (NICE) NG32 and QS137 which recommend singing to be beneficial for older people living with long term conditions or who are lonely or socially isolated. The benefits of singing have also been endorsed by the Care Quality Commission and Inspectors will be influenced by the existence of an appropriate music programme in a care home.


Hampshire, Thames Valley East Anglia

South West England

All other areas

For more information call 07709 625487 email or go to

We continue to create more community singing groups as well as enabling singing to be provided in care homes and hospital dementia units. The unique Silver Song Music Box is loaded with over 200 originally recorded versions of popular songs as well as hymns and Christmas Carols. More than 300 singing groups have been created using this system which enables singing to be provided by Activities Organisors who are not trained musicians. Singing can therefore be provided whenever or as often as required.

“A Song a Day Keeps the Doctor Away”

At Select Lifestyles, we respect, value and celebrate the unique attributes, characteristics & perspectives that make each person who they are!

All people regardless of ability are entitled to a full and eventful lifestyle Courses available either in house or on site at our training centre in the West Midlands: ·         Emergency First Aid at Work ·         Basic Life Support ·         Paediatric First Aid ·         Manual Handling ·         Fire Safety ·         Safeguarding ·         Food Safety And many more. For a full list of training we provide please see our website.

Our Training Manager Wayne Phillips has been delivering high quality interactive training since the start of 2011. Prior to this, Wayne was a Registered Domiciliary Care Manager with the Care Quality Commission (CQC) for our parent company Select Lifestyles Limited.


0330 333 7484

DEMENTIA CARE AND TRAINING What is Dementia Care Matters? We believe that when we get Dementia Care right – We get All Care right – so this model will support excellence across all needs and sectors – it’s about the person first and last. The next time you communicate with someone who is not at his or her cognitive best, remind yourself of this: “This interaction is not about me. This interaction is about someone who is seeking connection on terms that may not advance the interests or needs of my ego. I am going to go where your needs are taking you. I am going to be with you in that place, wherever and however it is. I am going to let my ego disappear now. I am going to love you in your image instead of trying to re-create you in mine.” Quoted from Love, Loss and Laughter: Seeing Alzheimer’s Differently by Cathy Greenblat 2012 Lyons Press: Guildford, Connecticut. • An Innovative, Transformative way of delivering excellence in all care settings • Proven to improve all Key Performance Indicators, both operationally & financially – keeping Emotional Intelligence at the heart of everything. • A step by step programme to support you to be the best, whilst remaining True to Yourself & Others • A pathway to Authentic Leadership that Transforms the lives of the people who work, live and interact with the support you offer.

times of our lives. Life is a journey and every moment has significance, it makes us who we are and this feeling is not limited by a diagnosis. We achieve significant moments by: • Knowing our Feelings Matter Most in life - we feel. • Turning a place into ‘feeling at home’ - we look. • Needing to be reached - we connect. • Having a purpose and engaging in meaningful activity - we occupy. • Valuing relationships with people - we share. • Being loved for who we are - we reach. • Sensing acceptance and freedom - we relax. • Nurturing and looking after oneself - we matter. Founded by Dr David Sheard in the United Kingdom in 1995, this inspirational model of care has now been implemented in world leading care homes, hospitals & home care services throughout the U.K., Ireland, Canada, Australia & the United States of America. Based on tried & tested operational tools, with demonstratively powerful results, we will work with care services of all sizes to improve your dementia care. Please contact Sharon Turner on or visit our website on or see the advert on page 43.

Feeling that you matter in dementia care involves just the same things as mattering in other

Focus Games: Enhancing Training With Educational Games Delivering high quality care means social care staff must receive high quality training. With so many options available, choosing the right method of training can be difficult. Our educational games provide a face-to-face training workshop without the expense of a specialised facilitator, or the hassle of a visit to an offsite training location. They provide focussed training sessions at a time and

Players can manage the game themselves and learn by taking part in structured discussions stimulated by the game. Talking and sharing ideas helps players to develop their confidence and acquire new knowledge and skills.

improving care delivery, including managing dysphagia, preventing pressure ulcers, supporting good nutrition, and teamwork and communication skills. All games are developed with experts in the related field, giving you the confidence that staff are being equipped with safe, accurate information.

We offer games to help your staff learn about a variety of issues important to

Visit to find the game that works for you.

location that suits you and your staff.

