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The Voice of Excellence in Social Care
Let's talk
social care!
Issue 39
February 2015
£2.50
Focus on
Nursing
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PLUS: Integration - the word of the moment
New year new job? 5 reasons to become a carer
How ‘special’ does ‘Specialist Dementia Care’ need to be?
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CCTV guidance for providers
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Contributors
Thank you to everyone who has contributed to this
magazine. Do keep your articles, news and views coming.
Sophie Andrews
Chief executive
The Silver Line
Adam Hartrick
Partner
Hempsons
Caroline Baker
Director of dementia
care
Four Seasons
Health Care
Anna-Maria
Lemmer
Trainee Solicitor
Ridouts
Maggie Candy
Home manager
Marlborough Court,
part of Four Seasons
Des Kelly OBE
Executive director
National Care Forum
Janet Crampton
Consultant
2020 commissioning
Philippa Doyle
Associate
Hempsons
David Fairweather
Staff training and
development coordinator
Bright Care
Prof Martin Green
Chief executive
Care England
Inside Issue 39
Paul Patarou
Divisional manager
Health & Social Care
Division
Access Group
Phil Howell
Communications
manager
BILD
Jim Thomas
Innovation
programme head
Skills for Care
Jeanette Whyman
Medical negligence
solicitor
Wright Hassall
23
24
News
Showcase
29 Care Talk on the road
05 Guest Editor
06 Newsround
08 New year - new job?
09 Delivering personalised care for all
10 New partnership with The Silver Line
Opinion
11 Learning the key components of
a ‘well-led’ care service
12 Is integrating health and social care
likely to reduce the number of
negligence claims?
Stories
14 Wheelchairs by Wings
16 NobleCare welcomes specialist nursing team to UK to share best practices
Good Care Week
18 Good Care Week 27 April 2015
Chat
20 Care Talk competition
21 360 opinion: How can we ensure
safe discharges?
22 Planet Janet
23 This is your life
24 Care creatures
25 Voice Over
26 Mrs MacBlog
Celebrate
27 And the winner is...
28 New categories for National
Learning Disabilities Awards
announced
Care Talk is a trading name
of Care Comm LLP.
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Care Talk contacts
Editorial: Lisa Carr [email protected]
Advertising: Kim Simpson [email protected]
Graphic Designer: Tanya Goldthorpe
General: [email protected]
Journalists: Julie Griffiths, Debra Mehta
50
Learn
30 Principles for change
31 Intimacy in care homes for people living with dementia
32 Health and social care qualifications see the biggest growth in vocational
Special
33 Evaluating the Positive Behaviour
staff supporting people who challenge
36 Specsavers Healthcall
38 How ‘special’ does ‘Specialist
Dementia Care’ need to be?
39 Technology’s role in quality care
40 Innovative Nurse Call Technology from Aid Call
42 How can mobile technology improve both care worker safety and data security?
Business
44
46
47
48
49
Tell us your news,
views and
suggestions!
Email [email protected]
Support Model in Practice
34 Improving the quality of training for
Business round-up
Success for care homes across North Yorkshire
HC-One makes senior
appointments to strengthen local government partnerships
Over 50s get ‘moor’ at Lightmoor extra care scheme
CCTV guidance for providers
now published
Follow us!
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Care-Talk
Editor’s Note
Welcome to the February issue of
Care Talk. The focus of this issues is
Nursing and at the time of writing Ed
Miliband and David Cameron have
again come to blows about plans for
the NHS with Labour promising to
create 5,000 more home care worker
posts to enable people to remain in
their own homes for longer - but for
those people already in a residential
setting quality nursing provision is
key to reducing hospital admissions.
Care home managers carry huge
responsibilities for the safety and
well-being of people with complex
needs receiving nursing, care and
support. Des Kelly, executive
director of the National Care Forum
looks at the key components of a
‘well-led’ care service on page 11.
We see a refreshing and candid
piece from our resident columnist
Janet Crampton, asking the
question, “Why do we have an acute
shortage of clinical staff, especially
nurses in this country?” Conversely
health and social care qualifications
have seen the biggest growth in
vocational success.
Integration of health and social care
continues to be the hot topic in our
sector. Our guest editor Professor
Martin Green, chief executive of Care
England, gives a frank account on
the reality of integration (page 05)
Finally Care Talk are once
again delighted to host
the National Learning
Disabilities & Autism
Awards in association
with the British Institute
for Learning Disabilities
Awards (BILD). The
awards will take place on 15th May at
Birmingham’s ICC. Nominations are
now open and this year sees some
fantastic new categories. See page
28 for more details.
We do hope you enjoy this issue and
thank you for supporting Care Talk.
And please keep your wonderful
stories, news and suggestions
coming.
Lisa
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GUEST EDITOR
Prof Martin Green, chief executive, Care England
Integration - the word of
the moment
One word has dominated the debate in
health and social care in 2014 and that
has been integration. It is a phrase that
trips off the tongues of politicians and
sector leaders, but there is little or no
understanding, either of what it means, or
how to deliver it.
“If we had a truly integrated
approach we would see housing,
transport, leisure, planning”
My definition of integration is one that
sees the person at the centre of every
service, and that all services within society
wrap themselves around the needs of the
individual. When I talk about all services,
I talk about something significantly more
than health and social care. If we had a truly
integrated approach we would see housing,
transport, leisure, planning and every part
of the system, working seamlessly to ensure
that people had a good quality of life, rather
than just a series of services.
One of the first problems in delivering
integration is that there is no consistent view
about what this means. I have been amazed
to see, that for some people in health
services, their definition of integration is how
the acute sector works with primary care,
and for them, integrating two bits of the silo,
is as far as their imagination stretches. There
are others, who have a view that integration
is about the health and social care system,
but there is no recognition of what needs
to happen in order to transform the current
fragmented system, into one that performs
seamlessly for the citizen.
In many ways I think our problem has
been we are focused far too much on the
structure and far too little on the outcomes.
There are countless examples of seamless
services that are delivered by multiple
providers in the service sector, but the
interfaces between these groups is so clear,
and so quality assured, that the experience
of the customer is of a high quality, good
outcome. In some service industries the
experience of the customer is so good,
that they are not even aware that there are
several organisations involved in delivering
their service.
