anniversary special! - care talkthe voice of excellence in social care let's talk social care!...

The Voice of Excellence in Social Care

Let's talk social care!Issue 31April 2014 £2.50

Anniversary special!

Focus on diversity and equality

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PLUS: Up Close and Personal with VODG’s John Adams The case for religion in care homes A fresh focus on making health and care fair Company profile - Four Seasons

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Inside Issue 31

Care Talk is a trading name of Care Comm LLP.21 Regent Street Nottingham NG1 5BS

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Care Talk contactsEditorial: Lisa Carr [email protected]: Rebecca Harrison [email protected] Designer: Tanya GoldthorpeGeneral: [email protected]: Vicky Burman, Julie Griffiths, Debra Mehta

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ContributorsThank you to everyone who has contributed to this magazine. Do keep your articles, news and views coming.

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17 19 36

Des KellyExecutive directorNational Care Forum

Dr Rhidian Hughes@rhidianhughes#integratedcare

Rafi Fuchs Religious coordinator Nightingale Hammerson

Gary FarrerManaging directorSureCare

Janet CramptonConsultant2020 commissioning

Janet CowieHead of people developmentPriory Group

Sandra Beale SJ Beale HR Consult Ltd

John AdamsGeneral secretaryVODG

Daniel SmithPartner and head of private healthcare Grant Thornton UK LLP

Anna-Maria LemmerTrainee solicitorRidouts LLP

Ellie NevilleMarketing and news editorcarehome.co.uk

Dr Chai PatelChairmanHC-One

Nick SullivanManaging directorHeritage Independent Living

Ian SmithChairman and interim CEOFour Seasons Health Care

Debbie SorkinChief executiveNational Skills Academy for Social Care

News06 Caught on camera 07 Communication in a world of confusion08 World Autism Awareness Day10 A fresh focus on making health and care fair12 Newsround14 NMC: Unfit to practise?15 Care boss warning over council hourly rates16 Engaging your own carer17 Staff should wear uniforms

Opinion18 Keeping values constant19 The case for religion in care homes

Good Care Week20 Support from sector at vision event for Good Care Week 2014

Stories23 Tammy helps resident lose weight24 Personal tragedy entices Natasha

into a caring career24 Postcards from the Edges

Chat26 Voice over: Making workplace

equality a fundamental part of care27 360° How do you promote diversity and equality in your role?28 Mrs MacBlog28 This is your life29 Up close and personal30 Care creatures31 Planet Janet

Celebrate32 And the winner is...33 Happy Birthday Care Talk35 The National Learning Disabilities Awards36 The skill and the will

Learn38 Using the talents of the whole care workforce39 How to be a good ... registered manager40 The benefits of mentoring for registered managers41 Complete meal solutions

Special42 ‘Perfect storm’ being inflicted on the elderly43 Autism pathway leads to independence44 Priory Group ‘trailblazer’ for new apprenticeship standards45 Safeguarding your medication management practices46 10 top tips for zero-hours contracts47 Touch – embedding values through learning

Business48 Signs of recovery for UK private care home sector49 Four Seasons Health Care 50 Business round-up 52 New lease of life for Arrowe Hall community53 Appealing CQC decisions and meeting deadlines

Spring is here and we have certainly sprung into action at Care Talk, celebrating our third year anniversary. We have had many comments and feedback since Care Talk was launched, which have been gratefully received and have helped us to shape content to reflect the wishes of our readers – so be assured that Care Talk will continue to be the voice of social care.

As I write this, Cheryl Cole and Simon Cowell have both announced that they will be returning to our screens this summer as X Factor judges. Coupled with this ‘recycling’ of judges it is rumoured that Cheryl will be the only female judge for the new season ... diversity and equality may be debateable, but it will most certainly boost the ratings – job done for Mr Cowell!

This leads on nicely to this month’s issue of Care Talk, which focuses on equality and diversity. Our lead feature looks at a fresh focus on making health and care fair. ‘Everyone counts’ when it comes to health and care is the latest thinking by the NHS Equality and Diversity Council, but what are the implications for our sector? See page 10 to read more.

April is a significant month for our sector. Our articles on pages 7 and 8 highlight World Autism Day and the value of communication. This year’s Good Care Week starts on 28 April, when the social care workforce, care

providers and service users will come together to raise awareness of social care on a local level. The aim of Good Care Week is to challenge the negative media perception of social care and shout about all that is good. Please do send in news and pictures about your local activity for Good Care Week and we will

endeavour to publish them in our May issue.

Talking of good care, the nominations are now open for the 2014 regional Great British Care Awards; we do hope you will encourage your colleagues,

service users and their families to send in their nominations. These awards recognise excellence in social care and pay tribute to those who work in the sector. There are so many unsung heroes of social care, and we would be delighted for you to join us in celebrating all that is so good in our sector. Enjoy this issue and please do keep your news and views coming in.

Editor’s Note

Lisa

Circulation listHas this month’s Care Talk been read by all your staff?

Use our easy circulation list to be sure!

JobChief executive

Managing director

Registered manager

Supervisor

Care staff

Ancillary staff

Service users

Families

Read?

GREAT BRITISH

CARE HOME AWARDS

Gala Dinner on 26th April 2014

at Grosvenor House, Marriott, London

CELEBRATING EXCELLENCE ACROSS THE SOCIAL CARE SECTORwww.care-awards.co.uk

2014

Champagne Reception: 7.00pm Carriages: 1.00am

Dress Code: Black tieThe champagne reception will be followed by a three course meal. There will be live entertainment throughout dinner after this, the Award Ceremony will begin followed by live music.

Book your table now email [email protected]

Hosted by Jane McDonald

You won’t be able to see this on TV yet, but fingers crossed a very special documentary will soon reach a wider audience.

Aktion T4, a film about how groups of vulnerable people, including those with learning and physical disabilities, hereditary conditions and mental health problems, were treated by the Nazis in the Second World War, was made by Berge Kanikanian, who has Down’s syndrome.

Berge hopes to use the film to teach young people about disability hate crime. He was inspired to create the documentary in 2011 after reading about the history of learning disabilities and attending a course teaching people with learning disabilities how to develop and lead their own campaigns.

Berge had support from the Ealing Mencap empowerment project manager and personal assistants to research the project and travel to Germany and Poland for filming.

While there, Berge visited the L’Arche supported living community in Poznan. He says that “things in Germany

and Poland are similar to here. They need better healthcare and more opportunities for people with a learning disability”.

Craegmoor, part of the Priory Group, donated £1,900 to Berge’s project, to help pay post-production costs – including creating a dubbed version of the film with an English voiceover – and for permission to use some archive footage, audio mixing and colour grading.

Berge thinks that if people with disabilities join together and have a voice they will make more of an impact. “It’s about raising awareness with young people, children and people with a learning disability. They need to be more encouraged to make sure they have a voice and speak up about hate crime. It’s about us being strong to stop the hate crime around Britain.”

Aktion T4 was the name of a so-called ‘euthanasia’ programme carried out by the Nazis in which many thousands of people, mostly living in clinics and institutions, and including those with learning disabilities, were killed by medical staff at special centres. Others were forcibly sterilised so they could

not have what the Nazis described as ‘genetically diseased’ children.

“I want to use the film to teach students in colleges and schools to have more understanding. I could present the documentary and take questions afterwards,” explains Berge. Schools may be able to buy the film on video to show to classes, and there is also a chance it may be translated into different languages and shown elsewhere in Europe.

There have been test screenings for groups of health and care professionals, at the Houses of Parliament, and for students at Hammersmith and Fulham College and history teachers at the Langdon Down Museum of Learning Disability in Middlesex.

Aktion T4 is being taken to documentary film competitions. “If we do well we could get a proper release and get the film on TV. I also want to show it at conferences,” says Berge. Berge was interviewed for the Ealing Gazette and enjoys spreading the word about his film.

Vicky Burman

Looking to the past to tackle hate crime today

CAUGHT ON CAMERA

CAUGHT ONCAMERA

06 I www.caretalk.co.uk

World Autism Awareness Day aims to increase global awareness about people with autism, particularly children. In a world where the ability to communicate effectively is so important to get by and build relationships, acclaimed autism practitioner Gina Davies sets out some of the challenges and provides practical advice for parents and professionals.

Communication is such an important part of living, yet most people take it for granted. We use words, body language and other forms of communication to get along with other people; it’s a basic but essential part of forming, building and maintaining relationships.

When it goes wrong, however, we can run into difficulties quickly. It’s hard to share information and get messages across when people don’t seem to understand each other and they can’t fix it by talking things through.

With autism in the mix, the natural art of human communication can be extremely challenging for children, parents and carers.

We can try making our speech simpler, begin to use more facial expressions and show what we mean with our hands. We might repeat what we say and ask questions to see if the message has been delivered successfully. With a bit of practice this helps in some situations and things rub along naturally, if a bit slower than ideally we would like.

When the problem is not just with words and their meaning, but the whole communications process, it’s much harder. We can get confused very quickly and start to react differently. For example, if a person doesn’t look at someone when they are talking it’s only natural to think something is wrong. Are they being rude? Are they preoccupied or disinterested? We interpret what we see even if the person involved has no idea we are thinking like that.

It’s not that we are bad or disrespectful, just that we are trying very hard to make sense of the situation. Inevitably we begin to change how we approach a situation the next time as we recall what happened, what worked or – more likely – what didn’t work. With autism it’s harder to participate in the easy flow of ‘chit chat’ that is so natural with others.

This happens a lot when we are trying to get a conversation going or to communicate with someone who has autism. So what can we do?

It’s useful to know that many children on the autism spectrum find visual images both powerful and engaging. Images can be used to help share ideas, such as showing food menu choices as a series of photos or making sure a child can see foods they can select. A photo or short film of a shared experience, hobby or special interest can also be shown; great activities can be enjoyed without too many words but lots of shared smiles and laughter.

Many youngsters love games – rough and tumble, tickle and chase – as well as running games, and these often don’t require the intricacy of words and verbal connections. They can be played out with enthusiasm and fun if the carer is ready to join in or take the lead.

Such activities are all about building a point of contact, creating connections and making communication between individuals easier. Communication occurs in many forms, it doesn’t always have to be with words, dialogue, questions and answers. Parents and professionals must remember, though, to give themselves licence to enjoy interactions and train their own brains to work out other ways to ‘chat’ while getting tuned into what works for each individual.

There are many ways of creating, developing and sharing successful communication with individuals on the autism spectrum. However, it does mean understanding that it will be more difficult and that our

way of communicating has to change too. If we recognise this we can learn other ways of managing and creating joyful and meaningful exchanges that help build healthy and respectful relationships.

World Autism Day is our annual reminder that there are many people throughout the globe dealing with autism and the challenges of communication on a daily basis. In a world where we are surrounded by the natural and modern tools of communication – everything from speaking to Facebook – only by really tuning into what works for autistic children and their parents and carers can better connections be made.

Gina Davies

Gina is a qualified speech and language therapist who turned her passion for communication development into practical and joyful intervention strategies for parents and professionals dealing with autism. She has worked with hundreds of autistic children in schools, nurseries and residential settings, and directly with parents, carers and families.

www.ginadavies.co.uk

www.caretalk.co.uk I 07

Communication in a world of confusionAWARENESS


AWARENESS

World Autism Awareness Day 2 AprilSo many children and adults with autism are in need of services – as are their families and carers. But people affected by autism often find that they can’t get local support that meets their needs.

Here is some guidance for local authority staff who assess or support people with autism, and those who plan and commission services.

Factors to consider while assessing people with autism

Autism is a lifelong developmental disability. The exact causes are still not known but research shows that genetic factors are important. The spectrum of autistic conditions covers a wide range. It varies from profound severity in some through to subtle problems of understanding in others of average or above average intelligence. Autism often occurs with other learning difficulties.

People with autism have a disability characterised by a triad of impairments:• absence or impairment of two-way social

interaction • absence or impairment of comprehension

and use of language and non-verbal communication

• absence or impairment of true flexible imaginative activity, with the substitution of a narrow range of repetitive, stereotyped pursuits.

Other conditions sometimes associated with autism may include attention deficit hyperactivity disorder (ADHD) or learning difficulties such as dyslexia and dyspraxia. People with autism may also experience high or low sensory sensitivity, resulting in unusual reactions to their surroundings.

Autism leads to related problems, which may include:• resistance to change • obsessive or ritualistic behaviour • high levels of anxiety • lack of motivation • inability to transfer skills from one setting to

another • vulnerability, and susceptibility to

exploitation • depression • challenging behaviour • self-injury.

Providing care services for

people with autism

People with autism need – and the service should provide – the following.

• A person-centred approach, taking the individual’s needs, wishes and aspirations into account

• Individual and detailed person-centred support plans

• Detailed and specific strategies to achieve social interaction, communication and independence skills

• Highly planned structured activity • Appropriate staff levels to implement the

strategies and provide staff support in all areas

• An appropriate physical environment.

The service and its staff should offer:• consistency and stability in the environment

and in all interaction • continuous external motivation and positive

intervention • alternative and augmented communication

systems that enable individuals to communicate effectively with those around them.

The service also needs to provide:• a support system to handle and relieve staff

stress • specialised staff training, including both

an induction programme and an ongoing programme to reinforce and update the required staff skills.

The staff role is crucial in enabling people with autism to participate more fully in everyday life. Staff need a thorough understanding of the underlying impairment and to be attuned to the way the person with autism sees the world.Staff training programmes should aim to provide:• an ability to understand and interpret the

verbal or non-verbal communications of the person with autism

• an ability to translate situations, events and concepts into language that can be understood and grasped by the person with autism

• a sensitivity in the recognition of anxiety levels

• non-aversive skills in the management and reduction of challenging behaviour

• recognition of the value of repetitive reinforcement and the ability to make careful use of structure in order to counteract the lack of motivation inherent in this disability

• an understanding of the effect of the

sensory environment on the individual.

The following resources can be found at http://www.autism.org.uk/working-with/social-care-and-support.aspx

Autism training• Resources for autism awareness

training. Materials, resources and ideas to assist in training professionals to have a better understanding of autism spectrum disorders.

Care and support services• Care and support services for adults:

information for local authorities. This information was written to help implement the NHS and Community Care Act 1990 but applies to all services provided for people with autism.

• Person-centred planning. Person-centred plans take into account what people want from their lives, and change as their lives change.

• Guidelines for inspectors of social care services. Commissioned by the National Care Standards Commission (now the Care Quality Commission), this document gives an indication of the knowledge service inspectors need about autism.

• Social care: assessments of need for adults with autism. The National Autistic Society, in partnership with the British Association of Social Workers, has put together a step-by-step guide to help social care staff prepare for and deliver assessments for adults with autism.

• Good practice in supporting adults with autism. Guidance for commissioners and statutory services, published by the Government Office of the South West and NHS South West.

• Supporting adults with autism: a good practice guide for NHS and local authorities. Produced by the National Autistic Society in response to demand following its ‘I Exist’ campaign.

• Islington multi-agency integrated pathway for children and young people with ASD. A report on a project in Islington to develop and pilot a multi-agency pathway for children and young people thought to have autism.


Take part in Onesie Wednesday®

Your support will raise vital funds for people with autism. Thank you!The National Autistic Society is the leading UK charity for people with autism (including Asperger syndrome) and their families. Around 700,000 people in the UK have the condition.

Together with their families they make up over 2.7 million people whose lives are touched by autism every day.

Visit www.autism.org.uk to find out more.

In support of

The National Autistic Society is a charity registered in England and Wales (269425) and in Scotland (SC039427) and a company limited by guarantee registered in England (No.1205298), registered office 393 City Road, London EC1V 1NG 1374 191213

1374_Onsie Wednesday Poster_A3_1pp_4 colour_FINAL ARTWORK_191213.indd 1 20/12/2013 12:06:44

Try Jane Asher’s fabulous recipe!

Join in the fun on Onesie Wednesday® and help us spread the message that it’s okay to be different!

Wear your onesie to work or school, host a onesie party or bake gingerbread onesies. There are lots of ways to show your support and join in the fun!

Everyone will love your onesie dress-down day.

To get involved and have an amazing Onesie Wednesdayorder your FREE Onesie Wednesday® pack today by calling 0808 800 1050 or by visiting our websitewww.autism.org.uk/onesiewednesday

Jane Asher’s onesie gingerbread men

Jane with her gorgeous onesie gingerbread men!

Ingredients Gingerbread men>

> 5ml (1 level tsp) bicarbonate of soda> 10ml (2 level tsp) ground ginger> 100g (4oz) butter or block margarine> 175g (6oz) light soft brown sugar> 60ml (4 level tbsp) golden syrup> 1 medium egg

Icing 500g white roll-out icing, tiny quantity pink writing

icing, assorted edible decorations.Special equipment You will need a gingerbread man cutter and a small

glass or round cutter (a star cutter is optional).

Take part in Onesie Wednesday ® on World Autism

Awareness day! Host a onesie bunsie on Wednesday

2 April 2014 or the weeks surrounding it and bake

something amazing to raise money for people

with autism.

Our charity’s President, Jane Asher, has developed a fabulous

gingerbread men in onesies recipe to inspire you. You can decor ate

these in many di�erent ways, using butter icing pulled up into

peaks, or royal icing spread with a spatula. The method we’ve

described here uses roll-out icing. It is easy to make the ici ng onesie arts.

Get creative – what kind of decorations can you think of?

1388_Onsie Wednesday Recipe_A4_2pp_4 colour_FINAL ARTWORK_201213.indd 1

20/12/2013 11:25:12

Draw your dream onesie!

Your name: …………………………………………

The National Autistic Society is a charity registered in England and Wales (269425) and i

n Scotland (SC039427) and a company limited by guarant ee registered

City Road, London EC1V 1NG

1372 121213

1372_Draw yo ur dream onesie_A4_1pp _4 colour_FI NAL ARTWORK_121213. indd 1

12/12/201 3 14:42:39

The National Autistic Society is

24962( selaW dna dnalgnE ni deretsiger ytirahc a

5) and in Scotland (SC039427) and a company limited by

1.oN( dnalgnE ni deretsiger eetnaraug

393 City Road, London EC1V 1NG

1373 191213

The Supporter Fundraising Team

The National Autistic Society

393 City Road London EC1V 1NG

Tel: 0808 800 1050

Email: [email protected]

Website: www.autism.org.uk/onesiewednesday

Stand out for autism onOnesie Wednesday®

We are the leading UK charity for people with autism (including Asperger syndrome) and

their families. With the help of our members, supporters and volunteers we provide information,

support and pioneering services, and campaign for a better world for people with autism.