Documenting Activity & Well-Being Why do many Carers record negatives not positives? This question was asked recently on a NAPA training day by a bewildered Manager. She was working hard to get the whole team to recognise the part they played in offering meaningful engagement to the residents. She knew that lots more, really good interactions were taking place because she saw them as she worked around the home. Checking on what was written in the care plans and daily notes made her realise that little, if any, of this great work was being written down. Instead she saw note after note that identified what a resident hadn’t done or couldn’t do. Lots of the notes detailed things like increased use of a hoist or poor appetite today. Where was the comment about the lovely lady that had her nails painted by a Carer and then took charge of the nail varnish and swapped roles? Where was the record of the gentleman that had spent all afternoon carrying light bulbs around for the Maintenance team? At NAPA we think this is indicative of a gap in training for carers. In their defence, in the past, little importance was placed on how people spent their day and as a result no thought was given to writing it

down. The focus was always on recording personal care and clinically based interventions. Best practice has shifted, and so has the Regulators’ requirements, to seeing everyone as an individual with a life to lead. Well-being and good mental health are now seen, among other things, as indicators of good care. Recording things that support this, like meaningful engagement, haven’t yet caught up with this way of working. One of the challenges is the time it can take to record lots of short exchanges. We know of a number of initiatives to address this problem. One care group has a ‘Golden Moments’ scheme. All staff have a small post-it pad in their pocket to quickly write down what happened and who with. These are handed in towards the end of the shift to a Senior responsible for documentation that day. The information is pulled together and captured in the care plan. The advantage is that, for example, a resident may have had a number of conversations with different staff about something he really enjoyed the day before. This information is priceless for the Activity team when they are making plans with him but also means that the care plan is recording his well-being and something that holds meaning for him too. The bonus is that staff members can get due recognition for the activity they are carrying out and, hopefully, greater understanding of the need to get up, washed, dressed and ………… enjoy the day. Sylvie Silver, Executive Director, June 2018 For further information please visit


DEMENTIA CARE AND TRAINING Call-to-Mind Can Give People with Dementia a Voice! The focus of this specially designed game is to get players talking about their preferences, their history, their opinions, and their hopes. It can really boost a player’s morale and confidence knowing someone is interested in them and that they and their thoughts really do matter. Call-to-Mind was designed as a tool to use in care homes, and was shortlisted for “Dementia Product of the Year”. It is now in it’s 2nd edition and proven to be popular in hospitals, dementia cafés, day care centre, and at home. Families and friends have found this a really effective

game to play. It’s an entertaining way for different generations to be involved in the same activity and a great way to know new things about each other! Families and carers can find it difficult to think of new ways of spending quality time together and engaging a person with dementia. Playing Call-to-Mind is a great activity in itself, but by finding out more about a person’s likes and dislikes, it suggests other ways they may wish to spend their time. It gets people talking and connecting. See the advert on page 41 for details.

Ten Happy Days Tips for Residential & Dementia Care Homes 2018 By Gillian Hesketh MA MD Happy Days Dementia Workshop & Nostalgic Design Designers spend weeks, months, even years researching safe environments, product durability, audience potential usage and much more. Founder and designer, Gillian Hesketh of Happy Days Dementia Workshop & Nostalgic Design has visited hundreds of residential and dementia care homes and care services over the past nine years, encouraging enrichment of social care not only through training and reminiscence materials, but by designing meaningful wall art collections and interactive displays to complement the home, the residents needs and their interests. She has developed many simple and cost effective solutions to enliven everyday residential living environments, uplift mood and help carers enrich social care for well-being. Proud to be supplying materials nationally and internationally, she has created a list of do’s and don’ts for residential care and dementia homes, hospitals, rehabilitation settings, dementia cafes, care teams and families to share. Try it yourself with Gillian’s Ten Happy Days Tips: 1. Entrance Porch and Area: Keep notices simple. Display emergency and important information together. Update information regularly and remove out of date information which may cause confusion. Use clear images to attract interest and simplify understanding. 2. Social Areas Furnish living and social areas with titles to help way finding. Add extra meaning by ensuring an image or colour is created within the name i.e: Garden Room Reminiscence & Activity Corner - Meadows Lane Bluebell Avenue - Coronation Street. 3. Smaller Areas & Awkward Corners Is the best outcome being made of unused spaces? Brighten up dark corners with a sixties patterned wallpaper, nostalgic displays or themed wall art. 4. Vistors