“Whatever money they have in
private sector organisations, it is
by no means anywhere near the
£119 billion we spend on health
and social care!”
These examples of seamless services tend
to be in industries that are delivering to
people who can pay for them. Whenever I
raise these examples, the public sector tells
me that it is a different scenario because the
private sector body has got the money to
deliver on these outcomes. My response to
this challenge is clear. Whatever money they
have in those private sector organisations,
it is by no means anywhere near the £119
billion we spend on health and social care.
As citizens and taxpayers, we should expect
that this amount of money would deliver
a high quality, responsive service. One
of the reasons why I think this does not
happen is because we are not perceived as
customers, and we do not have control over
how the budget is spent. The move towards
direct payments in both health and social
care is to be welcomed, but only if it really
puts the power in the hands of the person
who uses the service. However, for citizens
to exert control, they have to not only have
to have the money to buy services, but they
also need to have competition in the system,
so that they can make choices about who
will deliver a better outcome for their money.
I am also very conscious of the role the
culture of organisations play in defining
what sort of service people receive.
There is a radical need for culture change
programmes in the NHS, social care and
the public sector in general because many
of the challenges we face, are challenges
of cultures within organisations, rather than
structures. If successive governments
had spent 100th of the money they have
spent on structure change on changing the
culture, I believe we would be much nearer
to having fully integrated services.
“There will be no solutions coming
from the leaders in politics, the
NHS, or local authorities”
2014 was yet another year when rhetoric
and reality were completely out of sync
with one another and I have to tell you, with
an election looming, we are in for more of
the same. Faced with this challenge we
have to do it for ourselves. There will be no
solutions coming from the leaders in politics,
the NHS, or local authorities, and the only
hope to make integration real, is for the
people who work in services, whether they
are in the public or private sector, to make
a commitment to delivering better and more
seamless services to their customers, in
spite of what the system will do.
www.caretalk.co.uk I 07
www.caretalk.co.uk I 05
NEWSROUND
DEMENTIA
Higher dementia rates
found in northern countries
(Source: BBC News)
People living in northern countries are more
likely to develop dementia, according to
researchers. An Edinburgh University study
suggested that environmental factors, such
as lack of sunlight, could in-crease the risk
of developing the illness. Scientists mapped
the disease in Scotland among 37,000 people
born in 1921.
NHS
For more information visit http://www.bbc.
co.uk/news/uk-scotland-30879828
Problems spreading beyond A&E as risk
of NHS crisis grows – latest quarterly
monitoring report from The King’s Fund
Creating Dementia Friendly
Communities (Source: Mental Health
Foundation)
The King’s Fund has warned that problems in hospitals are spreading
beyond A&E to other key areas of performance, increasing the risk of a
NHS crisis.
For more information visit http://www.kingsfund.org.uk/press/pressreleases/problems-spreading-beyond-ae-risk-nhs-crisis-grows%E2%80%93-latest-quarterly
We all make decisions in our lives that involve elements of
risk - but for people living with dementia these decisions may
sometimes be harder to make or others prevent them from
doing so. Many countries are seeing initiatives aimed at making
communities more ‘dementia friendly’ – aware, supportive and
inclusive of people with dementia – an important part of this
is ensuring people with dementia are supported to continue
making their own decisions, even where there may be some
risks. This is known as ‘positive risk taking’. The Mental Health
Foundation recently produced a viewpoint publication for the
Joseph Rowntree Foundation outlining how positive risk taking
can make us think differently about dementia. It was based
upon discussion with people living with dementia, carers and
other experts.
A&E crisis not due to shortage of residential
care home beds (Source: Care England)
New quality standard resource from
NICE (Source: SCIE)
Over the past few days, there have been reports about how the current
pressures in A&E are partly a result of a shortage of care home beds.
New suggested ways of improving social care practice,
including preparing for inspection, have been published. The
National Institute for Health and Care Excellence (NICE) has
created a resource looking at how their quality standards can
be put to practical use. It also identifies which quality standard
statements are likely to be most relevant for each of CQC’s
5 key questions on services (Are they safe, effective, caring,
responsive to people’s needs and well-lead?) The resource was
developed by the NICE Collaborating Centre for Social Care,
which is led by SCIE. SCIE also worked with an advisory group
of sector experts, including care home mangers.
The Fund’s latest quarterly monitoring report follows widespread reports
about pressures on A&E units, and underlines that hospitals are stretched
to the limit. The report shows that waiting times for treatment and other key
performance indicators are getting worse, as the NHS struggles to cope
with increasing demand for services and the unprecedented financial
squeeze.
Commenting on this, Professor Martin Green OBE, chief executive at Care
England, said: “For a number of years, independent care home providers
have been offering the NHS increased capacity, in order to deal with the
pressures that the health service faces over the winter months. These
offers have been repeatedly ignored and it is no surprise that A&Es once
again find themselves overstretched.”
Martin continued: “A broken payment model, in which money flows into
the acute sector at the expense of the rest of the health and social care
system, has allowed the needs of individuals with complex conditions
to escalate to the point at which they have no choice but to present at
A&E. The only way in which the cycle of crisis can be stopped is through
streamlining primary, acute and social care, and I look forward to the day
that all of the rhetoric surrounding integration is translated into action.”
06 I www.caretalk.co.uk
Using NICE quality standards to improve practice: A resource
for managers of care homes for older people
Mental wellbeing of older people in care homes film
NEWSROUND
SECTOR BODIES
Care England launches
social care manifesto
On 28th January Care England
launched its manifesto, which provides
a future government with a roadmap to
an outcomes based health and social
care framework. In a difficult financial
climate, it is important that all parts of
the system are treated fairly and work
together in the interests of the people
who use services, and this manifesto is
written with that goal in mind.
Professor Martin Green OBE, chief
executive of Care England, said:
“The conversation on how we care
for individuals accessing health and
social care services must move from
discussion on the nature of these
services to the outcomes that they
achieve for the individual. This won’t
require structural reform, but will
necessitate a change in culture that
ensures all parts of the system work
together to deliver on what is important
for the person involved.”