Around 700,000 people in the UK have autism. Together with their families they make up over

2.7 million people whose lives are touched by autism every single day. Despite this, autism is

still relatively unknown and misunderstood. This means that many people don’t get the level of

help, support and understanding they need. Together, we are going to change this.

From good times to challenging times, The National Autistic Society is there at every stage,

to help transform the lives of everyone living with autism.

We are proud of the di�erence we make.

or email

for advice, information

EC1V 1NG – please include a letter explaining

who you are and that the money was raised for

so we can thank you.

www.autism.org.uk/donate

(please refer to Onesie Wednesday®).

Call 0808 800 1050 and donate over the phone.Take photos! We’d love to hear about your fundraising

e�orts and see photos of you in your onesies!

Send them to us at [email protected].

You can tweet us your pictures too –

#onesiewednesday @autism!

It will be a day to remember!

What animal will you be?

You wont fail to get noticed!

Wednesday 2 April 2014 is World Autism

Awareness Day. Join us that day – or

in the weeks surrounding it – in raising

awareness of autism. Our charity exists

to create a world where all people with

autism get to live the lives they choose.

Are you willing to stand out from the

crowd for autism?

Taking part couldn’t be easier! Grab your

favourite onesie or set of pyjamas (or use

the excuse to buy a new one!) and organise

or get involved with a fundraising event.

Whether you have limited time or big plans,

we have a great range of activities and ideas

to suit everyone!

The concept of equality is nothing new when it comes to health and care. After all, the NHS was created in 1948 out of the ideal that good healthcare should be available to all, and based on core principles that the service should meet the needs of everyone, be free at the point of delivery, and based on clinical need, not the ability to pay.

The NHS Constitution, published in 2011, reiterates the same basic aim of providing “a comprehensive service available to all … irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status”.

The constitution, also states that the NHS “has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population”.

The aims may be the same after more than 60 years, but is the reality any nearer?

Shifts in focusIt has already been a long and winding road, with shifts in emphasis along the way. Initial equality legislation largely focused on eradicating discrimination in employment, education and training, with Acts of Parliament such as the Equal Pay Act 1970, the Sex Discrimination Act 1975 and Race Relations Act aiming to level the playing field between genders and to protect people from specific groups from harassment and discrimination.

These laws did cover provision of services, but it was not until the UK began complying with EU directives, such as the Disability Discrimination Act 1995, that there began a shift towards combating wider discrimination, with more emphasis on providers changing the way they deliver goods, facilities or services and manage premises to make them accessible to everyone.

The Equality Act 2006 and the creation of the Equality and Human Rights Commission (EHRC) in 2007 were perhaps the first real steps towards embedding equal opportunities and respect for people’s rights throughout society, while at the same time recognising and celebrating the differences between individuals. A specific EHRC goal was “mutual

respect between communities based on understanding and valuing of diversity”.

“Now we’re seeing another shift in focus, in line with fresh thinking about what equality and fairness look and feel like in practice.”

The Equality Act 2010 pulled everything together (over 116 individual pieces of legislation) in a single legal framework to tackle disadvantage and discrimination, protect individuals from unfair treatment and promote a fair and more equal society. The NHS Equality and Diversity Council was set up in 2009 to implement the Act and raise the profile of equality and diversity in the NHS.

Fairness in practiceNow we’re seeing another shift in focus, in line with fresh thinking about what equality and fairness look and feel like in practice, and the barriers individuals face that can result in health inequalities.

A core principle of the NHS Constitution is that “everyone counts … Nobody should be discriminated or disadvantaged and everyone should be treated with equal respect and importance”.

Words like respect, dignity and choice have become firmly linked to the concept of equality. The focus is more on personal experience and the effect on individuals.

Reforms of health and social care in recent years – and the realisation that the two need to be considered in tandem – have no doubt played a part in prompting this new thinking.

The EHRC’s 2009 research into care and support looked at, among other things:

• Who could access state-funded care and who was excluded from it

• Whether the way care and support was delivered promoted equality and human rights

A fresh focus on making health and care fair‘Everyone counts’ when it comes to health and care. That’s the latest thinking by the NHS Equality and Diversity Council, which sees reforms to support integration and greater patient and public involvement as an opportunity to build on collective strengths and find new ways to create a truly personal, fair and diverse care culture.

NEWS - LEAD STORY


• The implications of the care and support system for carers and whether all carers were treated equally.

Personalisation the right directionThe conclusion was that the nature of care and support is moving in the right direction, particularly the potential of individual budgets and direct payments to enhance the rights of individual service users.

“Consultation with stakeholders – and evidence from the literature review – strongly suggests that the policy direction in relation to personalisation is exactly what is required in order to better promote equality and human rights,” says the report.

When set up in 2009, the Care Quality Commission (CQC) registration system was intended to move from purely systems and processes to an emphasis on people’s views and experiences. Outcome 1 of the CQC’s essential standards is: ‘Respecting and involving people who use services’, including recognising their diversity, values and human rights.

The Marmot Review in 2010 was another big step forward, with its exploration of social factors contributing to health inequalities, such as low income and poor housing. The resulting report, Fair society, healthy lives, pinpointed empowerment, enhancing people’s potential and protecting vulnerable groups among themes “significant to the task of reducing health inequalities”.

The Social Care Institute for Excellence felt that the Marmot Review made little reference to social care as a fundamental means

of improving health and reducing health disadvantage, and produced its own briefing, highlighting examples of effective approaches in the care sector.

Impact of care interventionThe SCIE report points out that social care staff are in an ideal position to make a difference to those individuals and communities most likely to require help with their health and wellbeing.

The briefing says: “Social care services are by and large delivered to people with social and health disadvantage, a large proportion of whom are already ill and/or disabled. Social work and social care have established experience of working with marginalised groups, and may play an important role in promoting individual and community health and wellbeing. The value base for social work includes a focus on social justice, and individual development and empowerment, which may directly impact on the social determinants of health.”

“Regular NHS Value Summits bring together patients and members of the public and healthcare leaders and frontline staff.”

But the SCIE warned that although social care interventions can reduce individual health disadvantage, to have an impact on health inequality they “must be adequately and sustainably resourced”.

Promoting inclusionThe Health and Social Care Act 2012 has prompted further fresh thinking and new ways of working to support the health and care system to promote a fair and inclusive culture.

The NHS Equality and Diversity Council aims to create and lead strategic discussions that will:• improve understanding of how people’s

differences can affect their experiences, health outcomes and quality of care

• inspire health and care organisations to go far beyond the legal duties required by the Equality Act 2010

• create health and care services and workplaces that are truly personal, fair and diverse for everyone.

One of the council’s new initiatives is to hold regular NHS Value Summits, to bring together patients and members of the public and healthcare leaders and frontline staff, so that they can explore and understand how people’s differences affect their personal experiences, quality of care and health outcomes.

Another way of raising and addressing challenges in promoting equality and tackling health inequalities at local level is the ‘Personal, fair and diverse NHS’ campaign by NHS Employers.

This focuses on the small but important things that individual health and care workers can do to help create services designed to give people what they want and need, offering real choice and where fairness is ‘built in’, everyone counts and is treated with dignity and respect.

The campaign aims to develop a network of champions but also to encourage staff to think about the contribution they can make on a day-to-day basis, such as providing a voice on behalf of people who find it difficult to make their views heard, learning more about the Equality Act and letting their employer know when they “see things that don’t feel right”.

Vicky Burman

Further information The Personal, fair and diverse NHS campaign provides resources and tips you may find you can adapt to use in promoting good practice in your own care setting, like the ambulance service worker who visited mosques, churches and a synagogue to learn about how best to enter such buildings in an emergency or the NHS trust that developed a protocol for providing services to transgender patients. Visit http://www.nhsemployers.org/employmentpolicyandpractice/equalityanddiversity/creatingpfdnhs/Pages/Signuptoday.aspx to find out more.

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CARE PROVIDERS

Bluebird Care to create 50 jobsHome care provider Bluebird Care (South Gloucestershire) has announced new job opportunities for local people for the year ahead. WithofficesinChippingSodbury,BluebirdCare already employs staff who provide care and support to the elderly, people with physical disabilities and adults with learning disabilities across the whole of South Gloucestershire.

In 2014 the organisation hopes to go even further by employing another 50 new care staff, all of whom will take an active role in delivering high-quality care.

DEMENTIA

NHS to tackle long waits for dementia assessment (Source: Gov.uk)Following December’s G8 summit and the ambition set out as part of the Prime Minister’s Challenge on Dementia, NHS England will invest £90m in diagnosing two-thirds of people with dementia by March 2015.

In addition to the £90m package to improve diagnosis and care, a ‘world dementia envoy’ will be appointed to raise funds for research towards a cure.

Leading British businesses M&S, Argos, Homebase, Lloyds Bank and Lloyds Pharmacy have already signed up to the cause by helping over 190,000 staff learn to support customers who have dementia.

As well as improving diagnosis, the new GP contract will mean that from April every person over 75 will have a named accountable GP and the most vulnerable 2% in each practice will receive an enhanced service, including same-day telephone consultations and proactive case management. People diagnosed with dementia and their carers will also be able to sign up to a new service on the NHS Choices website to get essential help and advice in the early stages of their condition.

For more information, visit https://www.gov.uk/government/news/nhs-to-tackle-long-waits-for-dementia-assessments

Allied Healthcare announces new £6.50 minimum rate for care workersHomecare provider Allied Healthcare has announced that from April none of its care workers will be paid less than £6.50 per hour –amovethatwillbenefitaround2,000ofthecompany’s care staff who are currently paid the minimum wage of £6.31 for some of their visits. This is six months before any new minimum wage is likely to come into force.

From April, Allied Healthcare’s 15,000 care workers will be able to earn between £6.50 and £15perhourdependingontheirqualifications,the complexity of the care they provide and the rate local authorities pay. The company has started introducing contracted hours for all its care workers, and to date almost a quarter of existing staff who have been offered contracts have opted for guaranteed-hours contracts.

NURSING

New nursing apprenticeship opportunity for talented care workers (Source: Gov.uk)Forthefirsttimeever,apprenticeswillbeabletotraindirectlytowardsbecominganurse,theGovernment has announced. A trailblazer group is developing a degree-level apprenticeship that will widen access to nursing. It will be targeted at the brightest and best healthcare assistants who haveproventheycangivehigh-qualitycaretopatients,butdonothavetheacademicqualificationsnecessary to get on to a nursing degree.

The new apprenticeship will make sure there is an opportunity for talented care workers to progress into nursing, giving them a route to advance their careers and a chance to use their vocational experience of working as a healthcare assistant to enter the nursing profession.

For more information, visit https://www.gov.uk/government/news/new-nursing-apprenticeships-for-those-who-have-proven-they-can-care

NEWSROUND


NEWSROUND

SECTOR BODIES

Future care workforce needs 1m more workers (Source: International Longevity Centre-UK)A new study by the International Longevity Centre - UK, The Future Care Workforce, has found that the adult social care sector in England will need to add approximately 1m workers by 2025 in response to population ageing and the implied increase in the numbers of people with disabilities.

According to the think tank’s report, the workforce will also have to be increasingly diverse in order to deliver a more personalised service to those in need of care and support. While there is evidence of good practice across the care workforce, there are a number of persistent challenges that could prevent the sector from evolving as required over the next decade, says the study. Many of these challenges are likely to be exacerbated by continuedfiscalconsolidation,whichhasresulted in local authorities reducing their expenditure on care services.

For more information, visit http://www.ilcuk.org.uk/index.php/publications/publication_details/the_future_care_workforce

Fundamental shift required in health and care systems (Source: The King’s Fund)A new report, Making our health and care systems fit for an ageing population, calls for a ‘fundamental shift’ in the way health and care are delivered as society struggles to meet the needs of an ageing population. The King’s Fund study says the country’s fragmented health and care system is not meeting the needs of older people, who are most likely to suffer problems with coordination of care and delays in transitions between services.

The report sets out a framework and tools to help local service leaders improve the care they provide older people across nine key components. Within each component of care, the report sets out the goal the system should aim for, presents key evidence about what works and gives examples of local innovations and some pointers to major reviews and relevant guidance.

The King’s Fund argues that if the health and care system can get services right for the older population – those with the highest complexity, activity, spend, variability and use of multiple services – it should be easier to get it right for other service users, and says “the twin challenges of demography and funding demand no less”.

For more information, visit http://www.kingsfund.org.uk/publications/making-our-health-and-care-systems-fit-

Patients ‘imprisoned’ in care homes, says committee report (Source: BBC News)Vulnerable adults are being kept virtual prisoners in care homes because of misuse of mental health laws, according to a House of Lords committee looking into the 2005 Mental Capacity Act. The report expresses serious concerns that safeguards brought in to protect vulnerable patients are actually being used to “oppress” them.

The committee has called for a new system to be drawn up from scratch; its report found that vulnerable adults are being failed by reforms introduced under the Mental Capacity Act.

However, the report also found that social workers, healthcare professionals and other people involved in the care of vulnerable adults are not always aware of the Act and are failing to implement it. The report concluded that “the only appropriate recommendation in the face of such criticism is to start again”.

For more information, visit http://www.bbc.co.uk/news/uk-26556732

Adult social care ‘under pressure’ (Source: BBC News)Adult social care in England is under increasing pressure and the Government has “no idea” how longthesystemcancope,accordingtoanofficialinquiry.TheNationalAuditOffice(NAO)hasalsoraised doubts over whether the planned overhaul of care services, which begins in 2015, will be as successful as ministers hope.

A lack of time and information could leave councils struggling to improve services, the report adds. Ministers say they are giving councils £1.1bn to protect such services. The NAO found that while demand for adult social care was increasing, spending by local authorities fell by 8% in real terms between 2010-11 and 2012-13. Some of this wasachievedbydeliveringcaremoreefficiently,but researchers also found evidence that councils paidprovidersless,puttingfinancialpressuresonsome companies, which complained of being able to deliver only basic care.

From next April, local government will be responsible for conducting carer assessments and other measures prior to the main measures of the Care Bill, including a cap on some care costs, being introduced in April 2016.

For more information, visit http://www.bbc.co.uk/news/education-26543367

Report highlights growing crisis in care (Source: Age UK)Age UK’s latest report, Care in Crisis 2014, has found that since 2010 spending on social care has dropped by £1.2bn or 15.4%. Even with the transfer of money from the NHS budget, there remains a shortfall of £769m, says the charity.

It reports that local authorities have become more restrictive in their criteria for deciding who is eligible for support. 87% of local authorities have now limited their threshold to ‘substantial’ needs, with a further 2% only offering support for ‘critical’ needs.

This leaves hundreds of thousands of older people with so-called ‘moderate’ needs, such as needing help getting dressed, washing or going to the toilet, without any help from their council, says Age UK. Instead, they may be expected to face potentially catastrophic costs to pay for support or rely on friends and family, even if that means carers giving up work to care for loved ones.

The report points out that at the same time the population is ageing and the number of people who may need care is ever increasing. The number of people over 85 years old, the group most likely to need support, has grown by 30% since 2005, but the number of older people actually receiving care has dropped by 27.2%.

To download the Care in Crisis 2014 report, visit http://www.ageuk.org.uk/Documents/EN-GB/Campaigns/CIC/Care_in_Crisis_report_2014.pdf?dtrk=true

Call for coordinated care (Source: PWC)The Independent Commission on Whole Person Care has published a report arguing for a radical new approach over 2015-2020 to rework the health and social care system to meet the changing needs of the population.

One person, one team, one system says behaviours across the system will have to change fundamentally, with the needs of one person being addressed by health and social care staff, acting as one team, from organisations behaving as one system.

The commission’s report points out that the model of care the NHS and social care currently deliver was created for a very different population, with different illnesses and care needs. Providing good, but episodic, care does not meet the needs of today’s ageing population, many of whom have long-term conditions, and people now need coordinated care based on the outcomes that matter most to them, says the study.

For more information, visit http://www.pwc.co.uk/government-public-sector/healthcare/publications/one-person-one-team-one-system.jhtml


NMC: Unfit to practise?At a time when social care issues are dominating the headlines and those who practise it are coming under increased scrutiny, Dr Chai Patel discusses the need to ensure the UK has an effective regulatory body for the country’s 670,000 nurses and midwives.

At its core, the Nursing and Midwifery Council (NMC) has a vision ‘to safeguard the public by ensuring nurses and midwives consistently deliver high quality healthcare’ and a mission ‘to protect patients and the public in the UK through effective and proportionate regulation of nurses and midwives’. These objectives are vital to ensuring that we provide first-rate healthcare for those who need it. However, the NMC’s vision can never be fully achieved if it does not look at resolving what is fast becoming a stain on its reputation; namely, the huge backlog of unresolved cases.

“Prolonged and protracted hearings only serve to compound the stress and trauma of all those involved.” In January, the NMC was warned by the Commons Health Select Committee that it must show it is capable of resolving its backlog of existing cases before it begins to look at plans to ‘revalidate’ nurses’ and midwives’ licences with three-yearly checks. At present, more than 400 cases remain unresolved by the NMC after two years or longer. I know the turmoil and uncertainty this can bring from direct experience. In 2003, a group of relatives at Lynde House care home in Twickenham (formerly run by Westminster Health Care, of which I was chief executive at the time) made complaints about a number of nurses connected to the home, which were passed onto the NMC.

It took the NMC five years to eventually bring formal charges against two nurses – Lynde House home manager Sarah Johnson and deputy manager and matron Lynette Maggs. Each was charged with more than 100 allegations. After a further 18 months, the NMC’s longest ever hearing began. This lasted nearly three years and

took 86 days of hearings.