Please mention THE CARER when responding to advertising

Encourage visitors to engage with residents. Often, relatives and friends are at loss of things to say or do when

visiting their loved one. Let visitors know you have a range of nostalgic games, jigsaws and memory boxes to share with residents. 5. Games & Activities Repair damaged boxes. People are used to the everyday task of fixing and sorting things - ask residents to engage in the project of fixing boxes or tidying creative areas. 6. All Around Remove shabby or jaded flower displays. Clear tattered books from bookshelves. 7. Fresh Flowers There’s nothing better than a vase of fresh flowers to please the eye and prompt conversations. 8. Wall Art - Displays - Murals Imagine seeing wall art through the eyes of your residents. Are the pictures too high for residents to see? If so, re-locate pictures to a lower position. Take down faded pictures or tiny pictures which are difficult to see. Remove black pictures with small images - These can sometimes give the effect of shadows or even holes for people living with dementia. Wall art can aid way finding too. Images of food often encourages eating and helps direct residents towards dining areas. Check out the extensive range of Happy Days nostalgic wall art online at 9. Outdoor Areas If windows look out onto a garden area, add bird, squirrel or rabbit garden ornaments and/or a bird table. 10. Balance noise levels. During visits, I often notice both a radio and a television are switched on in the same room, which causes sound confusion. Let residents know when you are going to use loud appliances. If you think and feel well, this will reflect onto the person or people you are caring for. Shop for reminiscence and decorative materials Themed Rooms - Nostalgic Displays - Murals and more at


Social Care Boost Would Transform NHS’s Next 70 Years Properly funding social care would help transform the next 70 years of the NHS, a care leader has said. As the NHS marks its 70th anniversary, Mike Padgham says the best present it could be given would be better support for social care. He is so worried about the current crisis in the care of older and vulnerable adults that he has penned his FIFTH letter to Prime Minister Teresa May calling for action. And he has repeated an invitation to her and to Secretary of State for Health and Social Care, Jeremy Hunt to visit a frontline care provider to see the challenges first hand.


better funding social care.

“In the meantime the number of people going without care – currently 1.2m – will continue to grow as care homes and home care providers close their doors, because they can no longer afford to operate.”

“The £20bn extra for the NHS recently was very welcome I’m sure but is meaningless unless it is matched by better funding for social care.

He said he had already written to the Government four times on the issue but had yet to get any promise of a solution.

“Without extra funding in social care it will, as quoted elsewhere, be like turning on a tap without having the plug in. The NHS will get an extra £4bn a year – but it is already costing £3bn a year to keep older and vulnerable people in hospital because there is no social care available for them to be discharged.”

“The reality is, the Government doesn’t want to face up to a solution that will mean they have to provide more funding for social care - even though better funding for social care saves the NHS money, as older and vulnerable people should be cared for at home or in care homes and not in costly hospital beds,” he added.

Mike Padgham says delaying the Green Paper on social care until the autumn was a betrayal of the growing number of people in this country currently going without the care they need.

“They have been promising action through the Green Paper this summer but now even that has been put back, which feels like yet another betrayal.

Mr Padgham, Chair of the provider organisation The Independent Care Group, said: “The NHS is a wonderful, amazing institution, admired and envied the world over and a fundamental pillar of life in this country, doing a fantastic job for all of us,” he said.

“Once again, social care has been kicked into the long grass by ministers who seem simply not to know what to do about the crisis.

“I won’t give up, the Independent Care Group won’t give up and more importantly, the public mustn’t give up, pressing for a fairer deal for social care.”

“As it celebrates 70 years, the best way to support it and help it begin the next 70 years would be to take some of the pressure off it, by reforming and

“In reality it means we will be waiting well into 2019 and beyond before we see even a start to any social care reform and the sector can’t wait that

“We have had at least 13 commissions, reviews, white and green papers and consultations in the past 17 years alone and nothing has changed.”

Change Needed to Meet People’s Health and Care Needs The Care Quality Commission (CQC), has published a report bringing together key findings and recommendations for change, following the completion of 20 local authority area reviews exploring how older people move between health and adult social care services in England. Many older people have complex needs, and meeting these needs usually requires more than one professional and more than one agency to work together. CQC’s local system reviews provide a detailed insight into the journey through health and social care for people who use services, their families and carers – and identify where there are gaps which mean that people experience fragmented or poor care. ‘Beyond Barriers’ highlights some examples of health and care organisations working well together – and of individuals working across organisations to provide high quality care. But the reviews also found too much ineffective co-ordination of health and care services, leading to fragmented care. This was reinforced by funding, commissioning, performance management and regulation that encouraged organisations to focus on individual performance rather than on positive outcomes for people. The lack of a shared plan or vision resulted in people not receiving the right care in the right place at the right time – with consequences ranging from care being provided at greater expense than necessary, to increased pressure on services, to people’s quality of life being significantly diminished.