Martin added: “By focusing
on innovation, the workforce,
commissioning and provision,
this manifesto provides a list
of recommendations which, if
implemented, will ensure that our
health and care system meets the
needs of a twenty-first century society.”
To see a copy of the manifesto,
please visit http://www.careengland.
org.uk/about-us
Report on the
deprivation of liberty
safeguards published
by Care Quality
Commission
brain injury or a learning disability who
cannot provide consent to necessary
care in order to keep them safe, a series
of assessments are carried out in order to
make sure the care that is being provided
is in their best interests. This is about
recognising people’s dignity and equality
and human rights.
The Care Quality Commission has
published its fifth annual monitoring
report on the implementation of the
deprivation of liberty safeguards (DoLS).
These are part of the Mental Capacity
Act, and they protect the rights of adults
in care homes and hospitals who lack
mental capacity, in situations where they
need to be deprived of their liberty to be
given necessary care or treatment.
The report examines the first five years
of implementation of DoLS, during which
time the numbers of applications to use
the deprivation of liberty safeguards rose
from 7,200 (per year) in the first year to
13,000 (per year) in the year ending in
March 2014. We have commented in
successive annual reports that these
relatively low numbers probably masked
The question of how we can provide
care for such people who are unable to
consent to treatment is the subject of
this report. For people with dementia, a
The full report can be found here:
http://www.cqc.org.uk/content/
deprivation-liberty-safeguards-201314
Ageing population ‘one of top three challenges
facing the UK’ (Source: YouGov)
The country’s ageing population is seen to be one of the top three challenges facing
UK society over the next 20 years, falling just behind healthcare and immigration.
Meanwhile, four fifths (79%) of adults think the ageing population will present a
large challenge for the UK. That’s according to a new YouGov poll commissioned by
Independent Age, the older people’s charity.
The poll questioned 2,421 UK adults to explore the support needs among over 65s in
the UK, and the role of charities and voluntary sector organisations in supporting older
people. The survey was commissioned as part of 2030 Vision, a national consultation
run by Independent Age about how to make the UK the best country to grow older in.
Age UK’s ‘score card’ – The
devastating truth of the social
care crisis (Source: Age UK)
Age UK’s research has found that older people in
England are being left “high and dry” by councils cutting back on the care they provide.
Research by the charity showed the numbers getting
help fell from just over one million three years ago to
850,000 last year.
Age UK said the cuts were one of the major causes
behind the growing pressures on A&E units.
Councils responded by saying that they had been
left with little choice because they were “chronically
underfunded”.
For more information visit http://www.bbc.co.uk/
news/health-30902555
Alarming numbers of people
feel isolated and lonely as a
result of caring for their loved
ones (Source: Carers UK)
New research by the charity Carers UK reveals
that 8 out of 10 carers have felt lonely or isolated
as a result of looking after a loved one and over
a third feel uncomfortable talking to friends about
being a carer.
Lack of understanding from friends, colleagues
and family, inadequate care services and financial
pressures leave huge numbers of people caring
for older, sick or disabled loved ones struggling
with feelings of loneliness and isolation.
Half of carers (50%) report feeling depressed and
82 per cent say they feel more stressed due to
their caring responsibilities.
Over half of carers (57%) have lost touch with
family and friends as a result of their caring role
and half admitted to experiencing problems in
their romantic relationships due to caring for their
partner or another family member or friend.
6.5 million people in the UK are caring for older,
sick or disabled loved ones. Carers UK gives
expert practical advice and information and
emotional support, connects carers, campaigns
for change and innovates to find new ways
to reach and support carers. The charity has
launched appeal during its 50th year to enable it
to reach out to and support more carers.
The full report ‘Alone and Caring’ and case
studies are available on request. www.
carersuk.org
www.caretalk.co.uk I 07
NEWS - SECTOR
New year - new job?
Five reasons why a job as a carer can
be a really fulfilling career choice
The caring profession is vital to the
wellbeing of our society, and the
people who work within it contribute
disproportionately to the quality of life of
some of our most vulnerable and elderly
citizens.
an elderly person
through their day
is cited by many
carers as one of
the great benefits
of the job.
However, a career in caring is not
universally regarded by those outside the
sector as a particularly desirable lifestyle
option, having earned a bad press over the
years regarding long hours and relatively
modest rewards.
Going home at
the end of a day
in the knowledge
that someone
who could have
been your mother
or father is more
comfortable
and content as
a result of your
efforts is a reward
not found in many
vocations.
What this view does not recognise is that
for many people - including those who
have not necessarily followed an academic
career path - caring can provide excellent
opportunities which fit in perfectly with the
way they want to live their lives.
Here are five reasons why employment as
a carer can provide fulfilling and rewarding
employment:
Flexible hours: It is in the nature of the
caring sector that many of the employees
are women who often have significant
family-related commitments which would
prevent them from considering a traditional
nine to five job.
Looking after children, or elderly or
disabled relatives is time consuming and
unpredictable. It is possible when working
as a carer, however, to agree hours which
fit round these commitments while also
providing a service at a time which is of
value to the employer.
Most employers value the flexibility that
carers can offer, since looking after their
clients is also a 24-hour a day duty with the
frequent potential for the need for sudden
and unexpected extra cover.
Job satisfaction: Helping other selflessly
is one of mankind’s greatest attributes and
the satisfaction that can arise from easing
08 I www.caretalk.co.uk
Companionship: Every resident in a care
home, or individual trying to carry on in their
own home, is a unique human being with a
story to tell. And sometimes the stories can
be fascinating, of lives richly lived and loves
won and lost.
For a carer to function properly, he or she
must have the time to stop and listen to the
people in their charge and to give them the
time and attention they so often desperately
wish for.
A dedicated carer can become a real friend
to a vulnerable person whose own friends
and acquaintances may have passed on.
Helping to relieve the curse of loneliness is
one of the job’s most satisfying rewards.
Regular training: Good employers will
hire carers because of their attributes of
kindness and compassion rather than on
qualifications, but they will also want to
build up their carers’ skill sets - and, as a
consequence, their future employability.
Training on the job is often reckoned to
be the most valuable form of learning -
practical skills backed up by progressive
qualification achievements can turn a job as
a carer into a career.