“The social care sector is undergoing a major review. For the NMC to fit into the new system it needs to change and become a regulator that is competent, capable and credible.” Last year, the case of Johnson & Maggs v NMC was thrown out by the High Court. Mr Justice Legatt, the judge who presided over the case, criticised what he described as a “misconceived and mismanaged case”. Ten years after the initial allegations were made, the names of these two outstanding nurses were finally cleared.

That two individuals, who have dedicated their lives to care, had to suffer a decade of accusations and court appearances before their names could be cleared is testament to the fact that procedures followed by the NMC are completely unacceptable. Prolonged and protracted hearings only serve to compound the stress and trauma of all those involved, including family members looking for answers. The NMC’s disciplinary processes, as they currently stand, are damaging to practitioners’ careers and livelihoods, and to public confidence in our healthcare professionals, particularly when many of those accused have done no wrong. The MPs on the Health Select Committee have also demanded that all cases should be completed within a 12-month timeframe. The NMC has retorted that statutory changes would be required to exempt it from having to hold full disciplinary hearings in every case, something it claims is

not possible before 2017. The Department of Health says legislative changes are due in July of this year after a consultation. However, health professionals, the ones who live and breathe care, are not being asked to contribute – a crucial oversight and one I would urge the Government to reconsider. The social care sector is undergoing a major review, which, as someone who has worked in social care for more than 30 years, I welcome. For the NMC to fit into the new system it needs to change and become a regulator that is competent, capable and credible. Ultimately, it needs to be a regulator that nurses, such as Sarah Johnson and Lynette Maggs, can trust and deserve. Yes, the NMC must ensure the public is served by competent and caring clinical staff, but it also has a duty to those whose livelihoods depend on it.

NEWS - SECTOR


NEWS - SECTOR

Care boss warning over council hourly rates

There is an urgent need for the Government and local authorities to wake up to the need to invest in the quality of care provided to older people.

“It is all price-driven rather than about quality of care.”

The seriousness of the situation facing carers and the cared for was highlighted again recently by a BBC investigation that showed that the recommended minimum hourly rate was being paid in just four out of 101 cases.

The UK Homecare Association (UKHCA) believes that the recommended minimum for personal home care should be at least £15.19 an hour to cover wages, travel and training.

My company, SureCare, operates 27 franchises and three branches across England, but since I took over as managing director just over a year ago, I have deliberately diversified into other areas of care, in part because of the poor fees available for providing personal home care to local authorities.

This investigation by the BBC confirms what providers within the sector have known for some time, namely that the contracts being

offered by certain local authorities are simply unsustainable.

Rather than cutting the quality of care available to our elderly, we should be investing in them, similar to other countries in Europe. Having worked all their lives, brought up families and, in many cases, served their country, the least they deserve in later life is quality care and to be treated with dignity.

I remember in my old business walking away from a tender opportunity with one of the country’s biggest councils because they were auctioning care services to the lowest bidder because of financial pressure from central government. They wanted me to take the risk of opening offices and employing staff, but in return would put me on a council framework with no guarantee of work. Sometimes there can be as many as 20 other providers on such a framework. It is all price-driven rather than about quality of care.

This latest BBC investigation comes just a couple of months after the scandal of 15-minute visits hit the headlines.

In some areas, you are doing well if you receive a 15-minute visit. Budgets from central government are so tight that some local authorities follow a policy of minute-by-

minute bookings in order to save as much money as possible.

Carers end up working in their own time to give that little bit extra, but even then they are having to follow a ridiculous schedule that means some elderly people have to wait for their breakfast until midday and others are being put to bed at 6pm. We simply cannot go on treating older people like this. There is no dignity.

“We are facing a care time bomb, a world in which more of us will be working until we are 75 and living past 100.”

We are facing a care time bomb, a world in which more and more of us will be working until we are 75 and living past 100.

Our carers tell us that, more often than not, what elderly people want most is time. I think we are starting to see a shift back towards the importance of community. Even the supermarkets are picking up on this trend and opening smaller, more community-based stores in towns.

The way our elderly are treated in this country is scandalous. We have become a country where we prioritise the buses running on time and the bins being emptied, but we are happy to let our elderly make do with visits of just a few minutes a day.

We need a government to be bold enough to find the extra investment needed to give our elderly the quality of care and dignity they deserve but, alongside this, we also need a change in attitude.

Gary FarrerManaging directorSureCare

www.surecare.co.uk www.surecarefranchise.co.uk


Engaging your own carer – an alternative option in face of council cutsA recent investigation by the BBC has revealed that most local authorities in England are paying less than the industry-recommended minimum for personal home care.

“People are turning to the relatively unknown option of engaging their own live-in carer, who will act as a companion and housekeeper.”

The UK Homecare Association (UKHCA), which represents providers, wants councils to pay a minimum of £15.19 an hour to cover wages, travel and training.

However, according to information obtained under the Freedom of Information Act by the BBC, this minimum figure was met in only four of 101 cases.

The investigation by BBC Radio 4 found that the average minimum rate paid by councils was just £12.26 an hour.

With cuts to local authority budgets, fees for homecare services have generally been suppressed as authorities look to make savings.

This has naturally led to accusations that the quality of care from council-backed providers has also reduced, as carers are confronted with high caseloads.

As a result, some people are turning to the relatively unknown option of engaging their own live-in carer, who will act as a companion and housekeeper, providing one-on-one care in the client’s home environment, throughout the day and night for either a few days’ respite care or long-term assignments of months, sometimes years.

We have had many clients who have shied away from social services-funded domiciliary care, where several different (and sometimes unfamiliar) carers visit

at different times of the day to fit in with their heavy work schedule and not with the needs of the client. This situation can be very confusing for elderly clients and particularly for those that suffer from conditions such as dementia.

The main reason behind the trend of engaging your own live-in carer is the ability to access tailored, high-quality and continuous care in a cost-effective way.

Engaging an experienced, mature carer/companion/housekeeper, who has a similar outlook, hobbies and interests as the client, and becomes familiar with their individual likes and dislikes and their daily routine, provides both stability and security.

“Carers can prompt dementia sufferers to take medication, as they may get confused and forgetful.”

Our elderly clients generally do not like change and being able to remain in the comfort and familiarity of their own homes with someone who is able to provide support and assistance with personal care and daily household activities such as laundry, ironing, shopping, cooking and housework, in addition to providing companionship, has both physical and emotional benefits.

Engaging a live-in carer allows the client to live life as they wish, not bound by care visits.

A live-in carer will also be expected to provide regular, freshly prepared food and drink, ensuring a meal is never missed or forgotten and guarantees the client remains safe in their own home throughout the day and night.

Similarly, carers/housekeepers can prompt dementia sufferers to take medication, as they may get confused and forgetful with key medication.

Furthermore, live-in carers will

liaise with relatives, and other health professionals, to ensure that the right aids and assistance are in place to ensure the health and safety needs of the client are met.

Engaging a live-in carer may seem daunting, but companies such as Heritage Independent Living can take away the hassle of advertising, interviewing, and vetting.

We take the time to truly understand a client’s needs, interests and goals. Using an extensive database of carers, we are careful to match carers and clients as closely as possible, ensuring they have similar interests and hobbies.

Our carers are experienced carers in their 40s and 50s and come from loving home environments where they have brought up children and are used to looking after a household. They are not just carers but caring people who understand the importance of client dignity and continuous high-quality care.

Nick Sullivan

NEWS - SECTOR


NEWS - SECTOR

Staff should wear uniforms in care homes, says recent poll

A poll conducted by carehome.co.uk has found that over half of the people who took part want to see care home staff wearing uniforms.

When asked whether staff should wear uniforms in care homes, 583 (58%) out of 1,014 surveyed voted yes, 345 people (34%) voted no and 86 (8%) voted maybe.

Director of carehome.co.uk Davina Ludlow says: “The results are very interesting, with the majority clearly in favour of staff in care homes wearing uniforms.

“There are many variations of uniforms that do not necessarily reflect ‘institutional’ wear that was once the norm.”

“Many still tend to feel strongly about uniforms and how they indicate professionalism and help with identification.

“Nowadays, there are many variations of uniforms, which do not necessarily reflect ‘institutional’ wear that was once the norm.

“Many homes have adopted more ‘relaxed’ workwear, so that residents can still recognise care staff, but can also feel comfortable in their surroundings. Some, however, do feel strongly the other way – and find that uniform creates unnecessary barriers between staff and residents.”

In favour of uniforms and cited in the poll’s debate was Janet Rowse, chief executive of Sirona Care & Health. She stated that uniforms were something the

company enforced because they present a “consistent professional image for staff and the service. They also make it easy for service users and their families to pick out our trained dementia staff and they also contribute to the effective control of infection”.

Janet added: “Research into colour psychology shows that bright colours can have a positive effect on staff and service users, so with help from local schoolchildren we developed a rainbow collar on different brightly coloured tops.”

She also mentioned the company’s experimental use of scrubs for staff on night duty. Janet said: “Service users often query why they have to go to bed if staff are staying up, and the scrubs look like pyjamas and can again help distract and calm clients when they are anxious.”

This observation highlights the importance of careful consideration when it comes to a uniform policy for care providers. Those against it cite a risk that uniforms can impact on a ‘homely atmosphere’. Jeremy Garman, director of sales and marketing at Sunrise Senior Living, supports this side of the argument and explains why the company has a no uniform policy.

“Research into colour psychology shows that bright colours can have a positive effect on staff and service users.”

He says: “Staff do not wear uniforms while serving the residents we have in our 27 communities. Our philosophy is to avoid any

potential social barriers between the staff and our residents and create a fraternised environment with mutual respect.

“Our communities are not just care homes, they are our residents’ homes, and we feel it is vital that we preserve this environment with a minimal clinical influence wherever possible.”

Sunrise does, however, have a staff dress code that “ensures that staff are always dressed respectfully and appropriately”.

Comments from voters have been decidedly mixed between each camp; some state that in their experience dementia patients have responded better to staff not wearing uniforms whereas others think it would be unhelpful, particularly to visitors, to be unable to identify a member of staff when required, if uniforms are not in effect.

One commenter felt that uniforms present a ‘one size fits all’ approach to care and a care home as corporate business. Another suggested a casual uniform that sets care staff apart but within the remit of ‘casual clothes’ as opposed to a clinical nursing uniform or scrubs.

Ellie NevilleMarketing and news editorcarehome.co.uk

See the full debate and cast your vote here: http://www.carehome.co.uk/news/article.cfm/id/5/should-care-staff-wear-uniforms-in-care-homes


Typically people talk of wanting to ‘make a difference’, for example. I think this attitude has an influence on the ethos of working in the care sector – whatever the role or settings or organisation. I’m generalising, of course, but it can also mean that you spend quite a lot of time in the company of people with similar values and views. I don’t mean that everyone agrees with each other all the time; nor do I want to appear naïve about how seriously things can go wrong in some care settings (I guess Winterbourne View is a stark recent example of the pervasiveness of an insidious and abusive culture).

“Commitment to values gets people up in the morning. Values unify, they affirm and motivate.”

The National Skills Academy for Social Care is currently overseeing the testing of a toolkit for employers on ‘values-based recruitment’, which was devised by learning disability care provider MacIntyre. All this has led me to reflect on the fact that for most people in the care sector values are really important. It is the commitment to these values that gets

people up in the morning. Values unify, they affirm and motivate.

Meeting, and being, with like-minded people is one of the joys of working in care, but it could be argued that it creates something of a protected or artificial sense of consensus. The development of online communities can certainly challenge the idea that we all have similar views. Virtually every day there is a story about a social media storm resulting from the expression of a viewpoint that has got someone into trouble.

The power of the internet, in its various forms, is the speed at which it can test opinion or share an idea. It is a social leveller – challenging, amusing, opinionated and shocking by turns. The many online forums and social media covering care-related issues seem to attract all types of views and values. It is a shock, therefore, when you spend most of your time with people who mainly see things in the same way, to be confronted by more strident responses. It seems as if there is a parallel world where the rules are different.

“Being with like-minded people is one of the joys of working in care but … it creates a protected or artificial sense of consensus.”

However, surely values don’t alter simply because we express ourselves in different media? If we are to be true to our values and the way in which they act as a moral compass for the way we behave and relate to people, then this has to be consistent with every situation we are in – both in our professional and our private lives. For this reason it is to be expected that employers will react strongly to any evidence that demonstrates that important values have been undermined or compromised. And so they should!

Des KellyExecutive directorNational Care Forum

p Des Kelly, executive director, National Care Forum

Much has been written about the value base of working in the care sector. While the notion of ‘vocation’ probably isn’t quite accurate for the 21st century, it is clear that the motivation for working in the care sector is often very different to working in other sectors.

Keeping values constant

OPINION


Not a day passes at Nightingale Hammerson that I don’t feel personally connected to the emotional experiences that many of our residents go through. For many, taking the step to assisted living can be very frightening and is usually considered the ‘last stop’ of their life journey.

Consequentially, in this setting questions about life, death and the afterlife do come to the fore, and I find that a large portion of my role as a religious coordinator is just being there to listen to residents’ concerns and provide advice and guidance in any way that I can. I find many residents can, in fact, be afraid of religion and judgement as they near the end of their lives, and having someone on hand to listen and provide support can be immeasurably helpful.

“Many older Jewish people are drawn to a care home … where they feel safe to embrace their Jewish identities.”

Working in a care home for Jewish people adds yet another layer to this as many of the people who come to us are of the generation that has been affected – either directly or indirectly – by the Holocaust. These residents in particular have had to work very hard to hide their cultural identity over the years to escape persecution and discrimination.

There is a lot of anger within this generation as well as a desperate need for independence, which is severely undermined when they come to a care home and lose the ability to take care of themselves.

Because of this history, many older Jewish people are drawn to a care home for Jewish people because it is a place where they feel safe to embrace their Jewish identities. Incorporating religious and cultural activities is very important in this respect because it helps to bring the care home together and work through some of the tougher

questions.

Every day I build my job role around what is needed within the home. One important aspect of this is ensuring that I make time every day to meet with individual residents one to one. I regularly schedule meetings with all the residents on a rotating basis and visit the hospital twice a week to see the residents who are unwell. The importance of giving each and every resident attention and the time of day cannot be overemphasised and can be as simple as stopping to say hi to people you pass throughout the day.

In terms of structured activity, I run a weekly Yiddish music session every Friday for residents in the Wohl Wing, which is specially designed to meet the needs of those living with moderate to severe dementia. Involving dementia patients in musical activities has been proven to have a hugely positive effect in terms of remembrance, and I have personally witnessed many residents who have been overcome with emotion as the songs bring back nostalgia and memories of themselves at a younger age.

I also organise a Shabbat service every Friday and all the festival activities for residents across the care home. As acting rabbi, I lead prayer service in our synagogue and encourage residents to take part and come along to services. Even for those who are not all that religious, these services and festivals are something for them to look forward to and can be a special occasion for them to get

together. Since I have started the services resident numbers have grown dramatically.

I believe that religious and cultural activities are a vital and necessary element to the running of a care home, even for those homes that are mixed or secular. Having some kind of open spiritual offering for everyone – such as a grace before meals, celebrating particular festivals or a spiritual adviser to talk things through – can be truly invaluable in helping people through their fears of the afterlife and brighten the overall atmosphere and culture of the home.

Rafi Fuchs is the religious coordinator at Nightingale Hammerson, one of the Jewish community’s providers of care for older people.

OPINION

The case for religion in care homes


Celebrating the good care behind Great Britain

Key figures from the social care sector came together at a Good Care Week vision event that took place over lunch at the St Pancras Hotel, London in January.

The purpose of the event was to debate the issues surrounding the public perception of social care and formulate plans to challenge the negative image portrayed by the media during Good Care Week. The lunch also served as a platform to formulate a business plan as to how Good Care Week 2014 and beyond can go from strength to strength, become a strong national campaign and encompass the Great British public.

Building on the success of last year’s inaugural campaign, the new-look Good Care Week, which is supported by Care Talk magazine, was launched at the National Children and Adult Services Conference at Harrogate International Centre last October. The aim – to change the dynamics of social care to include the whole British public.

At the launch Norman Lamb, minister for care and support, said of the campaign:

/Sector support

www.goodcareweek.co.uk

Support from sector at vision event for Good Care Week 2014

“I believe Good Care Week has a vital role to play, not only in giving a more a balanced view of the sector, but in starting a national conversation on the importance of good care. Care is something that affects everyone in the UK, and our care workers deserve to be recognised and celebrated for the vital work they do.”

/Sandie Keene, president of ADASS

Sandie Keene, president of the Association of Directors of Adult Social Services (ADASS), said: “I applaud this initiative to celebrate all that’s good in social care. Having a week to showcase all the best in the business is a welcome opportunity to highlight pride and passion in valued services. My best wishes for a resounding success.”

q Key figures from the social care sector come together to support Good Care Week


/Andrea Sutcliffe, chief inspector, Care Quality Commission

Commenting at the vision event, Andrea Sutcliffe, chief inspector of adult social care at the Care Quality Commission, said: “I am very pleased to support Good Care Week on behalf of the Care Quality Commission (CQC). This is a fantastic opportunity to champion the thousands of care services that provide quality social care every day.

“Social care supports people with a huge range of needs and at its very best it has the ability to completely transform people’s lives. As CQC develops its new regulatory model for adult social care, I will be putting a great emphasis on identifying, highlighting and celebrating best practice. I wish Good Care Week every success.”

Celebrating the good care behind Great Britain


/Debbie Sorkin, chief executive, National Skills Academy for Social Care

Debbie Sorkin, chief executive of the National Skills Academy for Social Care, said: “The National Skills Academy for Social Care is delighted to support Good Care Week for a second year. This awareness campaign will, by promoting excellence in social care, challenge negative perceptions and celebrate the good practice that we know is being delivered daily in a wide range of settings.

“Good Care Week will raise the status of people working in social care at all levels, and involve people using services and their carers in the spirit of co-production. We will encourage our members to get involved by writing to their MPs, local councillors and clinical commissioning group leads, and becoming Good Care Champions in their local areas.”