In one example, an older lady was living at home independently with the support of her son and services from a domiciliary care agency. One Friday evening she fell, bumped her head and was taken to hospital. After a night in hospital she was ready to go home – but because the right staff were unavailable over the weekend she could not be discharged. On the Monday morning she was ready be discharged, but because her home care support was no longer available, she couldn’t go home. She stayed in hospital for over a month, her condition deteriorated and eventually she was moved into a residential care home. She never saw her home again. The report sets out a number of recommendations designed to encourage improvement in the way agencies and professionals work to support older people to stay well, including: The development of: • An agreed joint plan created by local leaders for how the needs of older people are to be supported in their own homes, helped in an emergency and then enabled to return home; supported by: • Long term funding reform - involving national care leaders as equal partners - in order to remove the barriers that prevent social care and NHS commissioners from pooling their resources and using their budgets flexibly to best meet the needs of their local populations; underpinned by: • A move from short-term to long-term investment in services, and from an activity-based funding model towards population-based budgets which encourage

collaboration between local systems. • A single joint framework for measuring the performance of how agencies collectively deliver improved outcomes for older people. This would operate alongside oversight of individual provider organisations and reflect the contributions of all health and care organisations – including primary, community, social care and independent care providers – rather than relying primarily on information collected by acute hospitals. • The development of joint workforce plans, with more flexible and collaborative approaches to staff skills and career paths. National health and social care leaders should make it easier for individuals to move between health and care settings – providing career paths that enable people to work and gain skills in a variety of different settings so that services can remain responsive to local population needs • New legislation to allow CQC to regulate systems and hold them to account for how people and organisations work together to support people to stay well and to improve the quality of care people experience across all the services they use. Sir David Behan, Chief Executive of CQC, said: “Our findings show the urgent necessity for real change. A system designed in 1948 can no longer effectively meet the complex needs of increasing numbers of older people in 2018. People’s conditions have evolved – and that means the way the system works together has got to change too. “We have seen the positive outcomes that can be

achieved when those working in local health and care organisations have a clear, agreed and shared vision together with strong leadership and collaborative relationships, and we met some outstanding professionals, working across organisational boundaries to provide high quality care. However, their efforts were often despite the conditions in place to facilitate joint working, rather than because of them. We need incentives that drive local leaders to work together, rather than push them apart. “These twenty local system reviews highlight both the barriers that prevent collaboration – and the real impact that this lack of collaboration has on older people. Today we are calling for those barriers to be broken down. We are making specific recommendations to local and national leaders and government on new approaches to funding, commissioning, performance measurement and regulation, designed to encourage local systems to work together more effectively to deliver personalised care to the people who rely on their services, and to safeguard quality of care into the future.” Care Minister Caroline Dinenage said: “This report confirms what we already know – the provision of NHS services and social care are two sides of the same coin and it is not possible to have a plan for the NHS without having a plan for social care. “There are good examples of progress in integrating health and care, including through the Better Care Fund and ongoing joint health and social care assessments pilots, but we know we need to do more. That’s why we will publish a green paper in the autumn on social care around the same time as the Government’s long term plan for the NHS.”

MEDICATION MANAGEMENT New Report Released To Promote Best Practice Standards of PharmaCare-365 Care for the Management of Medication Across Care Homes - Your Care, Our administration records (MAR) means the accuracy of these records need constant review. They also bring a higher risk of human error in the selection and administration process.