Feedback from clients: This is what can
make a carer’s day. The genuineness of an
older person’s smile, a few grateful words
or perhaps a personal card on a birthday or
Christmas - knowing that you have made a
difference as only a carer can.
David Fairweather is staff training and
development co-ordinator at Bright
Care, the domiciliary care experts.
NEWS - SECTOR
Delivering personalised care for all:
Why care homes need to be better
equipped to care for deaf people
Losing hearing is a well-known part of the aging process,
which residential care homes have long since been able to
deal with effectively thanks to the accessibility of hearing aids
and hearing checks.
Care homes across the UK have, however, not yet fully
refined their care services to better meet the needs of elderly
people who are deaf. Recent research into the needs of older
deaf people commissioned by The Royal Association for
Deaf People (RAD) and [sonus] (formerly Hampshire Deaf
Association), found that older people who are British Sign
Language users are receiving inadequate residential care
because their cultural and communication needs are not being
met.
“The scheme encourages care homes
to develop their services to support deaf
residents by providing deaf awareness
training”
Furthermore, whilst there are some specialist care homes for
deaf people, local authority funding cuts have resulted in the
majority closing over the last few years, leaving many deaf
people without access to appropriate care services.
In order to try and ensure that elderly deaf people receive
appropriate care, the Royal Association for Deaf People,
[sonus], and Care Minister, Norman Lamb, have launched
the Care Quality Mark Scheme for Older Deaf People. The
scheme encourages care homes to develop their services to
support deaf residents by providing deaf awareness training
for all care staff members. Each home is then assessed on its
accessibility, its engagement with older deaf people, whether
it has enough British Sign Language staff members, and
whether it has recruited enough staff that have had previous
experience working with deaf people.
home, as well as being able to interact easily with residents
and staff members.
It is estimated that by 2035 there will be
between 11,500 and 26,680 deaf people who
are over the age of 65 living in the UK”
It is estimated that by 2035 there will be between 11,500
and 26,680 deaf people who are over the age of 65 living in
the UK; it is vital that care homes develop their services to
accommodate this demographic. If placed in a standard care
home with staff and residents who are unable to communicate
through sign language, deaf residents will be unable to
express their needs or thoughts to others. This can potentially
result in their isolation from the rest of the home’s community;
a sad and lonely experience for both them to endure and their
family members to witness.
Care homes across the country are now working towards
attaining the Care Quality Mark for Older Deaf People and it is
hoped that between 10 and 15 care homes will be accredited
by the end of the year.
Encouraging care homes to work towards gaining the Care
Quality Mark for Older Deaf People is critical if we are to
ensure that deaf elderly people receive care that promotes
their wellbeing and allows for regular social interaction.
Maggie Candy, home manager for Marlborough Court,
part of Four Seasons
Four Seasons Health Care’s Marlborough Court Care Home in
Thamesmead was one of only three sites selected in the UK
to participate in a deaf pilot scheme and was the first home in
the country to obtain the new Care Quality Mark for Older Deaf
People in April this year. The home implemented a number of
new practices and procedures in order to meet the benchmark
requirements, including the installation of Wi-Fi and provision
of iPads. Deaf residents will now be able to regularly
communicate and connect with their loved ones outside of the
www.caretalk.co.uk I 09
NEWS - SECTOR
New partnership with
The Silver Line
According to Sophie Andrews
chief executive of The Silver Line,
“It’s true to say that if you make something
simple enough for everyone to use,
then they will. Dame Esther’s vision to
create a ‘ChildLine for older people’ is a
simple concept – a free 24 hour helpline,
available every day and night of the year,
where you can ask about services in your
area, talk in confidence, get some friendly
advice or quite simply have a chat.
And for people who would appreciate a
regular call from the same person every
week we offer Silver Line Friends who
are volunteers and share our belief that
a simple connection with another human
being can make a difference. As one
caller told his Silver Line friend “when I
get off the phone, I feel like I belong to the
human race”.
The Silver Line Helpline is available on
0800 4 70 80 90 (or 0300 4 70 80 90
which is free from most mobiles) as the
first free and confidential helpline for
older people which is open every day
and night of the year. Since the helpline
was launched in November 2013 it has
received more than 325,000 calls, and
almost 7 out of every 10 are made in the
evenings and at weekends. These are
often the loneliest times for older people
which is why it is so important that Silver
Line is available when other services are
10 I www.caretalk.co.uk
not. The helpline team operates at bases
in Preston and Edinburgh and is made
up of professional staff working in shifts
across the 24 hour period so they are
always available. They are recruited for
their empathy and enthusiasm and every
older person speaks to someone who is
genuinely interested in what they have to
say.
In addition to the helpline, there are
about 1000 older people across the UK
receiving regular weekly phone calls from
their Silver Line Friend, who are trained
volunteers, and a further 1100 older
people are on a waiting list for friendship.
The Silver Line team keeps in touch with
them regularly so they do not feel they are
forgotten, and as soon as more volunteers
become available, they will be matched
for a Silver Line friendship.
To mark The Silver Line’s first birthday,
there was an important announcement
of a life-saving new partnership. The aim
is that the helpline will work jointly with
the Care Quality Commission (CQC) to
help older people and their families raise
concerns about the standard of care they
are receiving whether in a care home or in
their own homes. One of the first calls to
The Silver Line was from a lady in a care
home who was too afraid to give her name
but did give the name of the care home
where the residents had been left without
food and the heating turned off. The
police were involved and the residents are
now safe. The Silver Line is in a unique
position to reach and be reached by
people who would not otherwise report
poor standards of care and neglect and
to work with the CQC to better protect
the most vulnerable and growing sector
of society – the frail oldest people. The
Silver Line works in partnership with Age
Scotland to deliver Silver Line Scotland
– on the same phone number - and is
now exploring opportunities with Care
Inspectorates in all the nations.
At the launch of the partnership Andrea
Sutcliffe chief inspector of Adult Social
Care at the Care Quality Commission
said:
“I am very pleased that the Care Quality
Commission will be working in partnership
with The Silver Line to reach the most
isolated older people who are receiving
care and may need our support and
protection. We believe that working
together, we will be able to improve
the standards of care for older people
that may be falling short of the quality
they need and deserve. It is also an
opportunity to recognise examples of
excellence and to highlight best practice
to share with others.”