/Tony Hunter, chief executive, Social Care Institute for Excellence (SCIE)

Tony Hunter, chief executive of the Social Care Institute for Excellence (SCIE), said: “Good care has the power to transform people’s lives. It can restore confidence, sustain employment and maintain relationships. So let’s not keep that good news to ourselves. That’s why SCIE is a strong supporter of Good Care Week – it is a real opportunity to recognise the valuable work that 1.8m care workers undertake every day.”

/ Paul Ridout, managing partner, Ridouts

Paul Ridout, managing partner, Ridouts, said: “This event will be a huge opportunity to redress the persistently negative perceptions of social care constantly and misleadingly presented to the Great British public- Ridouts will be enthusiastic supporters.”

/Alex Fox, chief executive, Shared Lives Plus

Alex Fox, chief executive, Shared Lives Plus, said: “As a network for people who dedicate their time and energy to including disabled adults and older people in their family lives, Shared Lives Plus is delighted to support Good Care Week to celebrate some of the countless unsung achievements that make social care great.”

The campaign has once again received support from across the sector, including the Department of Health, Association of Directors of Adult Social Services, Care England, Care Quality Commission, Alzheimer’s Society, National Skills Academy for Social Care, Skills for Care, Social Care Institute for Excellence and the United Kingdom Homecare Association.

The campaign is also supported by journalist and broadcaster Fiona Phillips and television personality Jane MacDonald.

Lisa Carr, editor of Care Talk, said:

“At Care Talk we feel passionate about the social care sector. We are proud

of our social care workforce and the quality care that is carried out 24/7, 365 days a year. We are all too aware of the issues that our sector faces; a big lack of funding and an even bigger lack of recognition.

“We want everybody in the sector to take ownership of this campaign. We would encourage individuals and organisations to share ideas with us for raising the profile of social care locally so that colleagues throughout the sector can emulate this in their own communities and galvanise public support. We look forward to featuring examples, stories, comments and suggestions on the Good Care Week website and in Care Talk magazine.”

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Health & Social Care Reform Events

18th February - Reducing HCAIs Location: The Brewery, London

12th March - Public Health Location: The Brewery, London

25th March - Social Care Location: The Brewery, London

8th April - The Dementia Challenge Location: The Mermaid, London

24th June - Reducing HCAIs Location: The Mermaid, London

5th November - Public Health Location: The Mermaid, London

25th November - Improving Patient Care Location: The Mermaid, London

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High quality conferences focused on providing our audience of senior public sector decision makers with the latest information on policy and best practice alongside access to industry expertise to aid with delivery.

AN UNRIVALLED PROGRAMME OF EVENTS FOR 2014

Health & Social Care Reform Events

18th February - Reducing HCAIs Location: The Brewery, London

12th March - Public Health Location: The Brewery, London

25th March - Social Care Location: The Brewery, London

8th April - The Dementia Challenge Location: The Mermaid, London

24th June - Reducing HCAIs Location: The Mermaid, London

5th November - Public Health Location: The Mermaid, London

25th November - Improving Patient Care Location: The Mermaid, London

Advert.indd 1 24/01/2014 15:59

When a resident whose weight was adversely affecting her life asked for help to shed pounds, care assistant Tammy Morrison had no hesitation. At the time, Elsie (not her real name) was nearly 19 stone and struggling with mobility as well as suffering from joint pains.

Since then, Tammy has been shoulder to shoulder with Elsie every step of the way, offering encouragement to exercise and mentoring her when the going got tough with the diet.

“The road to success started with a frank conversation in which they covered the basics of losing weight healthily.”

Just over a year later, Elsie has lost two stone and has transformed her outlook

on life with Tammy’s help. The weight loss programme is still going strong and Elsie, who stays in mental health unit Eagle House, run by Anchor in Sheffield, is determined to lose even more.

Tammy says that the road to success started with a frank conversation in which they covered the basics of losing weight healthily.

“I sat with her and we went through a plan and I explained it had to be slow because fast weight loss doesn’t stay off. I got in touch with her GP, who referred her to a weight clinic in Sheffield, and we made a target to aim for over a period of time,” says Tammy.

The chef at Eagle House was involved in the plan so that Elsie’s menu could accommodate her weight loss goal while remaining nutritional.

Elsie was committed to her dream but nevertheless it was a struggle. She worried about her weight, which adversely affected her mood, and she found it tough to stick at a diet day after day when she could see no improvement.

Tammy says: “She needs lots of encouragement and I’d do that every day. She didn’t see or feel the difference until she went to the clinic to be weighed. That was hard for her.”

It was difficult for Tammy too since, as she was seeing Elsie every day, it was hard to see how much weight was being lost. It was often a struggle to find the right words of encouragement when Elsie asked Tammy

if she noticed her getting thinner. Tammy says that she did not want to be untruthful but she also did not wish to dishearten Elsie by admitting she could not see the weight loss.

So she came up with the idea of focusing on Elsie’s clothes as a way of keeping the motivation up. They began to measure the weight loss in terms of how items of clothing fitted.

“I’d tell her to think about her clothes and, when she did, she noticed they fitted better. Then she’d say was down from a size 26 to a size 24 and that was a boost. And she got a lot out of finding that a particular skirt fitted because it had not fitted for years,” explains Tammy.

Now two stone lighter, the weight loss has made a huge difference to Elsie’s life. Not only has her mobility improved, enabling her to exercise more, but it has benefited her mental health too. Her mood is more upbeat and she is jubilant when she thinks about her achievement or if someone comments on her weight loss.

“It picks her up like you would not believe when someone mentions how much she has lost. Her weight loss has given her a new lease of life and it puts her on a high when she thinks about how much she has lost,” says Tammy.

The weight loss has done more than improve Elsie’s life on a day-to-day basis. It has also changed the way she sees herself and views life.

“She’s so much more positive and feels better in herself. Rather than thinking about the negatives, she thinks more about the positives,” says Tammy. “In fact, when I think about the person she was when I met her two and a half years ago, it’s like a totally different person. It’s lovely to see.”

Julie Griffiths

Tammy helps resident lose weight and gain independence

STORIES


For most 14-year-olds, losing their mum to cancer would be a devastating life event. So it was for Natasha Richardson, but she has turned a tragedy into a positive by emulating the dedication and care that she saw carers provide for her mum when she was ill.

“Mum was ill for four or five years. She had breast cancer at first and had treatment for it but it came back after a year and spread. It was towards the end of her time that she had carers coming in,” Natasha recalls.

Already interested in a career in care, Natasha observed the carers making a difference to her mum.

“I noticed how much the little things can count. Painting Mum’s nails or combing her hair helped her to relax and feel better,” she says.

Now 21, Natasha is the one delivering care. She joined the South Gloucestershire team at domiciliary provider DoCare in early 2012. The attention to detail that impressed her when her mum was ill is evident in her relationships with clients. She says that the key to successful caring is to give people time, not to rush anyone, and to gain their trust.

Every person is different, she says, and it is important to take the time to get to know each client so that she can care for them better. To do this, she takes an interest in her clients’ histories and background by

asking questions, encouraging stories and listening.

For example, one client likes to reminisce about her days in the West Indies and Natasha enjoys hearing her tales.

“Being a good listener and being patient make a good carer. I find it really interesting to hear clients talk and, as you get to know them better, it helps them relax and trust you,” she says.

Another client has Parkinson’s disease and a tracheotomy, which makes communication a challenge. The client usually uses a keypad to communicate but Natasha has learned to lip-read to help her feel she is having a conversation in the way that she did before her illness. As a result, the pair have developed a good rapport.

“She prefers me to lip-read because I can carry out the care pathway and still talk at the same time. It’s more relaxing for her. When we started, it was a struggle and I’d have to ask her to speak slowly. But even if I had to take five or 10 minutes of sitting with her to understand what she was saying, I did it, and as the months go by it gets easier,” says Natasha.

Natasha strives to make every person feel special and cared for. One client, Dorothy, says that Natasha seems to have a gift for anticipating her needs without needing to be prompted.

“She knows what to do before I even have to ask her. There are 18 steps that I have to go up and down, and she always makes sure she goes in front of me or behind me as I can feel wobbly sometimes,” says Dorothy.

Natasha’s ability to retain information also impresses Dorothy.

“She memorises everything so she never needs to ask about something more than once,” Dorothy says.

Since joining DoCare, Natasha has achieved her QCF level 2 in health and social care. Next, she will train as a dementia link worker and take a course in end of life care.

“Dementia affects so many people but each person differently. I’d like to expand my knowledge to help people more,” she says.

A greater understanding of end of life care is important to Natasha too. She knows from first-hand experience how essential it is to get the care right towards the end of life.

“You only get one chance at it. It’s important for the person and the family. It’s about dignity and respect and helping them to feel relaxed towards the end of their life.”

Julie Griffiths

Personal tragedy entices Natasha into a caring career

STORIES

“Already interested in a career in care, Natasha observed the carers making a difference to her mum.”


A blank postcard arrives through your letterbox one morning, and with it comes the question: What do you want to tell the world? You have the freedom to write, paint, doodle, draw – whatever, however.

So, would you?

Perhaps when you think about it, there might not be something you actually want to tell the world. I have a theory that when we have a voice, are heard and express ourselves every day, maybe we don’t feel we need that platform.

“People with disabilities don’t feel listened to, are quite often excluded from public debate and can feel marginalised.”People with disabilities rarely feel this way and even though the last 40 years have seen big changes in society, there’s still widespread prejudice and lack of understanding. And few know this better than United Response, a national charity supporting children, young people and adults with a wide range of disabilities and mental health needs.

To celebrate its 40th birthday in 2013, United Response invited anyone who cares about disability to tell the world what matters to them, with just a blank postcard and some imagination.

And the result?

A unique exhibition at London’s Bankside Gallery called Postcards from the Edges, displaying hundreds of works in the form of poems, photographs, digital art, paintings and even knitted postcards. Visiting the day after the launch, I was given a guided tour by United Response’s head of press and public affairs, Jaime Gill.

“The launch was really emotional for me,

and for all of us, because people came from all over the country, as far away as Wales and Cumbria, to see their work and to support the event,” Jaime explained as we walked the gallery.

“The sheer diversity of art and messages across the walls was a lot to absorb.”“Crucially, we didn’t want it to be open only to professional artists, and we didn’t want the disability to be the defining factor. We wanted to be truly inclusive because people with disabilities don’t feel listened to, are quite often excluded from public debate and can feel marginalised.”

Left to myself for a wander, a simple beauty of the exhibition was spotting postcards from celebrities like Emma Thompson, Sally Gunnell and Evelyn Glennie, alongside works from disabled artists and people with moving, simple, joyous and heartbreaking messages from all over the country. A nice touch was the DIY section where visitors to the exhibition could sit and create their own cards – adding their own voices to the conversation.

The sheer diversity of art and messages across the walls was a lot to absorb. There were simple postcards: a collage of photographs of friends having fun with the words: My Happy Life. And someone who wrote beneath a picture of a house: “I am proud of living in my own home for

nine years.”

Others were rousing, like double gold medal-winning Paralympian Hannah Cockcroft’s great way of seeing life: “If you believe it, you can achieve it.” And then a lovely bit of philosophy from tennis player Martina Navratilova, who wrote: “Disability is a matter of perception. If you can do one thing well, you’re needed by someone.”

Blown up for the exhibition, I especially loved Andy Wild’s My energy and joy, which was a deep riot of live colour. Andy has a brain tumour that has left him with epileptic seizures on a daily basis. Drained by tiredness, there are few opportunities to enjoy life. The painting was possible on a rare day of feeling good. Beneath the picture he wrote: “Even if it is only for moments, life can be wonderful.”

Postcards from the Edges very much reminded me of that: life can be wonderful. It’s even more so when we have a voice and the chance to be understood.

Debra Mehta

Postcards from the Edges

STORIES


Making workplace equality a fundamental part of careDiversity and equality in the workplace is fundamental to providing flexible, quality care provision to meet the needs of service users. We asked a group of care workers, ‘How do you promote diversity and equality at work?’

Debra Mehta

Jackie Makwangwala Quantum Care

It’s about identifying what people can and can’t do and their skills in catering for the residents because at the end of the day, it’s what’s best for them.

When you’re employing and doing your skill mix, you have to ensure diversity needs are met. For example, we have a gentleman who speaks Spanish, so we will look to employ someone who speaks that language so we can cater for his needs.

Conclusion• Look for skills other than formal

qualifications• Recruit with skills and diversity

mix to match needs of service user

• Having a diverse mix within a team makes it stronger

• Service users can enjoy learning from different cultures

• Treat everyone as individuals

Glenda Barker Carebase We have equal opportunities and diversity policies, so they’re there as guidance, but obviously in employment we take the best person for

the job and that’s not necessarilyintermsofformalqualifications.It might be experience, and if they have a disability, that can be accommodated depending on the role. We come from a multi-ethnic society, so 60% of our staff are from ethnic minority groups and they come from quite a distance to Waltham Abbey from a number of surrounding of areas.

Zoe Ayliff Community Care Solutions

We always look to the needs of the service users. So if, for example, we have a service user who is Muslim and needs to

attend Temple, then we’d look at recruiting staff who have the relevant knowledge to support that person.

Amy ColeSolihull CouncilIt’s about treating people as individuals. Sometimes, organisations canbeindangeroftryingsohardtoavoidconflictthatitcreatesa culture where people might be afraid to go against the status quo and that, for me, is around diversity. It’s a team environment but they’re individuals within that and can express themselves in whatever way they choose. I try to think about my service culture and that we work as a team, but all views and opinions are respected regardless of anything. We try to avoid judgements and labels.

Keith BartlettHC-OneWeuseaspecificsetof questions for each role in the home when interviewing people because it’s easy to be overwhelmed by someonewhenyoufirstmeet them. And it’s fair

for everyone. Diversity depends a great deal on geographical area; we’re a ‘cloth cap’ industrial-type area where there’s a large Forces background so we’re looking to employ people who can relate to that type of client.

CHAT - VOICE OVER

Deanna Lane Barchester HealthcareWe’re in the middle of the Cotswolds, so we don’t have that much diversity around the area. However, when we have had, diversity and equality is promoted within the home, so we have used the cultures of staff within the home environment. For example, we have an Indian member of staff so he’s brought in things from his culture and used them to have a themed day, and the same with staff from the Philippines. The residents really enjoy it and some of them have been on holiday to these places so it’s good for reminiscence, and they’re able to add to the day by sharing their experiences of different cultures. In terms of equality, we do have a more female-oriented environment by nature, but more men are applying to come into care as it becomes a less stigmatised career.


The charityJan Lovett, registered manager, The Fremantle TrustIt’s always about recognising everyone’s individuality - so looking at people’s backgrounds and their needs and expectations about the working environment for the staff. For the residents, it’s about the person-centred care that we deliver. Most importantly it’s about recognising and respecting people as individuals.

How do you promote diversity and equality in your role?Maximising diversity and equality in care provision is key to person-centred planning. We asked a group of stakeholders, ‘How do you promote diversity and equality in your role?’

The provider

Neil Russell, manager, PJ CareIn the care industry you have no choice. The diversity of the people we look after, and also the people who want to work in the care industry, come from very diverse backgrounds. You have to encourage and enable them all to understand the different needs for each resident. If you treat each resident as an individual, then

the diversity is built-in because it doesn’t matter where they’re from, they’re all treated as individuals anyway. We massively stamp on any inequality

very hard. We have a strong HR policy that people have to follow and it ensures everyone is treated the same. When interviewing, we ask each candidate the same questions and the result is based only on the merit of their answers and knowledge. You have to give everyone the opportunity to achieve the same level, and some people need a little extra help to do that. We have

some senior carers who are severely dyslexic but we’ve workedwiththemtogetNVQandQCFqualifications.

The care association

Ann Taylor, director, Kent & Medway Care Alliance

I promote diversity and equality by leading from the front. The attitudes of the people who lead organisations are really important. If you have a good set of policies, procedures and operating processes, they are brilliant, but if you don’t actually implement them with your leaders, they mean nothing.

The provider

Anna Lesniak, practice leader, PJ CareBeforebeingapracticeleaderIwasfiveyearsas a unit manager, so for me, it was very important to treat everyone the same and that includes staff also. When doing interviews, I always make sure I respect everyone because here in England there are so many different cultures and different beliefs and nationalities and it’s so interesting to work with all these different backgrounds. Being from Poland, I appreciate this. Understanding and communication and treating people with respect as individuals is very important. You can’t bring home life to work, but we must recognise we’re all human.

Conclusion• Lead from the front• Respect everyone as individuals• Multi-disciplinary teams to support service

users• Empower staff to empower people• Offer the same opportunities to all staff• Listening, understanding and

communicating

The provider

Steve Todd, manager, Notaro Homes Ltd

We empower the staff to empower the people. So, in other words, our staff are empowered by the

residents. We involve our residents in the day-to-day running of the home, so they’ll cook and clean and take care of their rooms. It’s all part of giving people a chance to have a quality of life and be part of running the establishment.

The providerHerculano Castro, operations officer,MentaurLtd

We promote diversity and equality on two levels - at a staff level, and in terms of the service delivery. In terms of the people we support, we always try to look beyond their diagnosis and beyond all the challenges they might present: so for us, nothing stops us looking at the person rather than the report.Intermsofstaffing,wehave a multi-disciplinary team and employ people from several different nationalities. We look forqualifiedpeople,butaboveall we look for people who have certain human qualities and people who are honest, which is a very important feature for us. The people we support are involved in the selection of staff, so that’s another way of promoting diversity.

The providerMonica Prosser, manager, Carebase Ltd

It’s about looking at everyone as an individual and making sure everyone is treated in a very fair way. We’re very lucky when it comes to recruitment because we have a very stable team and have had for over four years. We go out of our way to ensure the staff feel valued. We do a Carers’ Week every year and all seven days and nights, there are treats for them and we take time to listen to them. We’re all part of the home and it’s their ideas we like to add to the running of the home. We have a very open door policy and anyone who comes up with good ideas, we look to reward them. We have a family-run type of organisation.