A new report ‘SAFE: Banishing Medication Errors in Care Homes (Safeguard Against Frontline Errors)’ has been launched by Omnicell UK & Ireland, the world-leading provider of automated healthcare and medication adherence solutions. The report is part of a campaign to raise awareness and promote best practice standards of care for the management of medication to help drive change and improve patient safety across care homes. Earlier this year, the Department of Health found that in England 237 million mistakes occur at some point in the medication process. Out of the 237 million medication errors that occur per year in England, the largest proportion occurs in care homes (41.7%)1. Residents in care homes take an average of 7.2 medicines per day2. With each additional medicine comes an increased risk of errors in prescription, monitoring, dispensing or administration, adverse drug reactions, impaired medicines adherence and compromised quality of life for patients. The SAFE report, which is authored by a leading pharmaceutical expert, found within care homes the overwhelming majority of medication errors (92%) happens during administration3. Almost 70% of care home residents have experienced at least one error in their medication regime, according to the finding from the Care Home use of Medicines Study4. The reliance on outdated paper-based medicines

Introducing Omnicell eMAR within care homes, automates the entire medication management and administration process making it safe, simple and compliant for everyone involved. The system, gathers information, provides prompts and accurate instructions for staff and gives managers real time medication administration data at the touch of a button, so they can be sure that the right dose has been administered at the right time to the right resident. With Omnicell eMAR, each individual medication is identified through a bar code applied in pharmacy, which can then be tracked at all stages from check in at the care home to administration to the resident, to unused items which are disposed of or returned to the pharmacy. The system uses on screen photograph identification, provides important medical history for each patient and includes a simple alert and verification system to minimise the risk of medication administration errors in the home. CQC inspections are much easier for care homes with eMAR. The system provides a clear audit trail and peace of mind that all resident medication has been administered safely through easy to follow processes for all staff. eMAR mitigates compliance risks and provides accurate information in the event that medication is not administered, providing a clear reason as to why. One care home, Coach House Care Home for the Elderly, installed the system after their CQC inspection highlighted their poor management of medication. After the system was implemented the CQC inspected the home again and were reassured by the safety measures that eMAR had put in place. Paul O’Hanlon, Managing Director at Omnicell UK

& Ireland, comments; “We’ve been working with care home managers and staff to implement Omnicell eMAR since its launch in 2016. Since launching eMAR, we found out that staff are willing to embrace systems that improve patient safety and enable them to dramatically reduce medication errors. The academic study commissioned by the Department of Health, helped to raise awareness of the scale of medication errors within the NHS and highlighted the need for technology to help to prevent them. The SAFE report recommends automation as a safety net for minimising selection and administration errors by care home staff in medicines rounds.”

Mission PharmaCare is a NHS registered online pharmacy that offers a wide range of services tailored to meet the health needs of the community. PharmaCare is supervised by fully qualified pharmacists who are available to discuss your medical issues and problems in a confidential environment through email, telephone or skype. At Pharmacare-365 we understand the importance of good medicines management for your care home and the need for first class, reliable pharmacy support, particularly in these times of increasing regulatory requirement. We are able to provide a comprehensive service package, including : • Separate Care-Home pharmacy premises closed to the public so we focus only on you. • Here for you EVERYDAY ! we offer 365 days access to our pharmacy branches.

This year, Omnicell is implementing a SAFE campaign amongst key opinion leaders within care homes, secondary care and pharmacies in order to raise awareness of the impact of medication errors. The campaign aims to drive real change and awareness of the role that technology can play in tackling the problem. You can support the campaign with the hashtag #BanishMedErrors. For more information visit For a copy of the SAFE report or Standard of Care brochure contact References 1. 2. 3. 4. 5. content/uploads/2018/02/eepru-report-medicationerror-feb-2018.pdf Medication errors in nursing and residential care homes, CHUMS, 2009 Authored by Fawz Farhan Medication errors in nursing and residential care homes, CHUMS, 2009

• Open till 11pm every night and local to you. • Same day delivery of urgent medicines (approximate 2-hour turnaround time). • Free Paperless Barcode medicine management system incorporating eMAR(electronic MAR). • Various monitored dosage systems if required (Award winning MultiMeds / Nomad / Venalink) therefore both unit-dose & multi-dose systems catered for. • Assist with CQC inspection preparation. • Annual audit to maintain efficiencies in medicines management (New CQC & NICE requirements and guidelines). • Free Flu vaccination for staff. • Staff training where required. • Unique Home Manager assigned to your home so you always speak to the same person Because we are independent we are able to offer you services which other pharmacy chains cannot cater for – simply ask us your requirement and put us to the test! For further details see the advert on page 5.



Eddie Dribble - the best known name in the private care industry

Carers and Personal Assistant Insurance from are dedicated to helping and protecting their customers against unexpected events, providing insurance to help them to live life confidently. They also believe in the crucial role carers play in our society and their aim is to protect them with the most suitable insurance cover for the risks they face within their workplace. Carers and Personal Assistant Insurance from covers against a claim in the event of accidental injury, damage to or loss of property, legal expenses and more.