NEWS - OPINION
SECTOR
Learning the key
components of
a ‘well-led’ care
service
“It is perhaps surprising that there has been
little systematic analysis or understanding of
the role”
Care home managers carry huge
responsibilities from the safety and
well-being of people with complex
needs receiving care and support,
relationships with their families/friends,
standards of quality and service, the
supervision, support, motivation and
training of staff, partnerships with
commissioners and regulators, business
strategy, managing resources … the list
is enormous!
No one can be in any doubt that the role
is absolutely vital to the delivery of good
quality care and support. In fact the new
inspection regime recently introduced
by the Care Quality Commission has
identified management as one of the
5 key questions - “is the service wellled?” Find an excellent care service and
there will be a good manager behind it
and similarly every time there a problem
associated with the services of a care
home it will lead back to the quality of
the person in charge.
Given the central role of the registered
manager in the leadership and quality
of care home provision it is perhaps
surprising that there has been little
systematic analysis or understanding
of the role. The publication of the ‘Care
Home Managers: A scoping review of
the evidence’ by the School for Social
Care Research at NIHR should help to
overcome this gap in our knowledge.
The report by Katherine Orellana draws
together a wide range of material
and summarises the evidence since
2000. This information is used to
explore the role, practice, experience
and skills of care home managers as
well as the challenges they face. It
yields fascinating data on the 14,432
registered care home managers (as at
February 2014 according to CQC), their
qualities and qualifications, motivation
and aspirations.
“An experienced and ageing
workforce likely to be facing
additional demands with an
average salary of a little over
£30,000”
Almost half of the registered managers
have more than 10 years of experience
and a further third have been in post for
4 to 9 years. A third are aged 55 or over.
Turnover rates seem to average about
12% although it rises to 17% for nursing
homes. So, some obvious issues that
will need to be addressed in preparation
for the additional duties that will result
from the implementation of the Care Act
2014.
The scoping review also found the
following key challenges identified by
the managers:
p Des Kelly, executive director,
National Care Forum
• Negative press
• Insufficient recognition
• Recruitment and retention
• Unnecessary bureaucracy, and
• Insufficient funding.
Although there are no particular
surprises in this list it highlights the
pressures which form the context for
their work. An experienced and ageing
workforce likely to be facing additional
demands with an average salary of a
little over £30,000 – it all points to a
tough and testing future.
However given everything we know
about the vital role of the manager
in ensuring quality of care the really
startling finding for me in the review was
the revelation that over 400 care homes
were found by CQC to have been
without a registered manager for two
years or more. There is an urgent need
for research that better understands
the dynamics associated with an
absence of management for such long
periods of time and what can be done
to improve the situation. No service
will be judged to be ‘well-led’ without
effective management and furthermore
will undoubtedly attract additional
monitoring and scrutiny.
Des Kelly OBE, executive director,
National Care Forum.
www.caretalk.co.uk I 11
OPINION
Is integrating health and
social care likely to reduce the
number of negligence claims?
The short answer is yes.
However, life is rarely that straightforward
particularly where healthcare is concerned.
With the headlines dominated by several
A & E departments reaching crisis point,
observers have been quick to cite a
number of reasons why some sections of
the health service appear to be in chaos:
lack of government funding, lack of staff,
anti-social hours, local authority cuts to
social care, and so it goes on. But there
is an inescapable fact: hospitals have
become the default option for many elderly
people with chronic conditions who do not
have proper community support and their
numbers are growing.
who has looked after an elderly relative
will understand the frustrations of trying to
coordinate input from GPs, physiotherapists,
occupational therapists and social workers
so that they can stay, properly supported,
in their own homes rather than end up,
as so often happens, as an emergency
admission. As the age profile of the UK
population steadily grows, the problem of
elderly people presenting with multiple,
chronic conditions will increase, as will the
pressures on an already overstretched NHS.
Mistakes tend to happen when people are
under pressure, corners get cut and those
least able to speak up for themselves are
normally the first to suffer. The price of not
integrating health and social care will be a
rising medical negligence bill.
The revolving door
Implementing change
The number of medical negligence claims
faced by the NHS has increased by 82%
since 2009/10. Although the majority
will be maternity or surgery-related, an
increasing number of claims have arisen
from the ‘revolving door’ syndrome
whereby vulnerable, elderly patients are
discharged, only to be readmitted as
they have neither the resources nor the
wherewithal to organise their own, nonclinical care. Simon Stephens, CEO of NHS
England, has already set out his vision for
a new, improved NHS with a patient-centric
approach at its heart, requiring closer
coordination between the health and social
care systems with the objective of reducing
hospital admissions. This in turn should
reduce the number of negligence claims
arising from inadequate care.
There are already a number of examples
of integrated care around the country
all of which have been developed in
accordance with local conditions and
needs; and the common feature shared by
all is the importance of the primary care
system being at the heart of the model.
The fact that some areas have proved that
The price of not integrating
health and social care
From my viewpoint as a clinical negligence
lawyer, better coordinated, integrated care
will reduce the number of patients falling
between the health and social care systems
and coming to harm, so I welcome the
acknowledgement by NHS England that the
current system is unsustainable. Anyone
18 I www.caretalk.co.uk
12
integrated care for specific patients can be
introduced almost on a case by case basis
within a relatively small area means that its
implementation should be manageable.
Medical negligence claims arise for a
number of reasons. Sometimes gross
incompetence is to blame; more often it is
errors of judgment caused by inexperience
or pressure of work which result in patients
being harmed. It is easy to see (but not
to excuse) why hospital staff struggling to
juggle genuine medical emergencies with
patients who really need support either
in their own homes or a care home can
find themselves at the wrong end of a
medical negligence claim. NHS England’s
stated objective to promote a joined up
approach to health and social care must be
applauded: the sooner integration can be
achieved, the better for all.
Jeanette Whyman from Wright Hassall is
a medical negligence solicitor with over
25 years’ experience and has acted both
for and against hospital trusts. She now
represents patients who are victims of
medical negligence.