Backinmyflat–phew!Notthattheyweren’t nice in the nursing home, but it wasn’t like being in my own place.

They said that it was their job to get me back on my feet since I had been in hospital so long that I’d nearly forgotten how to walk, and it’s true, I feel even more wobbly on my pins than ever.

But I’ve been sent home with what they call an increased care package and some more aids around the place to ensure that I don’t take risks and fall over.

They were very good at the nursing home – I was there four weeks and they undid the harm being in hospital caused me. They said there was no reason why I had been kept in hospital that long and that everyone knows hospitals aren’t good places for older people to be. Also that

you go backwards in hospital sometimes and it was their job in the nursing home to take me forward.

Andtheymadeit.I’mmoreconfidentonmy feet again and though I’m still a bit wobbly and prone to falling, it’s mostly when I’m getting up or sitting down again. The extra care hours are when I need to be going to the loo or something like that when I might take a tumble.

I said to the young man in the nursing home, “Isn’t it in your interests to keep me here?” but he just laughed and assured me that their job was to make an improvement so that I could be independent and I could choose. Then he winked at me and said, “But when the time comes when you decide you want to come and live in a nursing home, now you know us, we hope you’ll choose us”. And, do you know what, I probably would! After

all, it’s not every day a nice young man winks at you!

Mrs MAC LOG

Mrs MacBlogVerona MacIntosh is 91 years old and has lived in extra-care accommodation for over five years after she had a stroke, and gets four calls a day. She’s been widowed for 11 years.

Challenge for care workers – discuss

the following issues.

1. What extra support do you think Verona

will need coming back to her flat after three

months?

2. Things will have changed in that time. How

would you help her get back into the swing

again?

3. What do you think about the attitude of the

nursing home? Verona was right in her analysis

that it was in their interests to keep her rather

than rehabilitate her. What’s in it for them?

CHAT - MRS MACBLOG / THIS IS YOUR LIFE

This is Your LifeA strong bond forged with a maintenance man has given an Armagh care home resident a new lease of life.

AlfieHill,whohaslearningdifficultiesandis physically disabled, moved into Amore Care’s Apple Mews almost a year ago after a life spent predominately in long-term, institutional care.

AfirmfriendshipwithAppleMewsmaintenance man Johnny McKenna has enabledAlfietoinvolvehimselfineverydaytasks and activities that have led to a quality of life and level of independence he never dreamed of attaining.

Johnny, who has worked at Apple Mews since October 2012 after spending most of his working life on building sites, attended Amore Care’s Creative Minds training,

designed to motivate all care home staff and encourage creative ideas to improve the quality of life for residents.

Despite not having a care background, Johnny embraced the ethos of the programmeandengagedwithAlfieinawaythatchangedhislife.Alfienowhelpsaroundthehome,goesfishingwithJohnnyandeven mows the lawns from his wheelchair, with a little innovative assistance from Johnny. He is so motivated in his life that he has started regular physiotherapy with the ultimate aim of walking again.

Rosemary Dilworth, Apple Mews home manager, says: “The Creative Minds programme is designed to help everyone working within our homes to engage with residents in innovative ways that improve the quality of life.

“Johnny is a fantastic example of someone who has never worked in a care environment before but has welcomed the opportunity to develop his skills and is now engaging

with residents in a way that is changing their lives.

“HisfriendshipwithAlfieisinspirationaland perfectly demonstrates the value of the Creative Minds programme.”


Up close and personal with... John Adams, VODG general secretary

The Voluntary Organisations Disability Group (VODG) is the leading umbrella group of over 75 leading voluntary sector and not-for-profit disability organisations. It works on behalf of members to influence and develop social care policy, build relationships with government and other key agencies, promote best practice and keep members updated on matters that have an effect on service delivery.

Care Talk caught up with general secretary John Adams to find out about his vision for social care and VODG’s role in tackling challenges for the sector.

“Almost half a million people who would have received social care five years ago now receive none.”

Adult social care has suffered around £2.68bn of cuts in total over the last three years. As a sector, we desperately need to focus more attention on the dwindling numbers of people receiving council-funded support as a result of the austerity measures.

The cuts equate to some 20% of net spending and, as the Association of Directors of Adult Social Services (ADASS) stated in its recent survey-based research on the issue, such efficiencies are not just plucked from the ‘back office’, but are gained by squeezing the care packages of elderly or disabled people.

I wholeheartedly agree with the words of ADASS president Sandie Keene, who has warned that a future without additional investment for councils makes “an already bleak outlook…even bleaker”. Take, for example, the shocking results from a recent study commissioned by the Care and Support Alliance and carried out by the London School of Economics. This showed that the number of frail elderly and disabled people receiving care at home has been cut by a third in five years; almost half a million people who would have received social care five years ago now receive none.

This squeeze on funding is among the biggest challenges facing people with learning disabilities and their care providers, but

the problems are being compounded by proposed changes to the national eligibility threshold in the Care Bill.

The changes will exclude thousands of people with learning disabilities with moderate support needs and it is unclear what happens to those people once they ‘fail’ the eligibility test. Many have no choice but to live with elderly parents and there is even the risk that some may end up in the criminal justice system. A recent joint report by the Care Quality Commission, probation service, police and the Crown Prosecution Service highlighted how offenders with learning disabilities are being failed by criminal justice agencies.

While scandals like Winterbourne View and investigations like the Francis Report have brought a renewed focus on the needs and wellbeing of vulnerable people, quality social care providers have always offered support with the ethos of ‘nothing about me, without me’. However, I fear this is not the same for the NHS, where more work is needed in this area. A better focus on commissioning – ensuring that commissioning is based on actual costs and outcomes – would create major improvements for vulnerable people. The cuts, combined with commissioners’ relentless focus on price, are harmful to the development of strategic business relationships and undermine the likelihood of any real focus on meaningful outcomes and wellbeing.

The VODG, ADASS and the Care Provider Alliance recently produced a piece of work illustrating how it is not too late to design and adopt a strategic approach to commissioning. We need an approach that avoids the short-term, adversarial relationships that are detrimental to valuable services and a process that promotes leadership, a reduction in bureaucracy and shared risk-taking.

A short-term approach to planning undermines support for people with lifelong disabilities; VODG member FitzRoy’s study, A Plan for Life, stressed how lifelong planning in

social care for adults with learning disabilities improves wellbeing and reduces long-term care costs.

While we all understand the straitened economic times, the current emphasis on cuts in policy and political rhetoric moves us further away from the reality of the risks and pressures involved in running services.

“Current emphasis on cuts in policy and political rhetoric moves us further away from the reality of the risks and pressures involved in running services.”

Government should not only ensure that councils are adequately funded, it can do more to make clear that personal budgets really do mean something.

As for the VODG, we champion the role of progressive not-for-profit providers and illustrating how commissioners can gain major efficiencies through developing long-term strategic relationships. Everyone wins – especially the person being supported.

We will continue to hold up examples of great practice that save the tax payer money and meet people’s needs. Our aim is to identify those councils that work most effectively with our members and highlight them as ‘beacons’ – the kind under-performing councils should and can aspire to in order to improves the lives of society’s most vulnerable people.

John AdamsGeneral secretary Voluntary Organisations Disability Group (VODG)

Find out more on our website www.vodg.org.uk or follow on Twitter @VODGHQ

CHAT - UP CLOSE AND PERSONAL



Care creaturesThanks to Jenny Carlisle, activity support leader at Elder Homes, for these cute animal pics. Jenny says: “In our home in Leek, Staffordshire, we have pigs, sheep, chickens, geese, a cockerel and three cats. The cats can often be seen strolling along the corridors of the home looking for someone’s knee to climb on.

“At our Nottingham home we have a pair of rabbits on each unit. The rabbits have become part of the lives of all our residents, who cuddle them, feed them and watch them play.

At our Leek home we shear the sheep in the summer and residents get a chance to watch with their family members. Also, when we have good weather, there is a service user who has a daily activity of collecting some of the eggs.”

In a competitive market you want to stand out. Your website, brochures, policies, newsletters and much more need to tell people what great care you offer.

Good written communication:

• Reassures service users, their families and carers that you offer the best care around

• Gives your staff clear guidance and support to do their jobs

• Shows potential new recruits what a great

career they could have • Tells commissioners what makes you special• Demonstrates your high standards to

regulators.

WriteCare can help you send out strong messages and straightforward information, demonstrating credibility and professionalism. WriteCare is cost effective, saving you time but producing the results you want, offering a fresh perspective plus practical help with writing, editing, proofreading and planning.

Why not contact WriteCare for a no-obligation chat about your written communication needs? Email [email protected], call

Vicky Burman on 01889 590804 or visit www.writecare.co.uk.

CHAT - RESIDENT CAT

CHAT - PLANET JANET

There’s a gap in care! The more I get close, the wider the gap seems to be.

It’s no wonder our hospitals and nursing homes are filling up with older people - a population that is increasing faster than any other segment - and we haven’t got the right strategies in place to respond to the pressure this is causing.

The press is full of stories of inappropriate self-referral to A&E, and unnecessary admissions (mostly of older people) into hospitals (usually by paramedics and the ambulance service).

First of all, A&E. It seems we, the public, are guilty of wanting our needs met immediately and that younger generations in particular are the most typical of this instant gratification culture.

What’s wrong with the desire to have any deficit in our lives, or our relatives’ lives, put right at the earliest opportunity so that we can get on with living our lives? What’s wrong with expecting that a full range of excellent services is available on our doorstep night and day, whenever we want it? Every other provider of services has listened to this consumer demand and responded accordingly.

Nothing is wrong with the ideal; what’s wrong is that no one has the least idea how to afford it!

But I get tired of NHS managers bleating that the public needs re-educating in when, where and to whom their health needs should be referred. Of course, the NHS could take a different tack. It could instead think of itself as a genuine 24/7 service for everyone, everywhere, and start to structure itself to think a different way.

Next, inappropriate admissions – and there are so many of these that national studies are being done on the impact on both patient and hospital. My own mother is a living example.

She was living in her own little flat in an extra care complex with four calls a days provided by the on-site care team. She became lonely and isolated and, mostly because of her dementia, she needed more input than the care workers ‘had permission’ to give. They were good local women, quite kind really, but they were not very imaginative nor had they any discretion to

provide anything more or less than what was written in the care plan.

So, when my mother began to have accidents because she couldn’t get to the loo fast enough, they had no strategies for managing that. When my sister and I asked that on each of these four calls they made sure Mum went to the loo and also helped her with her clothing before and after, they couldn’t do any more than prompt because it wasn’t in the plan. When some of her medication ended up on the floor, they couldn’t do any more than prompt because it wasn’t in the care plan. This was a regular response to anything we requested that would meet a development that made Mum a little more vulnerable, a little more isolated.

She got a tummy bug and had a day of vomiting. That was enough to tip her from being habitually a bit dehydrated to critically dehydrated. When she was found unharmed on the living room floor one morning, still in her nightdress but with no idea how long she’d been there, the care workers had no other recourse than to call 999.

The paramedics confirmed she was unharmed but, because of their rules and training, had no alternative than to take her to hospital. Where she remained for EIGHT weeks. During which time, after tests proved negative, she received no treatment whatsoever except some physio to get her mobilised.

What was needed, rather than hospital admission, was the immediate ability to ramp up Mum’s care plan to provide some more intensive support for a short while.

But what was really needed was to abandon our slavish adherence to care plans that are unresponsive, inflexible and out of date. With a progressive disease like dementia, this is even more necessary; a care plan written yesterday may not be relevant to today, let alone one written six months ago.

And did that care plan, useless as it may be, follow Mum into hospital? No, it did not! The hospital had to do its own assessment. When completed – some six weeks after admission – the view was that her care needs had escalated to the extent that they could no longer be met in

extra care.

And by then, that was probably right, because during her time in hospital she had regressed enormously. She would need some fairly intensive reablement and that is not available in extra care.

The policy of the local authority is to offer reablement only to people in their own homes in the community. Pointing out that a tenanted flat in an extra care scheme is someone’s own home in the community yielded nothing, and in fact, no extra care input was deemed suitable, appropriate or available and consequently not on offer.

So my mother languished in hospital for another two weeks while we, her two daughters, sought appropriate registered care, and, somewhat sadly, cleared out her flat and gave notice on the tenancy.

She was left in bed most of that time because the nurses felt they had ‘taken her as far as they could’. Discussions about muscle wastage when someone is immobile, risks of pneumonia when someone is lying more or less flat all the time, and the appropriateness of conducting a care plan in a hospital setting (especially after the patient had been there for six weeks) all fell upon deaf ears. Reminders that all the good practice says that assessments should not be done in an acute setting, and that discharge planning should start as soon as someone is admitted, were equally unwelcome.

Do I feel sorry for the staff at the extra care scheme who watched Mum go off in the ambulance never to return to their care? Yes I do, to a point; they must be frustrated knowing there is so much they can do but are not allowed to. But there’s a bit of me that also knows they’d have been glad that a quite demanding tenant was now off their hands for a while, because there was always going to be someone else to fill the gap.


▲ Host Fiona Philips with winner Jackie Rutterford and sponsor Lisa Hovey from Alzheimer’s Society

What the winner said…“I feel honoured to have been nominated for this prestigious award, never ever thinking I would be lucky enough to actually win it! The awards evening was definitely a night to remember! It was a combination of excitement, apprehension and finally relief when the announcement was made. The adrenalin was running high! Having spent the evening with so many amazing people who are totally committed to caring for others, I feel humbled to have received this award.”

What the judges said…“The judges were impressed by Jackie’s openness and tenderness, linked with her absolute concentration on the needs and preferences of the individual with dementia. She always sees the whole person and views the task of supporting them as seeking out and using a whole range of opportunities for them. Her persistence and imagination in tailoring her support very specifically to the individual ensure very special care.”

The Dementia Carer Award, Jackie Rutterford, Home Instead Senior CareJackie Rutterford from Home Instead Senior Care was the proud winner of the Dementia Carer Award at the national finals of the Great British Home Care Awards.

Care Talk on the road

Coming upGovtoday

The Dementia Challenge

Mermaid Centre, London

8 April 2014

NICE Annual Conference 2014

ICC Birmingham

13-14 May 2014

Care Talk has a packed agenda of conferences and seminars ahead. We are proud to be media partners and supporters for some fantastic events, listed right.

National Learning Disabilities Conference and Awards 2014

Edgbaston, Birmingham

16 May 2014

The Great British Care Shows

See the back page of the magazine for full details of venues and dates

SHOWCASE

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Jane Ashcroft, chief executive, Anchor“Care Talk has rapidly become a key voice in the sector and an important champion of the great people who work in care homes across the country. I’m very proud to be a part of that and am sure it will go from strength to strength.”

Mary Bryce, director of strategy & development, Axiom Crossroads Care“Care Talk is the ‘must read’ magazine for everyone working in the social care sector. I certainly look forward to receiving my copy. I am proud to contribute to debates or share best practice and experiences with other Care Talk readers. The more we share the more we learn, the more we raise the profile. Happy Anniversary, Care Talk.”

Anna Gailsford, Fitzroy“Fitzroy are keen to contribute to Care Talk, a great magazine that highlights the range of work going on across the care sector, keeping us up to date with developments and initiatives that affect all those supporting people with a learning disability.”

Mark Greaves, managing director, Ideal Care Homes“Care Talk is a unique proposition in my experience of the care press, in that it appeals not only to home managers but also directly to frontline care workers. The magazine has boldly championed the celebration of the care sector, good practice and the workers whose efforts improve the quality of life of vulnerable people on a daily basis. It is a pleasure to work with the Care Talk team. “

Professor Martin Green, chief executive, Care England“Care Talk has established itself as one of the leading magazines within the care sector and is a must-read publication for anyone who has an interest in social care. The magazine is always topical, relevant and a thoroughly good read.”

Dr Rhidian Hughes, researcher, consultant and writer “Care Talk cuts through the noise and gets straight to the frontline.”

Dr Glen Mason, director for people, communities and local government, Department of Health “Care Talk is a great magazine in its focus of getting best practice, news and views directly to the frontline

of social care. It’s very accessible to all and its style makes it a must-read publication.”

Steve Palmer, press manager, Social Care Institute for Excellence “We know that Care Talk goes out to the people that really matter: frontline workers and managers. For instance, when we reported from National Care Home Open Day 2013, with a story about how our director was taught how to use an iPad by a 92-year-old resident, we could see that writing articles for Care Talk is a worthwhile activity.”

Paul Ridout, managing partner, Ridouts“Carers are people who care for people. Care Talk is the only publication that is exclusively dedicated to supporting those carers. That is exactly why Ridouts support and contribute to Care Talk.”

Karen Rogers, managing director, Herefordshire Care Homes“It’s a privilege to support Care Talk magazine, sharing good practice and innovation throughout the industry. This publication has without doubt improved the care delivered to many older people throughout the UK.”

Shelia Scott, chief executive, National Care Association“I am delighted to congratulate you on your three-year anniversary and look forward to participating in your next three years!”

Debbie Sorkin, chief executive, National Skills Academy for Social Care“The Skills Academy exists to strengthen leadership at every level of the workforce, and Care Talk is a wonderful way for us to connect with registered managers and other people working directly on the frontline of care. We regularly get great feedback from people who’ve read something about the academy in Care Talk, and so for us it’s one of the best ways to connect with people in social care.”

Andrea Sutcliffe, Care Quality Commission“Care Talk is a fantastic way for us communicate with frontline care workers about the issues that matter to them most. This is really important as we work towards improving the way CQC regulates services across the sector in genuine co-production with providers, people who use services and our other partners.”

Care Talk!


in association with

Categories include awards for:· Support workers· Employers· Registered managers· Trainers· Accessibility· Innovation· Arts, sports and theatres

For more information about the awards or to nominate call 0115 959 6133 or visitwww.nationalldawards.co.uk

Celebrating excellence in supporting people with learning disabilities and autism

Gala dinner on Friday 16th May 2014,

Edgbaston Stadium, Birmingham

The

National

Learning Disabilities

and Autism

Awards

& Pre-Awards

Exhibition

The National Learning Disabilities Awards

Supported by

Hosted by Jeff Brazier

The National Learning Disabilities Awards

Care Talk and the British Institute of Learning Disabilities (BILD) are delighted to announce details of the inaugural National Learning Disabilities Conference, Valuing People Today.