If you work as a self-employed carer, they also have a policy to suit you. Covering a variety of circumstances from personal liability to legal expenses, all of their policies aim to protect you against life’s unpredictabilities. All policies are underwritten by SAGIC, The Salvation Army General Insurance Corporation, and have no hidden charges, and interest free monthly payments. Policies start from as little as £4.92 per month and are available in 3 levels of cover from bronze to gold, for the most comprehensive protection. For further information, please see the advert on the inside back cover.

Global Business Finance was established over 26 years ago by the firm’s present senior partner, Mark Widdows, and since then has arranged over £1.8bn in loans for healthcare clients. The firm works exclusively in the care sector providing a very personalised service, as the firm knows every client is individual with individual requirements. Mark and his team spend time getting to know each of their clients in order that they can ensure all needs are met and the loan facility tailored to their client’s individual requirements. Global offers national coverage and with the support of email, fax, regular telephone conversations and face to face meetings the firm are able to put together a professional and comprehensive bank application. The bank managers that Global work with are all specialist healthcare managers who have extensive knowledge within the sector and

Reduced commission rates for RNHA members

With over £1.8bn in completed care home loans you should strongly consider Global Business Finance to represent you for your next loan application. Reader Enquiries - Tel: 01242 227172 Email: For further information, please see the advert on the following page,

Wright Care Solutions Ltd.

Get your LPA prepared from start to finish by one of our LPA experts from the comfort of your own home.

During the last 18 months there has been an increase in homes engaging us to support with reaching compliance following receipt of an adverse CQC inspection.

People are often shocked when they find out a loved ones bank account has been frozen because they have lost capacity. What would you do if your loved one was the main bread winner yet their bank account was frozen due to a loss of capacity? How would you pay the mortgage or provide the essentials without access to a bank account? Having a LPA in place would allow the Attorneys to access the bank account, pay bills, have a say on financial matters. As well as the financial element (Property and Financial Affairs), the Attorneys are able to make health decisions (Health and Welfare) for the person such as which care home they are to live in, what they are going to eat down to what activities they do in the care homes. Without an LPA social services will have full control of your health and welfare and will dictate your lifestyle.

We have a “hands on” approach and provide action plans and reports, but where needed, roll up our sleeves and support to put things right.

Wright Care Solutions (WCS), an award winning Advisory Team, was originally established in 2006, moving to a Limited company in 2012.

Our Advisors are qualified nurses with current PIN numbers and have over 90 years combined experience in the sector. Recent contracts include: • Supporting a care group in the South of England to reach compliance, through audits, action planning and mentoring, • Supporting a Care Home issued with a “Proposal to Cancel Registration” and ‘Inadequate’ CQC rating, to move to ‘Requires Improvement’ and the “Proposal to Cancel Registration” notice removed. • Working with a group of homes by undertaking external audits- a fresh pair of eyes to overview an already ‘Good’ rated service. For a full list of services available and a free quote, please visit our web site: Or, call our dedicated enquiry line: 07557 761141 or e-mail: or see the advert on page 6.

Direct Debit for Care Homes

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PROPERTY AND PROFESSIONAL Wider Issues Around Registration for CQC Regulated Bodies Following Case of Convicted 82-yr-old Able to Register as Care Home Manager By Laura Hannah, associate solicitor at national law firm Stephensons


What defines ‘good character’?

The Application Process

It was recently reported that an 82-year-old woman was permitted to register as a manager of a 25 bed care home for elderly residents by the Care Quality Commission (‘CQC’) in 2010, despite the CQC’s knowledge of her previous conviction for which she received a jail sentence in 2003 after deceiving a client of £9,000 in her previous role as a ‘financial advisor’. It is reported that it was only a matter of years after leaving prison that she was appointed as a manager of a care home, where she had obtained employment as a carer following the completion of her sentence. This role involved her caring for residents with dementia. In 2014, she moved to a different home where she again successfully registered as manager with the CQC, who were subsequently contacted by a whistle blower earlier this year to question the appropriateness of her registration in light of her previous conviction.