In partnership with
Media partner
Leading change in dementia diagnosis and support
Actions to inform future national strategy
Tuesday 24 February | The King’s Fund, London
This conference will bring together professionals in health,
social care, housing and the community to learn from current
examples and find new ways of delivering transformational
change in dementia diagnosis, care and support
Learn how care is assessed, planned, delivered and monitored
within care homes, and find out more on supporting palliative
and end-of-life care for people with dementia.
Key speakers include:
• Andrea Sutcliffe, Chief Inspector of Adult Social Care,
Care Quality Commission
• Professor Keri Thomas, National Clinical Lead,
Gold Standards Framework Centre for End of Life Care
• Hayley Rowson de Vares, Residential Manager,
Sherdley Court
Quote
‘CareTalk’ when
registering and
receive a 10%
discount
Discover more and register at:
www.kingsfund.org.uk/dementia15
STORIES
Wheelchairs by Wings
It is not everyday a full time home help
and part time blogger gets to make such
a difference to the lives of the elderly.
Caron Cares provides advice and information for anyone
caring for the elderly and was a finalist in the Older
People in the Media Awards 2014.
p
On February the 27th, 2013 I received an
email from someone called Veronicah
asking for help providing a wheelchair
for an elderly relative.
I contacted every organisation she could think to
help with this request, Red Cross, UN, World Health
Organisation, Rotary Club, The Buddist Temple of
Nairobi, the Wheelchair Association, Richard Brandson,
the Foreign Consulate for Nairobi to name just a few.
I had a feeling this had not come from the UK and
replied asking for more details only to learn it had come
from the remote village of Mbooni, Kenya. Veronicah is
47 and lives in Mbooni. Not only does she help look after
the elderly in the village she also looks after some of the
children many of whom have lost their fathers. Many of
the children don’t attend school and some don’t have
enough food.
For a long time I had few responses and no offer of help.
Veronicah, a widow has brought up her two children
alone after her husband was killed in a road accident.
This is a very caring and compassionate woman and I
was determined to help her. Most busy people would
have decided this was an impossible challenge, however
I became determined to meet it.
14 I www.caretalk.co.uk
Veronicah
Finally I had a response from the orthopaedic services
manager for the Nairobi branch of the Association for the
Physically disabled of Kenya. They very kindly offered to
donate a wheelchair the only difficulty was they insisted
that the recipient had to travel to be fitted for it on two
occasions. This would involve a round trip of 260 km
each time and with little transport apart from the Matatu,
local bus. This was impossible for an elderly and infirm
woman.
Feeling dejected I contacted Veronicah . Whilst
absolutely delighted to have the offer of a wheelchair, it
now seemed that we would be unable to accept due to
the logistics involved. I told her not to give up, somehow
STORIES
I would resolve this.
I thought laterally and had the brain wave that the easiest
form of transport would be ….helicopter ! So, I emailed
all the helicopter charter companies in East Africa and
had one reply.
Richard Leach from Hybrid Solutions emailed me
explaining that my request would cost up to £3,000 in
flying time and that it would be cheaper for them to buy
a wheelchair in the UK and fly it out to Nairobi from their
UK arm.
during the first week of June to spend almost a week in
customs.
They were then given to Veronicah by Richard who
flew them out to Nairobi and taken to the village by
Veronicah.
Another lady who has benefited from Wheelchairs by
Wings is Agnes. Agnes has had a stroke and is unable
to speak or walk unaided. She also has no toes.
I was amazed and delighted at this very generous offer
of help said I would see if she could find a UK distributor
to contribute a wheelchair as Richard was prepared to
organise and fund the air transportation.
I set about emailing numerous companies throughout
the UK and the same day received an offer from Iain
McLarty, director of Great Range Mobility, in Berwick
upon Tweed, Northumberland.
p
Iain McLarty, director of Great Range Mobility
p
Agnes
Agnes has now been able to take her wheelchair
following one fitting.
I also decided whilst I had the offer of transportation, to
purchase a second wheelchair from Iain for the elderly
of Mbooni and they arrived at Wilson Airport in Nairobi
This story is a shining example of
individual’s determination to meet a
challenge from the other side of the
world for the good of an elderly people.
www.caretalk.co.uk I 15
STORIES
NobleCare welcomes specialist
nursing team to UK to share
best practices
If the saying ‘knowledge is power’ is to be
believed, then spreading knowledge can
only help others in the long run.
Expert learning disability care provider,
NobleCare, had exactly this thinking when
they welcomed four specialist psychiatric
nurses from Hong Kong to view the latest
advances in care provision that they, as a
company, are offering in the UK.
During the visit the nurses worked with
both NobleCare and the British Institute of
Learning Disabilities in order to learn about
some of the best practices used in the UK,
which they then took back to Hong Kong to
use throughout their work.
“The visit aimed to impact
positively on service
users in both countries by
encouraging the nurses on
both ends to develop their
approach to care”
Qualified as advanced practitioners in
their own country, some of the training that
the nurses underwent included meeting
with NobleCare managers and observing
the best care practices at four of their
residential learning disability and autism
services – giving them invaluable hands on
experience.
Dr Gurpeet Takhar, chief executive of
NobleCare also delivered a training module
on ‘caring in the 21st century’, which
showed the nurses how it is important to
keep your care practices person centred in
a changing time and environment.
He said: “The care of people with learning
disabilities has come a long way in the UK in
recent years and it is refreshing that people
from other countries have recognised this.
“We find it helpful to reflect on how we do
things and then innovate to improve the care
and outcomes for people we care for. We
16 I www.caretalk.co.uk
are delighted
that those in
our industry
from different
countries
recognise us
for this and
are keen to
work with us
and learn
from what we
know.”
The team of
nurses were
also shown
around
specialist
learning disability hospital, Brooklands
Hospital, where they had the opportunity
to shadow staff, as well as provided formal
classroom training that covered a number
of modules, including: positive behaviour
support, advanced autism, person-centred
planning and history of learning disabilities
care in the UK.
Established in 2000, NobleCare prides
itself on caring for people with learning
disabilities at five residential care services
in the Midlands. Winning two national care
awards in 2014 NobleCare’s team was keen
to encourage a best practices exchange to
improve the quality of care for those with
learning disabilities. Bringing in the nurses
from Hong Kong has helped spread UK
care approaches on a worldwide scale.