The conference is the forerunner to the National Learning Disabilities Awards event, which take place in the evening and aims to celebrate excellence in the sector and pay tribute to those who work in the learning disability workforce.

Conference delegates will be exposed to an innovative and exciting speaker programme with interactive workshops and the latest products on display throughout the day. The aim of the conference is to achieve positive solutions for achieving excellence in this specialist area of care provision.

This inaugural event will also serve as a platform to highlight examples of excellence from the awards, as well as showcasing the latest products, services and innovations for the learning disabilities and autism sector.

During a day there will also be a performance by a group of young actors (some of whom happen to have Down’s syndrome) from Kaleidoscope Theatre, a theatre company that has been performing worldwide since 1980.

Confirmed speakers Confirmed speakers for the conference include: • Bev Ashman, United Response • Jacqueline Bell, chief executive, The

Association for Real Change• Dr Sam Bennett, programme director,

Think Local, Act Personal• Viv Cooper, founder, Challenging

Behaviour Foundation• Phil Howells, intervention scheme

manager, British Institute of Learning Disabilities

• Jayne Leeson, chief executive, Changing Our Lives

• Andrea Pope-Smith, learning disabilities policy lead, Association of Directors of Adult Social Services

• Alan Rosenbach, special policy lead to the chief executive, Care Quality Commission

• Jan Seamer, Challenging Behaviour Foundation family carer

• Scott Watkin, eye care and vision development officer, Seeability

• Alastair Graham, director, Golden Lane Housing

ProgrammeThe programme will include:

• Morning keynote – A new era• Perspectives from people with a

learning disability• Beyond Winterbourne• Afternoon keynote – Changing lives• Community living and housing

solutions• Positive behaviour support• Performance from Kaleidoscope

Theatre

Sector supportThe National Learning Disabilities Awards have been well received by the sector and are already supported by the Department of Health, Mencap, the Care Quality Commission, the Association of Directors of Adult Social Services (ADASS), the Driving Up Quality Code, Skills for Care, National Care Association, National Skills Academy for Social Care, Social Care Institute for Excellence and Voluntary Organisations Disability Group (VODG).

Who will attendDelegates will represent all areas of the sector, private, statutory and voluntary, and include commissioners, directors of adult social services, care providers, owners, managers, care and support workers, unpaid carers and people with a learning disability.

Why attendYou may be an organisation providing services for people with a learning disability, an individual worker supporting a person with a learning disability, an informal carer or family member. You may work in the sector, be studying to join the sector or be a person with a learning disability – the National Learning Disabilities Conference will have something for everyone and provides a platform for networking, communicating, learning and sharing good practice. The event will also provide an opportunity to develop links with local commissioners, local care associations and people with a learning disability, and is set to be a significant date for the sector.

When and whereThe conference takes place on Friday 16 May at Edgbaston Stadium, Birmingham. Registration is from 8.30am.

www.nationalldawards.co.uk

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The skill and the will GBCA Judging Day 2014

Why are the Great British Care Awards like a game of football? Because when it comes to winning, you need the skill and the will.

And never were these two qualities more on show than at the recent Care Home National Judging Day at the Grosvenor House Hotel, Mayfair. As London woke to a blanket blue sky, care employers, registered managers, trainers, care workers, cooks, activity organisers, gardeners and many, many others made their way from across all corners of the country to await their time to shine in an impressive crystal-chandeliered room with views from every window across to Hyde Park with its drifts of dramatic daffodils.

Caffeine on tap, and with the seamless organisation of the GBCA team doing what they do best, the first arrivals sat quietly looking at notes, or scrolling their phones for the inevitable, ‘Go for it’ and ‘Good luck’ from family and friends.

First interview of the day was registered manager for The Fremantle Trust, Jan Lovett. “It means an awful lot to be here today in this stunning and beautiful environment,” she said just before being called to Judging Room 4. “It’s an accolade for the work the care staff do, and a representation for the residents who live in our home. Really, it’s a great recognition of all the hard work that’s done; without the team, the manager is lost.”

And, no surprise, this was a sentiment echoed throughout the day by almost everyone interviewed: ‘There’s no I in team.’ And it didn’t seem to matter where anyone came from.

Practice development leader for PJ Care, Anna Lesniak, up for the Frontline Leader

Award, made it very plain how much the judging day meant to her.

“I’m not British and am originally from Poland, so I’m extremely proud to reach this point in the competition. It means a lot because it’s an award for what I have done here in England for the last eight years. I came here in 2004 and have worked eight years for PJ Care, putting a lot of passion into leading the staff and teams, so I’m really happy for everyone that our work has been recognised.”

“It’s given me a great deal of confidence knowing I’ve been nominated by the people I work with and my manager.”

Sat nearby, activity organiser Janice Rice could barely hide her nerves. “The fact that I got through the regional means I’ve already won, really. So whatever happens is a bonus, but there’s a feel-good factor knowing that I’m doing a good job even to be nominated. I’m nervous, but it’s amazing to be here to see all these other winners in the same room. When you think of the UK as a whole, this is an amazing achievement for all of us.”

And for many of the candidates, the visit to the venue, and our capital city, was an important part of the occasion. “This is immense,” activity organiser Lesley Quigley, of Amore Care, said. “On a personal level it’s given me a great deal of confidence knowing that I’ve actually been nominated by the people I work with and my manager. It’s such a beautiful place to be for the day and even more so

because, although I was born in London, I’ve never been here!”

Candidates also recognised the value of the day and the awards for their organisations and employers. Nervously awaiting her call, registered manager Monica Prosser said: “It’s a real honour to have got this far. So many people do such good work, and talking with people, there are some fabulous stories here today. But like anything, you get this far because you have such a good team behind you and so for me, this is a team award. For Carebase, it works really well for them because they like being in this position, and have been so before, and we feel very supported by them.”

And it wasn’t only the candidates. Over in the judges’ waiting room Eileen Reid, business development manager for Specsavers Healthcall, put aside her judging guidelines folder to explain: “On a personal level it’s great to be here today because it’s something I feel passionate about. And with regard to Specsavers, they only entered the market in July 2013, providing services to people who are housebound or in care homes, so becoming sponsors of the Great British Care Awards is a great way for a profit-making company to give back to the care industry.” As Eileen made her way down a plush corridor to judge the Care Home Manager category, Nutrition category judge, PJ Care’s Jan Flawn,


CELEBRATE

broke away from her fellow judges to heap praise on the work of these national awards and their importance across the breadth of the

social care landscape.

“The Great British Care Awards are brilliant for recognising the people on the ground who work long hours for little money. They value these people and give them a special evening where they can come and celebrate being finalists and winners and it’s great. Without

these people, I wouldn’t have a business.”

Reassuringly for the future of the sector, the Department of Health feels the same way. Doyen of these judging days Glen Mason was again bowled over by the excellent standard in the Care Employer category. Ever keen to take the day’s learning and inspiration back to the Department of Health, he reiterated the importance of the department’s decision to be in strategic partnership with the GBCA.

“Today has been a fantastic opportunity to be judging the Great British Care Awards. We’ve just seen nine absolutely stunning employers. What the awards do is recognise the excellence in social care that is not done in any other way.”

But despite their committed involvement and obvious passion, the day belonged not to the judges but the scores of regional winners

hoping to prove themselves national winners.

Ancillary worker John Rose, whose job involves everything from helping on garden projects to driving buses and taking people with learning disabilities out clubbing, sensed an air of competitiveness. “The atmosphere seems quite fierce! Fierce in a competitive way,” John laughed. “It’s good because it keeps people hungry for doing their job properly at the end of the day.”And this is important?

“The awards are brilliant for recognising people on the ground who work long hours for little money. Without these people, I wouldn’t have a business.”

“Yes,” he replied, with no hesitation. “The bigger picture is that you’re providing a better service to the people who matter: the client you’re supporting. That’s how I look at it. I know it’s nice to be celebrated and to be here, but in the long run it’s our guys who will

benefit.”

So, there’s the will.And the skill?

Well, from the moment the Grosvenor opened its doors on National Judging Day, skill defined the day – superlative social care skill that will one day be the absolute norm across the sector with the help of the Great British Care Awards.

The football analogy fits and is fine, but having interviewed very many people throughout the day, a better line comes to mind: Real winners are the people who look at every situation with an expectation that they can make it work, or make it better.

It’s a cliché, but in this case it’s true; every candidate through those doors is a winner every day of the working week.

Good luck to all from GBCA!

The issue of the lack of diversity of social care leaders is not new, with still only four directors of adult social services in England coming from a diverse ethnic background.

“The programme is underpinned by an innovative blend of solutions such as action learning, one-to-one coaching and mentoring.”

Much has been written and discussed as to the reasons for this, and a conference organised by a partnership including the National Skills Academy for Social Care in 2011 revealed a number of barriers together with some solutions towards improving this statistic, which in 2014 has not yet changed.

The 2011 conference took place at the outset of our leadership programme for Black, Asian and Minority Ethnic

(BAME) social care leaders, and since then the programme, which is now entitled Moving Up, has become a well-established part of the suite of programmes delivered by the Skills Academy.

In Moving Up, we work with leaders from a wide variety of care backgrounds in order to harness the full talents that they bring to the workplace. The programme is underpinned by an innovative blend of solutions such as action learning, one-to-one coaching and mentoring throughout.

The leaders who participate in the programme already have experience managing services, and they have the ambition and potential to move to more senior positions. We ask learners to nominate a senior manager from their own organisation to act as their sponsor.

We aim to develop the leadership potential of learners, and extend their ability to lead in increasingly complex and changing care environments. And we help them to understand and adopt the softer skills, such as networking, that are essential to functioning in a competitive working environment. And it works – it impacts positively on aspirations, skills and approaches.

The last word should go to one of our 2013 learners, Sydney Coy. His testimony, the fuller version of which can be found on our website, illustrates the impact that the programme has on careers of learners, and their organisations.

“I have benefited from the course so much – it has strengthened my confidence. The organisation that I work for has also directly benefited from the skills and behaviours I have advanced in, in turn raising the level and quality of our service. We are planning on sending a further candidate to the next cycle of the BAME Moving Up programme.”

Debbie SorkinChief executiveNational Skills Academy for Social Care

To learn more about Moving Up – BAME, please contact us at [email protected], call us on 0203 011 5270 or visit our website. Special rates are available to Skills Academy members.

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Moving Up - the programme that aims to use the talents of the whole social care workforce


For Stephen Penketh, one of the most important principles of being a good registered manager is to accommodate clients’ aspirations, regardless of what they are. As a result, the staff team at AffinitySupportingPeopleinAccringtonare supporting one man with a learning disability to achieve his dreams of becoming a stuntman.

“While he understands why there is an aversion to risk in the care sector, Stephen feels positive risk taking is important.”“We never say no. We work out how we can help that person take small steps towards their goal. It is all about positive risk taking,” says Stephen.

In the case of the client who hopes to be a stuntman, the team have supported him to take up interests that bring him closer to the dream. This has included weekly gymnastics and horse riding as well as a performing arts course at a local college.

“It means that he has little hurdles to achieve in a six-week period. It works as an incentive for him so if he’s not well and he’s going through a challenging time then we can remind him of his goals,” explains Stephen.

“Becoming a stuntman is something for him to work on. He may choose to change his goals as he goes and we will adapt our support to suit him.”

AffinitySupportingPeopleisanorganisationfor people with learning disabilities, acquired brain injury and mental health problems in Lancashire.The30staff,includingfivebankworkers, support 15 people across three houses in East Lancashire. Stephen became abankworkertherein2002,workingfivehours a week. Soon after, he became a permanent member of the team and three years ago he was promoted to registered manager.

While he understands why there is an aversion to risk in the care sector, Stephen feels that positive risk taking is important.

He says that it is not their job to say no to someone’s aspirations. Instead, they point out the positives of the goal and then the possible challenges on the journey to achieving it, and design support to help the person overcome or minimise those obstacles.

The most common goal among service users is to have a closer relationship with their families. Years of being in supported living means that a disconnection can happen with their loved ones and a great many of the people they support are eager to remedy this.

But some goals are riskier. The protocol for accommodating high-risk wishes is for a staff member to talk to the person they support to ascertain if they are aware of the risks involved.

“If they do understand the risks then it’s a caseoffindingthesafestwaytodoit,”saysStephen

Yet overprotective tendencies can spring up on a frequent basis. An example is the desire expressed by a group of four men, aged between 20 and 35, at Cannon Street, who wanted to have a night out, like many others their age. They were keen to go to a night club, but staff felt it was a bad idea.

“We had to let them do it. The only way they learn is by making mistakes, and they camebackandwereflectedon it.”“Handlingthatonewasthemostdifficultthing I’ve had to do in my whole career. On the one hand, I knew it would be a good social experience for them but, on the other, it is risky because they are vulnerable and open to abuse,” says Stephen.

The solution was to keep in contact by text and phone calls with the group throughout the night. Stephen says that disallowing the outing would have been the wrong decision.

“We had to let them do it. The only way they learn is by making mistakes and they came

backandwereflectedonit–whatworked,what didn’t and what would we do differently next time,” he says.

Stephen and his team have become adept at working out how to make a goal happen in the safest way possible.

So, when one man recently said that he wanted to go to Cardiff for the weekend, they began thinking of ways to make it a reality. The solution that they have come up with is to arrange all his accommodation and transport and send a staff member to stay withinfivemilesofhim.

“It means that if help is needed then we are there but we’re not intruding on the weekend away,” says Stephen.

And it means that another ‘no’ has been avoided.

Julie Griffiths

Key points• Accommodate clients’ aspirations,

regardless of what they are • Positive risk taking is important• Ensure service users understand risks

and challenges• Ensure the service user understands the

safest way to undertake a risk• Become adept at working out how to

make a goal happen in the safest way possible

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How to be a goo d... registered manager


Working as a registered manager can be challenging and rewarding but can leave us feeling isolated and unsupported at times. Mentoring can make all the difference.The White Paper Caring for our future has highlighted how registered managers, as the lead professionals in homecare and residential settings, have a crucial role to play in the individual’s experience of care and support, yet can be isolated, unrecognised and unsupported.

We know that coaching and mentoring are now widely accepted as a valuable way to support and enhance personal and professional development in all sectors and areas of work. The National Skills Academy for Social Care is establishing a mentoring offer for registered managers working in both residential and domiciliary care that will be delivered by, and for, our members, who all have substantial experience in social care. It follows current best practice and provides ahigh-quality,confidentiallearninganddevelopment opportunity for both mentors and mentees.

What is mentoring and how does it help? Mentoring is a one-to-one, non-judgemental relationship in which one individual gives time to support and encourage another. It is a way of sharing knowledge and experience, supporting an individual’s personal and career development and providing a safe, supportive and neutral space for an individualtotakestockandreflectupontheirwork. Very rarely, given our busy roles, do we take time out to ‘stop and think’.

Perhaps you have a new role, with more responsibility, or are moving organisations or sectors? Have you been thinking about how your career can develop and progress but are not sure how to go about it? Are you feeling the pressure and could do with some spaceandtimetoreflectandthinkabouthow to best solve a particular challenge or problem?

People who have received mentoring talk about a boost to their morale, motivation and productivity as well as an increase in their resilience and ability to cope with what the job brings.

“‘Having access to someone outside my formal employment and learning environment, who had walked my path and with whom I didn’t have to be wary of being seen as underachieving, was valuable. Looking back now, I don’t feel that my mentortaughtmeanythingspecific.Shesimply lent support and guidance in my journey, and helped me to unlock, from within me, latent abilities she recognised I already had, but which for whatever reason I had not fully utilised. I feel mentoring is a vital ingredient to helping people realise their potential.”Joe Wey, Country Court Care

Their mentors describe increased motivation and job satisfaction as well as the opportunity to develop their own skills around giving feedback, listening and gaining exposure to a different perspective and work experience.

How does it work in practice?

At the Skills Academy, mentoring relationships typically last for 9-12 months. We expect that at least four meetings would be held, and at a location that suits both parties and is away from the work setting to allow time out and limit distractions. All mentors go through a structured application and training process, and mentors are carefully ‘matched’ to their mentees.

How can I get involved?If you are a registered manager and would like to request a

mentororfindoutmore,dogetintouch.InJanuary we began recruiting volunteers to be mentors, with the Skills Academy’s own chief executive, Debbie Sorkin, signing up. If you would be interested in becoming a mentor too we would be delighted to hear from you.

Rebecca Bayliss, programme manager, and Christine Fogg, senior programme manager National Skills Academy for Social Care

To find out more, visit the NSA website www.nsasocialcare.co.uk/registered-managers-mentoring-service or get in touch by emailing [email protected]

The benefits of mentoring for registered managers

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ADVERTORIAL

apetito understands that every care home is unique. It is important to have a catering provider that recognises each home’s specific needs in order to help create a bespoke approach. apetito can fully appreciate these challenges and concentrates on providing great tasting food in a cost-effective and efficient way.

For many care home residents mealtimes are a highlight of the day, and they want to eat attractive and enjoyable food. apetito has more than 200 dishes in its range, allowing a menu to be planned that accommodates all tastes, appetites and dietary requirements. Dishes are quick and simple to prepare and portions are easy to control, meaning that less staff time is needed and wastage is significantly reduced. It is the easy way for care homes to provide an interesting and varied menu, ensuring that food remains one of life’s simple pleasures for residents.

Lee Sheppard, divisional manager care homes at apetito, explains: “Our dishes are cooked just like you would prepare a meal at home, but on a larger scale. For instance, the casseroles are started by sweating off

onions before adding the meat to brown.

“When a care home cooks on site for residents, providing consistent quality meals can sometimes be difficult; for example, the chef might only work from Monday to Friday, meaning that the weekend meal consistency can vary. With a complete meal solution provider like apetito, residents can enjoy the same high standards and quality at every mealtime. In addition, care homes can choose from a range of pack sizes, allowing them to serve the number of portions they need and therefore reduce waste and lower costs.”