Before an application can even be submitted to the CQC, the person applying must obtain a CQC countersigned DBS as the disclosure number is required for submission. This is to check that the person applying is not barred from working with children or vulnerable adults. Where a company is applying to be registered as provider, a CQC DBS check will need to be undertaken for all directors. Whilst a Nominated Individual does not require a CQC DBS check, providers must carry out their own DBS check and may be required to provide evidence of this during the registration process. It is also important to note that any DBS certificate received must not be over 12 months old at the time the application is submitted and validated. In our experience, these applications will be returned immediately to the applicant and will not be reconsidered until a new, up-to-date DBS is obtained. In some cases, this can often delay an application as it can take a number of weeks before a DBS is received. For new providers, this means that they are prevented from carrying out regulated activities for a longer period and for managers, it could potentially affect any job offer received.

The CQC is the independent regulator for adult social care services in England and its purpose, as stated on its website, is to “make sure health and social care services provide people with safe, effective, compassionate, high-quality care”. The CQC is responsible for the registration, monitoring and inspection of any persons or services registered to carry on regulated

It is not uncommon for applications for registration to be returned by the CQC a number of times during their initial checks, usually due to minor errors with the completion of the relevant forms. A common error is where the provider and manager applications do not match; this can include the regulated activities applied for, the location details or even incomplete provider details. Within an application, an applicant must provide full details of their employment history, as well as contact details for their GP and a professional referee, preferably from their most recent employer. The applicant must also make a declaration that they are medically fit to carry out their role. It is extremely important that the applicant considers this declaration very carefully as any evidence of dishonesty will be taken seriously by the CQC and will have a significant impact on their registration decision. The key to any application is full disclosure; if there are any factors which an applicant is concerned about, disclosure of those factors at an early stage would place them in the best possible position. Any attempt to conceal these factors is only likely to lead to a negative decision on the registration or lead to cancellation of the registration and/or potential criminal enforcement later down the line. In this recently reported case, the manager had been open and honest to the CQC and her employer throughout the entire registration process and the CQC were therefore already aware of her previous conviction at the time the whistleblowing complaint was made earlier this year.

Registered Manager – what is the criteria? When determining whether a person is suitable to be registered as a manager, the CQC must consider whether the person applying is fit to be registered in accordance with Regulation 7 of the 2014 Regulations. More specifically, Regulation 7 sets out that a person is not fit to manage any regulated activity unless: (1) they are of good character; (2) they have the necessary qualifications, skills and experience to manage the carrying on of the regulated activity; and (3) they are able by reason of their health, after reasonable adjustments are made, of doing so. The purpose of this is to ensure that service users’ needs are met; this is done by ensuring that the regulated activities are managed by a suitable person.

Whilst it may not be possible to establish all of a person’s character traits, a registered provider is responsible for compiling all relevant and accessible information to assess whether a manager is of ‘good character’. A robust process should be followed to take into account their honesty, trustworthiness, reliability and respectfulness. This includes a consideration of the matters outlined in Schedule 4, Part 2 of the 2014 Regulations, namely whether the manager has been convicted of any offence, or whether they have been erased, removed or struck-off a health and social care regulator’s professional register such as that of the NMC, GMC or HCPC. Any matters which arise from this process should be fully investigated and any appropriate action taken. If this results in the manager retaining their position, the provider should ensure that the reasons for this decision are noted in full and in some circumstances, a provider may consider that a risk assessment may be appropriate. In this recent case, the CQC reportedly advised the whistblower that: “Individuals with a criminal conviction such as theft from an elderly person should be on the barring list as held by the Disclosure & Barring Service. We would like an opportunity to investigate this further.” However, it is reported that shortly after, the CQC stated that it was satisfied that it had carried out a detailed and rigorous investigation into the circumstances of her conviction and furthermore, that she had been open and honest with both the CQC and her employer. The CQC also stated that it had sought legal advice before proceeding with this registration decision. Some may argue that this decision was arbitrary and goes against the core aim of the CQC as an independent regulator, namely to protect and promote the well-being of vulnerable members of society. This case, in fact, makes it clear that a conviction is not an absolute bar to a person obtaining registration with the CQC and being deemed fit to manage any regulated activities.