However, far from a one way street of
learning, the team at NobleCare also
benefitted from the visit and absorbed
teachings from their visitors, who taught
them a lot about the care practices in a very
different culture to that of the one in place in
the UK.
The visit aimed to impact positively
on service users in both countries by
encouraging the nurses on both ends to
develop their approach to care, which in
turn would improve the service offered to
those who rely on it most.
Colin Smith, associate consultant at BILD
carefully planned the programme to be
a mutually beneficial experience for both
guests and visitors and believes that the
visit itself was a massive success.
“We are delighted that those
in our industry from different
countries recognise us for
this and are keen to work
with us and learn from what
we know.”
Colin said: “This is the first programme
of its kind and we wanted to blend formal
classroom learning with the observation of
real life applications, allowing the nurses
to put what they have learnt into practice
straight away.
“I personally selected NobleCare as an
example of best practice as their thoughtful
person-centred approach has been very
successful in enhancing the lives of the
people that they care for.
“Overall, I was absolutely delighted with
the outcome of the programme and I am
certain that it has been both a valuable
and enjoyable experience for everybody
involved, which means that those who are
cared for by the team we have worked with
will receive an even better service.”
A HENRY STEWART MARKET BRIEFING
Nursing Homes,
Care Homes, Assisted Living,
Domiciliary Care Services
and Third Age Housing
Le Meridien Hotel, London W1
Wednesday, 11 February 2015
This year’s essential briefing will cover:
• Current market trends in property values and
opportunities for growth
• What funding is available, for what purposes and
on what terms
Care Talk
Readers are
eligible for a
10% discount
Use discount
code
CT10
• Making the most of existing buildings and limited capital to increase
value and fundability
• The impact of CQC inspections and the Care Act on your business in 2015
For all those involved in the ownership, operation, valuation, funding, sale and
purchase of care and nursing homes, assisted living property, domiciliary care
businesses and third age housing.
To book your place online and for the full agenda, visit:
www.henrystewartconferences.com/nursinghomes2015
Celebrating the good care behind Great Britain
Good Care Week 27 April 2015
Good Care Week 2015 takes place 27 April 2015. Care providers and individuals from the sector are already demonstrating their commitment towards
Good Care Week with some fantastic examples of raising the profile of social care to their wider community.
The UK-wide annual awareness campaign, in association with Care Talk magazine, saw local initiatives
Get involved and champion
good care
Be a part of this groundbreaking initiative to raise awareness
of social care and ensure that this sector gets the respect and
appreciation it merits.
•
Get your colleagues involved; care workers, managers
and providers. What could you do collectively to raise
the profile of social care in your local community?
Open days, encouraging volunteers and visits from
local schoolchildren are just some simple yet effective
initiatives.
•
Get your service users and their families involved. Ask
them to support the campaign by providing testimonials
about their care provision.
•
Write to your local MP about Good Care Week. Ask
them to help you raise the status of social care in your
community and formally support the campaign.
•
Share your ideas with us for raising the profile of social
care locally so that colleagues throughout the sector can
emulate this in their own communities. We will feature
your examples, stories, comments and suggestions on the
Good Care Week website and in Care Talk magazine.
Sector demonstrates principles of Good Care Week
Bield tenants get crafty
for charity
“It’s obviously a great project to be involved in, but
it also benefits the residents at Dickson Court as it’s
great to have something to be actively invovled in.
Charitable tenants at a very sheltered housing
development have been putting their knitting skills
to good use, making blankets to help keep people in
poverty warm this winter.
“It also creates a real sense of community because
the other residents get involved when the blankets
are stitched together. It really helps the social aspect
and brings everyone together.”
The dedicated group of tenants and volunteers at
Bield’s Dickson Court in West Calder have been
getting crafty for the Blythswood Care charity, who
send the blankets to some of the poorest parts of
Europe, Asia and Africa.
Bella Kirk, an 88 year old tenant who has been
living at Dickson Court for 10 years, said: “I
thoroughly enjoy attending the craft group.
The committed team from the very sheltered
housing development, made up of 7 tenants and 7
ladies from the local community, have been knitting
vests and patches for blankets all year. The patches
are then sewn together by the residents from the
development before being shipped out in shoe boxes.
Eileen Milne, a 70 year old retired Good Neighbour
Network Coordinator, has been running the
craft group, which meets every Monday morning
throughout the year, since her retirement in 2005.
Eileen said “The blankets and vests go wherever
they are needed so it’s good to know they will be
helping people keep warm in some of the coldest
and poorest places in the world.
/Sector support
www.goodcareweek.co.uk
“I’ve been a member of the group since it first
began and although I’m not as able to knit now as
I used to be, I still like to attend. It’s really great
being involved in something like this.”
Celebrating the good care behind Great Britain
Hill Care Homes celebrate National
Employee Motivation Day
Member of staff at care homes across the North East have been
treated to pampering sessions, meals and special activities as part of
the UK’s first National Employee Motivation Day.
The homes, all part of the Hill Care group, took part in the
nationwide initiative, introduced by Argos Business on Wednesday
21st January, to show staff appreciation for their work and to
encourage them to feel motivated about their jobs.
Each home celebrated the occasion in a different way with Mandale
House, in Stockton-on-Tees rewarding their staff continental style by
holding a French themed day.
The home was decorated with flags, balloons and bunting whilst staff
and residents were treated to delicious French cuisine for their lunch
and evening meal. The staff also dressed in traditional stripy t-shirts
and everyone enjoyed taking part in a European quiz at the end of
the day.
Unusual art project sparks care
home conversation
A project which brings artists and creative experiences into
care homes in Cornwall, saw an innovative concept become
reality.
Led by Arts for Health Cornwall in Penryn, the Home
Service project is designed to enrich the lives of older people
living in care homes.
A specially designed artwork, in the form of a range of
crockery, was put to use for the first time by care home
residents. Designed in collaboration with residents and staff,
the cups and saucers are intended to help spark conversation
and rekindle memories amongst the residents at the home,
which specialises in caring for people with various forms of
dementia.