The increasing incidence of dysphagia (swallowing difficulties) among care home residents means that homes are under more pressure than ever to provide safe and nutritious meals of the right consistency, which are both visually appealing and taste delicious. This in itself can be extremely difficult for care home chefs, which is why apetito has developed an award-winning range of texture-modified meals to ensure residents with swallowing difficulties dine with dignity. .

The range offers a wide choice of Category C thick puréed meals that look appetising, taste delicious and, most importantly, deliver the nutritional content needed to help keep residents healthy and happy. These meals retain their shape after heating, so residents can enjoy meals as much with their eyes as with their tastebuds.

Lee adds: “At apetito, we understand how difficult it is for many residents to adapt to a texture-modified diet – it can be emotionally challenging. To ease this transition, our texture-modified range also includes Category E fork-mashable meals that closely resemble normal food. As residents’ needs increase, our flexible range can continue to support them with pre-mashed, thick and thin purée meal options.

“We’re extremely proud that our world-leading range provides tasty and nutritious meals, so no matter where residents are on their dysphagia journey, they can be sure of safer swallowing.”

To find out more about how apetito can improve your catering, visit challengeapetito.co.uk or call 01225 756064.

Complete Meal Solutions: the efficient and cost-effective way to provide nutritious and great tasting food

NUTRITION

My challenge was nutrition

If the CQC inspected us today, I could tell them the exact nutritional content of every single meal we serve

Passionate about care home food

challenge usHave you got a nutrition, cost, service or quality challenge? Get in touch and we’ll help you solve it – GUARANTEED.

www.challengeapetito.co.uk/paul or call the team on 0800 542 2631

Paul Swithenbank Founder Chairman and Chief Executive,The Willows, Blackpool

13457 Adverts 215mmx134(h) aw2.indd 1 30/04/2013 12:48

Responding to the recent Age UK report that highlighted a massive £3.4bn shortfall in planned expenditure on social care for 2015-16, the Registered Nursing Home Association (RNHA) says nursing homes in many parts of the country have experienced significant ‘real terms’ cuts in the fees paid by local authorities towards the care costs of vulnerable older people who qualify for public funding.

RNHA chief executive Frank Ursell says: “Those of us who provide 24-hour care to some of Britain’s frailest older citizens have witnessed at first hand how, despite the Government’s hype to the contrary, frontline services have seen budgets cut.

“The reality, as Age UK has yet again confirmed, is that public expenditure on care for the elderly has been dropping quite markedly while the number of individuals in need of care has been growing. In that respect, it’s what you might call a ‘perfect storm’ in which the biggest losers are those least able to stand up to the Government.”

Figures from the RNHA suggest that for the 12 months ahead the vast majority of local authorities have offered either no increase at all in fee levels for publicly funded nursing home places or a below-inflation figure. In practical terms, the RNHA points out, this amounts to a cut in funding at a time when the Care Quality Commission is putting even more pressure on nursing homes to raise standards.

“In the four years of this coalition government nursing homes will have been lucky to see the fees they receive

from local authorities go up by between 1% and 2%,” says Frank, “and even this minuscule increase has been more than wiped out by inflation, including higher fuel and food costs.”

He adds: “There’s a lot of smoke and mirrors surrounding the Government’s claims about local authority spending on social care. As the Age UK report shows, between 2010-11 and 2013-14 the total amount of public funding spent on older people’s social care – even when taking into account money transferred to local authorities from the NHS – has fallen by as much as 10%.

“Central funding support to local government has been slashed to such an extent that local authorities are unable, or unwilling, to protect services for older people who are, it seems, at the bottom of the pecking order even though, by virtue of their age, frailty, multiple health problems and social needs, they should be at the top.

“Successive governments have paid lip service to the needs of older people, with occasional cosmetic initiatives such as the Better Care Fund scheduled to come into effect in 2015 but relying entirely on existing NHS money. There is no new money being put on the table, so the Government is simply robbing Peter to pay Paul.

“There is also the rather unsavoury post-Dilnot saga in which the Government claims to be putting a cap on the amount of money individuals will have to find from their own pockets for care. It sounds good but, as ever, you have to look at the small print of the deal. Sadly, individuals in care homes who are not eligible for public funding will have in perpetuity to carry on paying around £12,000 a year or more for so-called ‘hotel costs’ – the cap is not really a cap at all.”

Frank concludes: “We in the RNHA have a simple message for the Government. Please put your money where your mouth is because, so far, the money isn’t flowing where you said it would. Age UK was right to call its report Crisis in Care 2014 – there certainly is a crisis and it’s mainly of the Government’s making.”

q Frank Ursell, chief executive,

Funding gap shows ‘perfect storm’ being inflicted on the elderly

NURSING Advertorial


Advertorial NURSING

Lighthouse Healthcare provides specialised services to individuals with an autistic spectrum condition (ASC), including Asperger’s syndrome, at The Woodhouse hospital in Cheadle, Staffordshire. There are three specialist units based within the hospital that offer a bespoke internal pathway for adult men with an ASC.

Lighthouse’s unique three-stage autism specific pathway offers a consistent and predictable environment, providing a person-centred model of care that aims to increase the individual’s independence and skills in communication, daily living and self-regulation.

The three-stage autism specific pathway involves an initial assessment

that measures, among other things, sensory integration, communication capabilities and difficulties, and a detailed needs analysis. The second phase is the treatment stage, which after an initial period of treatment focuses on behavioural analysis and communication; existing therapeutic intervention is continued or intensified with psychology, occupational therapy and speech and language therapy.

The final stage of the pathway is the pre-transfer, where the team focus on daily living activities in order to prepare the individual for life outside the service. Individuals are offered a greater degree of choice and subtle changes are introduced to their normal routine. The Woodhouse Hospital benefits from an on-site National Open College Network

education department, which offers a range of educational, therapeutic and recreational activities, and individuals are encouraged to participate more in the programme on offer here.

The team at The Woodhouse have made huge progress in the lives of many service users who when admitted have been unable to be managed previously, but following the unique three-stage autism pathway have successfully reduced the intensity, frequency and duration of their severely challenging behaviour.

To find out more about the specialist autism services at The Woodhouse contact Lighthouse Healthcare on 0844 4172983 or visit our website www.lighthouse-healthcare.co.uk.

ADVERTORIAL

Autism pathway leads to independence

MEDICAL & CLINICAL

The Government has recently announced significant reforms to its Apprenticeship programme. ‘Trailblazers’ have been established to support these changes, bringing together groups of employers working in partnership to design new Apprenticeship standards for their sector.

Eight initial ‘trailblazers’ from a broad spectrum of industries, including aerospace, automotive, digital, electro-technical, energy, financial services, food and drink and life and industrial sciences, have already become involved in the project to develop new Apprenticeship standards for occupations in their own sectors.

“Healthcare assistants already working in a care environment will be able to train on the job to become a nurse under the new initiative.”

Phase 2 of the reforms focuses on the healthcare sector, which will put employers in the driving seat to create new standards that will deliver the skills care providers and learners need.

Healthcare assistants already working in a care environment will be able to train on the job to become a nurse under the new initiative. The new degree-level Apprenticeships being set up will allow more people to become nurses.

The programme is targeted at top healthcare assistants who may not have the qualifications they need to do a nursing degree at university.

As one of the Phase 2 ‘trailblazers’, the Priory Group will have the chance to lead the development of new standards

for nursing training and the high-level assessments that will sit alongside the learning.

The reformed Apprenticeships will be employer-led and designed so they respond to the needs of industry, meaning each apprentice has the skills required by the sector.

They will be focused on quality and will ensure that the apprentice can demonstrate their ability through rigorous assessment at the end of their Apprenticeship. On completion all apprentices will be graded – pass, merit or distinction – to mark the level of skills and competence achieved.

Latest data from the seminal Registered Nurse Forecasting (RN4CAST) study showed having a better educated nursing workforce reduced unnecessary deaths. The study, published in The Lancet, found every 10% increase in the number of bachelor’s degree-educated nurses within a hospital was associated with a 7% decline in patient mortality.

It is vitally important that the Apprenticeships reflect the diverse and ever-changing needs of healthcare and ensure that the sector has properly trained professional staff to provide quality care and positive outcomes for patients and service users.

In line with our own nursing strategy, the philosophy of compassionate care and high standards must drive the sector as a whole.

Professional standards ensure that the highest level of quality nursing care is promoted. Excellent nursing practice is a reflection of sound ethical standards.

Patient care requires more than just the application of scientific knowledge. A nurse must be able to think critically, solve problems, and find the best solution for the service user’s needs to assist them in maintaining, regaining, or improving their health and quality of life.

“It is vitally important that the Apprenticeships reflect the diverse and ever-changing needs of healthcare.”

Nursing is not simply a collection of specific skills, and the nurse is not simply a person trained to perform specific tasks.

Being involved in the conception of the new Apprenticeships will give us the opportunity to influence the way standards are set and to tackle head on the recruitment issues there are today in nursing by setting high standards of nursing care that is safe, effective and delivered with compassion.

At Priory Group, we are committed to providing our colleagues with challenging, fulfilling working environments and investing in their personal and professional development. As a learning organisation, we place great emphasis on the importance of developing people to enable them to meet current and anticipated service user requirements.

Janet CowieHead of people developmentPriory Group

Priory Group ‘trailblazer’ for new apprenticeship standards

Advertorial


Advertorial TECHNOLOGY

According to the Care Homes Use of Medicines (CHUM) study, errors occur in 8.4% of medication administration events. That would mean that a care home resident being administered medication three times a day would have an 84% chance of receiving a medication administration error every week and a 99.9% chance every month.

The primary tools being used by the majority of care providers to manage their residents’ medications still revolve around paper-based systems with significant limitations. Not surprisingly, this can lead to serious compliance risks.

“By investing in electronic medication management (EMM) systems, many providers are achieving an immediate and substantial reduction in preventable medication errors.”

An upward trend has occurred over the past few years, where we are witnessing a greater number of care home providers taking the necessary steps to improve medication management processes. By restructuring and investing in electronic medication management (EMM) systems, many providers are achieving an immediate and substantial reduction in preventable medication errors.

EMM systems create comprehensive medication administration that records the time a medication is administered, who administered the medication and the resident outcome. This creates a clear and auditable trail, crucial to demonstrate compliance.

Logging this information electronically is particularly important for time-sensitive medication that requires a minimum time to be left between medication doses. EMM

systems outperform paper-based systems in this regard with intuitive alerts and warnings if medication is trying to be administered inside the restricted time window, ensuring organisations comply with the highest standard of medication administration procedures.

These embedded safety alerts and warnings further support compliance requirements by enforcing the six Rs of correct medication administration – right resident, right medication, right route, right dose, right documentation and right time – and confirming that the welfare and rights of the resident receiving the medications remain the priority throughout.

EMM also enables care home providers to safeguard against the compliance risks associated with the administration of ‘PRN’ medication that is taken as required. EMM systems ensure staff coordinate, administer and track PRNs with greater efficiency, by capturing a detailed history for each resident, as well as documenting the reason why the PRN was administered. The outcome is then recorded and monitored to check if the medication has been effective, or highlight the need for additional medication. Scheduled tasks or reminders can be set within the software to aid this approach.

“Embedded safety alerts and warnings further support compliance requirements by enforcing the six Rs of correct medication administration.”

EMM systems that integrate with electronic clinical systems also allow this information to be automatically updated and recorded within daily notes, eliminating the need to rely on human memory. This ensures overall greater accuracy and more effective evaluation of PRN medications.

Another common compliance issue and a regulatory focus is the stock audit, as

it is viewed as a good measure of how robust a care home’s procedures are. A typical inspection will look at a sample of residents and perform a physical stock count, comparing this figure to the theoretical count. It is vital that these counts correspond as any discrepancies can result in at least a minor compliance warning being issued and, more likely, an enforcement order being placed on the home.

EMM systems aid the efficient management of stock audits, drug disposal and medication recording by streamlining inventory management processes. With access to an electronic stock file that is updated in real time, staff can more effectively manage medication stock levels, ensure required medications are always in stock, and reduce drug wastage.

In a revenue-constrained environment, care home operators must ensure compliance. Due to the funding framework in the UK, non-compliance negatively impacts directly on funding and hence the organisation’s bottom line. By safeguarding your organisation’s medication management processes with a robust electronic system, you’ll achieve a greater compliance rating and more funding as a result.

Karis BrummittMarketing executiveiCareHealth

Safeguarding your medication management practices


RECRUITMENT

10 top tips for zero-hours contracts Zero-hours contracts have been in the news, stirring up controversy in recent months due to misuse by some rogue employers – so much so that Secretary of State for Business, Innovation and Skills Vince Cable will be looking at them very closely and a consultation process has been launched at https://www.gov.uk/government/consultations/zero-hours-employment-contracts.

Zero-hours contracts have been in place for many years without much trouble, but since the recession they have been used increasingly, creating job uncertainty for many and low pay conditions. They are ideal for students and individuals who are only seeking occasional work, but not for individuals with heavy financial responsibilities such as a mortgage.

Zero-hours contracts do have many benefits for employers, allowing a flexible workforce that can grow or diminish according to workload demands. Here are 10 top tips for zero-hours contracts.

1. Use zero-hours contracts reasonably. They are ideal to flex your workforce when workloads have peaks and troughs and there is not a constant need for certain members of staff. Having a pool of workers to call upon is ideal. Any workers who regularly refuse work should be removed from the company’s books.

2. Zero-hours contracts should not be given to staff who you use on a very regular basis, otherwise they could claim enhanced employment rights. Pulling different employees from the pool is best so that the working arrangement is very ad hoc. Employees who are used regularly might be best suited to a fixed-term, annualised hours or part-time contract.

3. If you decide at the last minute you don’t need to call an employee on a zero-hours contract into work, if you have already pre-arranged that they

will work, you should pay them. The Chartered Institute of Personnel and Development (CIPD) recommends as a minimum paying their travel expenses and one hour’s pay as compensation.

4. Ensure you provide staff on zero-hours contracts with written employment terms and conditions; this is required by the Employment Rights Act 1996. Terms and conditions should be reviewed on an annual basis to ensure that the zero-hours contract still reflects the actual working relationship.

5. Do not impose any restriction on staff with zero-hours contracts so that they are free to work for other employers. Therefore, remove any exclusivity clauses in employment terms and conditions. Zero-hours staff should also not be on call without pay or the offer of work.

6. Consider providing comparable rates of pay to staff on zero-hours contracts with those on other types of contract. While this is not essential, there is an outside chance you might have to justify any wage disparity should this be challenged in an employment tribunal.

7. Ensure staff on zero-hours contracts are aware of your company’s employee handbook and HR policies and that they know they should comply with them.

8. Train your line managers in the operation of zero-hours contracts to ensure they are managing zero-hours staff in accordance

with employment law and shifts are issued appropriately.

9. Keep careful records of zero-hours staff working hours to ensure they receive the correct amount of accrued holiday pay. Holiday pay can be paid on a quarterly basis. If rolled-up holiday pay is used instead, it must be clearly shown in the employment terms and conditions (how it is calculated) and in wage slips.

10. Manage the working hours of zero-hours staff well by distributing work. Zero-hours staff are not entitled to statutory sick pay or maternity pay if they are only allowed to work on an ad hoc basis. It is therefore lawful that they do not accrue these employment rights on a correctly used zero-hours contract.

Sandra Beale SJ Beale HR Consult Ltdwww.sjbealehrconsult.co.uk


RECRUITMENT

Touch – embedding values through learning

Engaging a previously demoralised workforce in learning new skills through technology was a tall order for the HC-One’s development team. We completed a thorough review of learning and development, its content, compliance requirements and operational challenges.

In our vision to provide the ‘kindest care’ to residents we had to focus on the how and why of delivery. We built on the outcomes of focus groups, surveys and data analysis to scope a dynamic learning environment that would empower colleagues in their own personal development.

“We have created a ‘pull’ for learning – a curiosity, instead of ‘pushing’ programmes at our colleagues.”“We will move ‘beyond the module’, using the most appropriate channel for the business need” was one of three guiding principles that led us throughout the programme’s development. This meant using a blended approach for specific learning objectives, embedding peer-contributed content and using technology, tablets, mobiles, video and podcasts to allow staff to access content when and wherever they wished.

In one of the early stakeholder workshops I remember a carer telling me that they

would go to ‘training’ then go back to work and carry on in much the same way they had before the training. Training had lost its purpose. This really made us stop and think about how to we should develop our new learning and development platform at HC-One.

In September 2012, with the help of learning partner Acteon, we placed personal development at the heart of our services and launched Touch.

Touch is a corporate learning solution that delivers a wide range of courses through e-learning, video, podcasts and other online and offline formats, including groundbreaking courses in dementia, medication, dignity and care, many of which are endorsed or accredited by professional organisations. Touch has transformed our business, our people and the way they think about their professional development.

I don’t believe you can teach ‘kindness’. But you can find it in people and help them use it and express it while they work, which is why, for many people, learning by doing and observing is the best practical and effective way to change the way that they deliver care. If we are serious about transforming the way care is delivered in the UK, then we have to transform the way that we develop the skills of the people who work in the sector.

We know of nurse colleagues, for example,

who completed their medication training on their mobile phones while travelling to work on the bus, of managers who dip into a little piece of learning before carrying out a performance review to give them the confidence to do it well, and we have people discussing case studies or scenarios while waiting for the lunch trolley.

We have created a ‘pull’ for learning – a curiosity, instead of ‘pushing’ programmes at our colleagues.

It is now more important than ever to link up learning and development programmes with the continuing professional development schemes driven by professional associations. At HC-One we are really pleased to be one of the first private care providers to run a preceptorship programme for new nursing graduates that has been accredited by the Royal College of Nursing. With the pressure to move towards greater integration of social care and health provision, these sorts of arrangements are going to become crucial.

Perhaps the most powerful and objective endorsement of what we have achieved comes from outside HC-One. Touch has been recognised as being innovative and ‘best practice’ in the Cavendish Review, and has also won no less than six national and international awards across all sectors.