Necessary qualifications, skills and experience… When assessing a person’s skills, qualifications and experience, the CQC look into whether the proposed manager has a full and adequate understanding of the requirements of the associated legislation, particularly the Health and Social Care Act 2008; the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 [‘2014 Regulations’]; and the Care Quality Commission (Registration) Regulations 2009. Whilst the CQC’s Andrea Sutcliffe states that around 37 applications are rejected each month, these are not necessarily attributed solely to a person failing the good character assessment. When assessing a person’s skills and experience, the CQC will also look at a person’s previous management record and the inspection history of those services they managed, including the current service they are applying for. Whilst we do not have access to the CQC’s internal thought processes and investigations, what is clear is that the CQC’s registrations are now much more stringent than they were in 2010, shortly after the CQC was established. In any event, if anything, this case demonstrates the importance of being open and honest with the CQC during the registration process, as well as any employer, where there are any circumstances which could potentially result in the refusal of a registration. Being upfront with the regulator and working collaboratively with them, providing any information pertinent to an application, is only likely to increase your chances of obtaining registration.

Nurseplus Importance of Being #CareAware According to the CQC, a survey which polled over 1,000 adults who were responsible for choosing care either for themselves or a loved one over the last three years, highlighted that 70% of people found it more stressful than choosing their child’s nursery or school, or a venue for their wedding.

As well as CQC inspection reports, those looking for care can also visit, the leading UK homecare review website.

At Nurseplus, we have 50+ branches that can provide care to individuals in care homes and in the community. We are more than aware of the concerns individuals face when choosing a care provider for their loved ones.

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CCTV In Care Homes

• Care home owners need to ensure they do not override the rights and freedoms of the residents, staff and visitors to the care home. Owners will need to show they have considered these rights and put technical measures in place to ensure compliance.

In May this year, former Attorney General, Dominic Grieve, called for a legal requirement for every care home in Britain to be fitted with surveillance cameras to protect residents. He suggested that: “Requiring the public parts of care homes to be monitored by CCTV would contribute to reducing the possibility of abuse and make detection easier where it has occurred.” Some supporters of CCTV have welcomed it as a way of providing an additional protection to vulnerable residents and incorrectly accused staff, but opponents point to the adverse implications for the privacy and dignity of residents.

Informed consent:

Surveillance systems could provide greater transparency and deliver more certainty. Jayne Connery, who founded the pressure group Care Campaign for the Vulnerable, said: “This simple step will help safeguard those who are no longer able to safeguard themselves.” However, the introduction of surveillance cameras in care homes has legal implications, particularly in light of General Data Protection Regulation (GDPR) and the new Data Protection Act 2018 (DPA). These will affect residents and staff.

Is CCTV the solution?

Operation of CCTV in a care home gives rise to the following considerations:

Justifying collection of surveillance data: • GDPR requires that when collecting, processing and storing personal data, which would include surveillance data, data controllers must have a legitimate interest to do so and the processing of such data must be lawful, fair and transparent. • In some circumstances, such as where data is more sensitive, further conditions may also have to be met, such as explicit consent of the data subject.

• Residents, staff and visitors must be informed that they may be captured on video surveillance. Visitor signage should inform that CCTV is in operation, who operates it and how they can be contacted. For residents and their families this will be via a privacy policy and/or contract, which might require consent to the use of CCTV as a condition for residents to be admitted to the home. • Care home operators need to ensure that residents have the necessary mental capacity to give consent and consult with their legal guardians if not. • If a system is to be provided and monitored by a third party then the care home will need to ensure the security and confidentiality of the data and ensure that it is only processed in accordance with the care home’s instructions. This will require appropriate contractual provisions to be put in place to govern the requirements of GDPR. • Can less intrusive steps be taken by care home providers to ensure the same aims are achieved? The use of surveillance systems fails to directly tackle the root cause of abuse. CCTV should act as a deterrent and encourage misbehaving staff to consistently display appropriate behaviour. However, the recommendations are for public areas only – will this prevent these behaviours when out of sight of the cameras? Perhaps greater investment in the initial and ongoing training of staff and managerial oversight of day-to-day operations could reduce the need for surveillance. While surveillance appears to be one possible means of helping protect people from the risk of abuse, and provides valuable evidence when investigating allegations or serious concerns about a possible abuse or crime, its use has to be justified and protections need to be put in place for the resulting data. Although it appears that equipping all communal areas with cameras would help reduce abuse, it is likely to be at the cost of privacy for the residents. Whether these negatives outweigh the potential benefits is still to be decided.

Profile for The Carer

The Carer #41 Summer 2018  

Issue #41 of The Carer - The leading independent publication for nursing and residential care homes. Published Summer (July) 2018.

The Carer #41 Summer 2018  

Issue #41 of The Carer - The leading independent publication for nursing and residential care homes. Published Summer (July) 2018.

Profile for thecarer