Our chairman, Dr Chai Patel, says: “The great achievement of HC-One’s Touch training has been to take the vision we have for HC-One and use learning and development to link that with the aspirations of colleagues. That’s why we’re seeing the improvements in quality, safety and engagement that are transforming the business.”

Alison Innes-FarquharHead of people HC-One


BUSINESS AND FINANCE

p Daniel Smith, partner and head of private healthcare, Grant Thornton UK LLP

Following a prolonged period of financial instability in the private residential elderly care sector, signs of renewed health are emerging and care home operators are now cautiously optimistic over what the medium-term future has in store. Although there is a huge diversity of views in the market, depending on geographical locality and the quality of physical assets, some noticeable trends are emerging.

Our latest report on the sector identifies a number of factors underpinning this brighter outlook in the longer term, particularly linked to broader economic and demographic changes taking place across the UK. However, as the sector recovers from one of the worst economic downturns in recent memory, future prospects are being

assessed through a cautious lens.

“Innovative and more efficient operating models adopted for survival are now offering a competitive advantage.”

Within the past three years, high-profile collapses, government austerity measures and increased regulatory pressures have forced operators to think differently about their business models. In many ways, the innovative and more efficient operating models they had adopted for survival are now offering a competitive advantage which positions them to capitalise on the current growth opportunities. This,

along with a positive demographic outlook, should see recovery in the sector continue at pace, across all parts of the UK. That said, the nature of competition means not all operators will see as rosy a picture as that presented to the overall private residential elderly care sector. Challenges still remain, and though some operators managed to make it through the worst of the past few years unscathed, there’s no guarantee that all will now benefit.

The sector currently faces a unique and dynamic challenge. At one end, the majority of operators have become leaner and more fiscally responsible, while ensuring resident care is not jeopardised; at the other end, there still exists a low number of high-specification facilities and a proliferation of operationally or financially ‘no longer fit for purpose’ care homes. This highlights a growing polarity in the sector.

Moreover, a geographic disparity in business opportunities could further compound some operators’ growth prospects. Our report notes that London and the south east remain the most buoyant markets, namely on account of localised affluence and residents’ ability to self-pay.

The north east, Yorkshire and Humberside are noted as some of the most challenging regions, on account of local economic factors, overcapacity and lower fees, coupled with lower occupancy rates and a higher proportion of ageing properties in these regions.

In the short to medium term, highly leveraged operators, and particularly those with compliance issues and operating from older properties and outside of London and the south east, are most likely to be challenged, potentially leading to further business failures. Although we’re now seeing debt/EBITDA parameters across the sector return to more normalised levels of x4-6 (versus the ‘pre-credit crunch’ leverage extremes of up to x14), some businesses haven’t fully become ‘financially fit for purpose’ and are struggling to secure the lending they need to survive, let alone capitalise on growth.

“A geographic disparity in business opportunities could further compound some operators’ growth prospects.”

Critically, in the longer term, an increasingly elderly demographic, the long-term transfer of residents from local authority homes to independent care homes, and earlier credit pressures that restricted new builds (and thereby assisted current occupancy levels), all point toward favourable conditions for the sector overall. This, along with the broader economic revival we’re seeing across the UK economy, bodes well for prospects in the sector. However, for those few operators who are unable to adapt their businesses to the ‘new world order’, the worst could be yet to come.

Daniel SmithHead of private healthcare Grant Thornton UK LLP

Signs of recovery for UK private care home sector


p Ian Smith, chairman and interim chief executive, Four Seasons Health Care

Ian Smith is currently chairman and chief executive of Four Seasons Health Care, which owns and operates over 500 care centres and hospitals in the UK, employing 30,000 people. Ian is also an adjunct professor at the Imperial College Business School, an honorary professor at Salford University and on the board of the Institute for Dementia.

Public sector funding constraints have led to difficult choices having to be made. Payments by local authorities for care home places for older people have reduced in real terms versus inflation in care providers’ non-discretionary costs.

Fees have slipped to well below the levels recommended by the ‘fair price toolkit’ devised by authoritative market intelligence source Laing & Buisson in conjunction with the Joseph Rowntree Foundation. Additionally, local authorities are using more rigorous criteria for people to qualify for funding to go into care homes.

This means that operators are increasingly required to focus on higher dependency care that cannot be easily provided by domiciliary services, and to achieve year-on-year operating efficiencies. This is a challenging environment for all operators, but potentially more so for family businesses and smaller firms. The larger independent providers have invested in developing capabilities in more specialised higher dependency care services and they have been able to achieve efficiencies of scale and to support investment in technology to optimise back office functions.

Staff wages are the biggest cost item for independent operators, accounting for about 60% of their overheads. The recommendation by the Low Pay Commission to raise the adult minimum wage to £6.50 per hour from October would represent a 3% rise.

I want to see better pay rates for the care staff who work for Four Seasons and the estimated half a million people employed in the wider independent care sector, the overwhelming majority of whom do a challenging job extremely well day after day, and I know my contemporaries in the other leading operators feel the same way, but it is not sustainable in the long term to continue to impose rising costs on operators at the same time as reducing payments for the care services they provide. There needs to

be a funding system that ensures adequate provision for elderly care and this may mean ring-fencing care budgets.

There is widespread recognition of the disconnect between health and social care funding and we have been advocating a more joined-up approach over recent years. One example is in the commissioning of domiciliary care versus care in a residential setting. We should not approach the debate from ideology but from the perspective of the person’s wishes and what is in their best interests.

Domiciliary care is widely perceived to be the more economic option, and it may be for local authorities but is not necessarily so for the public purse overall. People being supported to live at home may receive four or five visits a day by carers. When the cost of care and all other costs are taken into account, such as housing benefit, local tax credits, fuel allowance etc, the total cost to the public purse of home care versus care home may be comparable. When a higher level of care is required, the care home may well be a more cost-efficient option. However, under the current funding structure the person is passed between budgets, which masks the cost.

There is an opportunity for independent care providers to play a more beneficial part in the health and social care mix alongside the public sector. The larger independent operators have qualified nursing staff, medications capability etc. They are already providing specialist dementia, nursing, respite and end of life care. They could gear up to take some of the strain from the NHS to ease bed blocking by the estimated one third of patients, mostly elderly, who have no clinical need to be in a hospital ward. By caring for them in residential settings in the community the independents could potentially save the NHS budgets billions of pounds. It would not be privatisation of the NHS because the services would be commissioned by the NHS.

For this to happen requires political will to reform and, once again, an integrated approach to health and social care, with the main political parties reaching consensus on a strategy that goes beyond a five-year elected term in office.

BUSINESS - COMPANY PROFILE

Four Seasons Health Care


Business round-upCare providersAccord Group to recruit 150 residents as apprentices

The Accord Group will recruit 150 of its own residents as apprentices as part of its wider plans to help them into work and expand its range of care services. It is hoped the apprenticeships will help residents affected by changes to benefits and those struggling to find work in the West Midlands region, where unemployment remains above the national average.

The West Bromwich-based housing and social care organisation will create the positions, which will lead to ongoing paid care work, over the next three years. The plans were announced during National Apprenticeship Week in March and are part of Accord’s innovative ROLE (recruitment, opportunities, learning and employment) programme.

Open to all Accord Group residents and their family members, the programme consists of a six-week pre-apprenticeship course and a 12-month paid apprenticeship. Everyone who completes an apprenticeship will be offered paid work in services ranging from caring for older people and those with learning disabilities to working with young people.

Sara Naylor-Wild, Accord Group assistant director of care and support, says: “Care is changing and over the next three years we want to increase the range of services that we offer to allow people to reach their full potential, which means that we will need more people to deliver them.

“We want residents to be at the forefront of this, which is why we have created a programme that trains people who may not have the experience of working in care but have the right attitude and a real willingness

to learn. Many of our residents are going to be affected by the changes to benefits, such as the ‘bedroom tax’, and this is just one way that we are helping them get ready and into work.”

Former Southern Cross care homes set for sell-off (Source: Financial Times)

Hundreds of former Southern Cross care homes may soon be sold to new owners, two years after Britain’s biggest residential care provider collapsed and sparked a national debate about care for the elderly.

The financial backers of HC-One, which was formed as a management company to run about a third of the estate managed by Southern Cross, have shortlisted five bidders to buy the 241-home portfolio, with a deal in excess of £500m expected.

Potential buyers include Patron Capital, Duke Street, Four Seasons, Formation Healthcare and Fondia Investment Management, according to Financial Times sources. Deutsche Bank is running the sales process.

HC-One is a subsidiary of NHP, which owns the freeholds and leaseholds of the properties and is saddled with £1.35bn debt, which its creditors are keen to recoup.

The business is managed by Court Cavendish, led by Dr Chai Patel, former owner of the Priory rehabilitation clinics. He and his management team are incentivised on the value of any sale, and could receive 2-6% of the value of an exit, or an estimated £30m in total.

The HC-One component of the business is unlikely to sell for more than £450m. It turned over £297.7m in the year to 30 September 2012, generating £49.9m in earnings before interest, tax, depreciation, amortisation, rent and management fees. It also needs about £30m in capital

expenditure during the next two years to prevent its care homes deteriorating.

Care UK wins new offender healthcare contracts

NHS England has awarded the healthcare contracts for HMP Brixton and HMP Pentonville to independent health and social care provider Care UK, the largest single provider of healthcare to HM Prison Service.

The contracts – which will see Care UK provide a full range of primary care and mental health services – will run for five years with the option of two 12-month extensions.

Ross Dowsett, regional director for prison health at Care UK, says: “We won the contracts because of our commitment to providing a quality service, driven by the recovery model that will see us using highly tailored healthcare to improve prisoners’ health and wellbeing.

“We are also able to offer business efficiencies and strategic knowledge because of our position as the leading provider of healthcare services. We can draft in expertise from across the country and that will always be attractive to commissioners who are interested in excellent care as well as cost efficiencies.”

Barchester recognised as one of the UK’s top employers

BUSINESS ROUND-UP


BUSINESS ROUND-UP

Business round-upBarchester Healthcare has been officially certified by the Top Employers Institute for its exceptional employee offerings.

The Top Employers Institute globally certifies excellence in the conditions and development opportunities that employers create for their people. Barchester is one of the select organisations to achieve the Top Employers United Kingdom 2014 certification and delighted to be officially recognised as a leading employer.

Crucial to the Top Employers process is that participating companies must complete a stringent research process and meet the required high standard in order to achieve the certification. To further reinforce the validity of the process, all answers are independently audited.

Jeremy Colman, HR director at Barchester, says: “We are delighted to have achieved certification on the Top Employers list for the third time. The feedback we receive helps us focus our efforts on improving our employee offering and the cross-company benchmarking offered is a really valuable way to share best practice.

Nottingham care home funded by Yorkshire Bank creates 50 jobs

The opening of a Nottingham care home funded by Yorkshire Bank has created 50 new jobs and set new standards for the industry locally.

Acorn House, which is owned by care home entrepreneur Jay Patel, opened in December 2013 with the support of a seven-figure funding package from Yorkshire Bank. The deal was delivered by Graham Harper, business development manager at the bank’s Nottingham and Derby Business Private Banking Centre.

The 64-bed purpose-built home is located within landscaped gardens in the Carrington area of the city. A total of 50 new jobs have been created by the opening of Acorn House, which is the first brand new facility of its kind in Nottingham city for several years.

The home is owned and operated by Acorn House Care Home Ltd, whose managing director, Jay Patel, has been in the care home business for 10 years. Jay, who also owns a care home in the south west of England, plans to establish a chain of high-quality facilities.

Jay says: “We chose Yorkshire Bank as our funding partner as its knowledgeable team understood our strategy and what we hope to achieve. We’re now examining plans to acquire a second care home and look forward to developing the business further.”

PropertyMcCarthy & Stone announces half-year sales and revenue growth

McCarthy & Stone, one of Britain’s leading builders of retirement housing, has provided an update on trading for the half-year ended 28 February 2014.

In the latest full financial year, ending 31 August 2013, McCarthy & Stone confirmed 1,527 unit sales, a 21% growth in revenue to £310.8m, and posted a 15% increase in earnings before interest, taxes, depreciation and amortisation (EBITDA) to £46m.

At the six-month point of this financial year, the company reports:

• A 30% increase in legal completions to 659 units, compared to this point in 2013

• Overall half-year revenues up by approximately 50% to approximately £150m

• Continued strong sales growth, with forward sales into the second half standing 30% ahead of prior year at circa £133m

• Since September 2013, the company has legally agreed to buy 34 new development sites, totalling more than 1,100 units. The company now has a sizeable land bank under its control, equating to c8,500 units

• Net debt at 28 February of £95m following refinancing, down from £431m at end of February 2013

• A new board in place, including former Barratt director, Clive Fenton, who has joined as chief executive.

McCarthy & Stone has also announced that it is undertaking an organisational review, with the goal of transforming the business and achieving long-term growth. It will consider the right structures, systems and processes to create a more profitable, scalable and effective business. Change is expected to impact on a number of individual roles, primarily in its head office, and a more limited number across the company’s five regional offices. All affected employees will be consulted.


Following a two-year refurbishment programme, the supported living community at Arrowe Hall in Wirral has been given a new lease of life by care provider Regard, according to its tenants.

The domiciliary care provided at Arrowe Hall is for adults aged 18-65 with learning disabilities, mental health needs or acquired brain injury, many of whom have been involved in the plans for redevelopment.

The 178-year-old stately home has been converted into modern apartments, while carefully retaining the character of the original building in the communal areas.

It can now accommodate 21 people and comprises 17 single-occupancy units and one flat for three people.

Catrin Hankin, a service user since January 2011, was one of those whose views helped guide the project.

Catrin says: “I love my flat now. It’s my home and I feel safe here. I really enjoy the company of the other people I live with, and it’s good to know support is available whenever we need it.”

A major part of the project was a total overhaul of the first floor, including conversion of a three-bedroom apartment into three flats for solo occupation. Like the rest of the residents, tenants of these new flats will benefit from open views across Arrowe Country Park and golf course.

Most recently completed is a wheelchair-friendly apartment on the ground floor, with French windows giving direct access to the grounds and garden.

The final phase of the project is the conversion of a store at the rear of the building, to create two self-contained apartments. These will be available, with shared support, to service users

who have developed a sufficient level of independence.

Paul Wilkinson-Barton, service manager at Arrowe Hall, says: “By consulting with those who live here, we’ve ensured that the redevelopment reflects their needs and caters for their interests. The result is not just a great-looking residence, but a community where everyone is settled and living happily together.

“We also have a wonderful support staff here now, which puts us in a position to successfully cater for emergency referrals. We were able to receive an emergency referral recently at very short notice and care for the young man concerned for six weeks, until he was sufficiently recovered to relocate to a unit elsewhere better suited to his long-term needs.

“What was especially pleasing about this case was the high level of satisfaction expressed by his family, particularly relating to the way the Arrowe Hall team pulled together for his benefit.”

Unlike many similar supported living communities, Regard selects small staff teams for each individual to provide consistent care and allow meaningful

relationships to develop.

Strategies such as regular ‘speak out’ meetings mean that the views of tenants will continue to influence the way Arrowe Hall is run.

An example of their involvement is the recent transformation of the garden attached to Arrowe Hall – previously an overgrown and neglected area – which, according to their wishes, has been totally revamped and now features a barbecue, seating areas, a water feature and spaces for the residents’ own gardening projects.

Catrin says “We can’t wait for spring to come so we can enjoy the bulbs we’ve been planting. And we’re talking about having some swings out there, which will be fun. It’s great to be involved.”

q Arrowe Hall

PROPERTY

New lease of life for Arrowe Hall community

q Catrin Hankin, service user


BUSINESS - LEGAL

The Care Quality Commission (CQC) sets various deadlines and it is important to be aware of them. This article sets out the process of meeting deadlines in relation to appealing draft inspection reports, warning notices and ‘notices of proposal’. I will not refer to ‘notices of decision’ as the process of appealing against them is separate to CQC.

Draft inspection reports

Draft inspection reports are sent to providers once CQC has inspected a service, and they report on what was found on the day of the inspection. However, reports are not always accurate and it is important to challenge reports if they are incorrect

When a draft inspection report is received, providers have 10 working days in which to make representations and challenge any factual inaccuracies contained in the report. Providers can do this by completing a factual accuracy comments log and sending it to CQC.

Warning notices

CQC can issue warning notices if it believes the service is non-compliant with the Health and Social Care Act 2008 and the regulations made under the Act.

There is no legally-set timescale for complying with a warning notice; CQC can set any reasonable timescale.

CQC’s guidance states that a warning notice is deemed to have been served: • the day after it was sent, if served electronically (by email)• on the third day after the day it was sent, if served by

registered post• on the day it was given to the person, if delivered by hand.

If a warning notice is served, the provider may want to challenge it and make representations against it. Providers must make representations against a warning notice within 10 working days of receiving it.

Notices of proposal

CQC serves a notice of proposal on a provider when it wants to limit the way an activity is carried on or managed, suspend

Appealing CQC decisions and meeting deadlines

a registered person’s registration, or cancel a registered person’s registration.

Providers are able to make written representations to CQC asking for the notice to be withdrawn. Section 27(1) of the Health and Social Care Act 2008 states that representations must be made within 28 days “of service of the notice”. CQC’s guidance states the following.• For notices sent electronically (by email), the day of

service of the notice is the day after the notice was sent. • For notices sent by post, the day of service is two days

(48 hours) after CQC posted the notice. • Representations must be submitted within 28 calendar

days of the ‘date of service’.

Steps to take to ensure deadlines are metIf you receive any letters or documents from CQC, the best thing to do is take them to the registered manager of the service and they can decide what action to take and ensure a prompt response if they wish to challenge anything.

What happens if you think a deadline can’t be met?If you need more time to make representations, you should ask CQC for an extension and give reasons why you are seeking an extension. However, unless an extension is granted you should assume extensions will not be given.

The best thing to do is calculate CQC’s deadlines and ensure they are met.

Anna-Maria LemmerTrainee solicitor Ridouts


Coming up in the next issue of Care Talk• Dementia

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