Each identified by a different word, the range of cups and
saucers are the work of artist Jonty Lees, who has been
developing ideas for an original and practical art intervention
at Crossroads House Care Home in Scorrier for several
months.The cups and saucers were delivered last week and
will be used at mealtimes and tea breaks, becoming an
integral part of these important daily routines.
Jonty explained the concept:
“I wanted the lasting legacy of my project at Crossroads
House to reflect the importance of conversation; it’s not
always easy for us to find that point of departure that sparks
a conversation - that helps us identify shared aspects of our
individual history.”
The cups and saucers, inscribed with a single word free
from any context, act as a prompt or visual trigger, which
stimulates the imagination or provokes an unexpected
In Hartlepool, Queens Meadow care home treated their employees
to pampering sessions in a relaxing chair, complete with a duvet and
pillows. Each member of staff was also served drinks and chocolates
and had other colleagues, including managers, at their beck and call
whilst they enjoyed the experience.
The Gables, in Middlesbrough, provided their staff with relaxing
traditional massages and ancient Reiki treatments, carried out by
local professionals to make their workers feel special.
Liz Jones, customer relations officer at Hill Care, said: “We have
amazing staff across all of our homes who work tirelessly to ensure
our residents have a wonderful experience and everything that they
need.
“After hearing about National Employee Motivation Day, we knew
that we wanted to take part and make our staff feel appreciated for
everything they do and to inspire them to continue their invaluable
work. Everyone really enjoyed the activities that were planned and,
as the day was so successful, we will certainly be taking part again
next year.”
response.
Jonty tested out words using flashcards, choosing 100 which
inspired the most reaction. The cups and saucers were then
specially made by British-Japanese designer Reiko Kaneko
using Fine bone China.
Care home keep fit with
innovative exercise class
A Hartlepool care home is helping residents keep fit by
introducing specialist exercise classes designed for the elderly.
Like other artists taking part in the project, Jonty’s work has
been commissioned in collaboration with Cornwall’s top art
institutions; in this case Newlyn Art Gallery & The Exchange.
Abbeyvale Care Centre, which cares for 48 residents from the
ages of 28 to 104, invited Nouveau Dance and Fitness instructor
Carly Taylor to introduce chair exercise to the class.
Gallery Director James Green, who visited the care home as
the cups and saucers were delivered, commented:
Chair exercise has been recognised as a way of maintaining and
improving the health and fitness of the elderly and less mobile in
a safe way.
“This deceptively simple idea will have a real and lasting
impact, promoting greater contact and engagement amongst
the residents, and also with their visitors and the care home
staff.”
“Jonty’s work is part of a larger conversation about the
relationship between older people and the arts - about what
more we can do to provide opportunities for creativity, and
what we might learn from encouraging greater scope for acts
of imagination in older age.”
Home Service is a three year initiative which will have
a lasting impact; other strands of the project include
storytelling, dance, theatre and music.
Home Service is funded by Arts Council England and The
Baring Foundation, who jointly committed over £250,000 to
the project in January 2014.
Julie Shield, manager at Abbeyvale Care Centre said: “The
residents really enjoyed the class which saw them get active and
carry out exercise in a very safe and secure environment. We
are hoping to make the class a regular event and I have every
confidence that it will improve and maintain the health and
wellbeing of the residents here at Abbeyvale.
“The expertise and experience that Nouveau Dance and Fitness
have made it a perfect partnership for us with our residents in
mind.”
Seated exercise has been noted to lubricate joints and keep them
flexible, strengthen and stabilize individual muscles and increase
blood circulation.
Studies have
also supported
improved
outcomes
for chronic
conditions
such as
hypertension,
diabetes and
osteoporosis.
We will be publishing Good Care Week initiatives in every issue of Care Talk ... so why not make every week a Good Care Week?
CHAT - CARE TALK COMPETITION
Care Talk
readers
Wanted – Good News
Stories
from
the
Frontline
n
o
i
t
i
t
e
p
m
co
At Care Talk we love shouting
about what is good in social
care, challenging negative
media perceptions and raising
the profile of our sector
through good news stories and
examples of excellence.
It’s time to blow your own
trumpet!
Many of the articles we receive are sent
in by colleagues, managers, care home
and domiciliary care providers, service
users, friends and relatives ... but so
often the amazing stories of examples of
excellence and innovation are not told
by those who have carried them out ...
YOU!
We at Care Talk want to encourage and
motivate the frontline workforce (this
includes the gardener, the cook, the
housekeeper …) to raise the profile of
the sector by writing about your own
examples of good practice.
•
How have you improved quality of
life for a service user?
20 I www.caretalk.co.uk
•
How do you help colleagues to
improve their good practice?
•
How do you involve relatives in your
care home?
•
Have you involved the local
community in any way?
•
Have you had an idea that your
company has taken on board to
improve services?
Through Care Talk we can share your
examples of good practice with your
colleagues in the sector – a great way to
initiate joint working.
Each month Care Talk readers will
be invited to submit an article that
highlights particular areas of innovation
and good practice. Care Talk will
choose a winner every quarter to
receive a two-night stay in a luxury
hotel, including an evening meal,
courtesy of PJ Care and Specsavers.
Winners and photos of them enjoying
their prize treat will be featured in Care
Talk.
So don’t delay, get writing today!
Email us at [email protected]
Sponsored by
specialised neurological care
Rules of competition
•
Articles must be written by the
individual who features in the article
demonstrating good practice and
innovation.
•
Word count is 600 words, plus
photos and an image of the
contributor.
•
Copy deadline is the first day of
the month prior to publication; e.g.
the copy deadline for March issue
would be 1 February.
•
Winners will be chosen by a panel
of judges and announced quarterly.
•
Winners will have a choice of UK
‘home’ or ‘away’ destination for their
weekend hotel stay.
•
The prize must be used within 12
months of winning.
•
There is no cash alternative.
How can we ensure safe
discharges?
Effective discharge planning can reduce readmission to the hospital, help in recovery of
the service user and avoid unnecessary distress for the service user and their families. We
asked a group of stakeholders ‘ How can we ensure safe discharges?’
The quango - Harriet Phillips, graduate scheme
manager, National Skills Academy for Social
Care
It’s all about having that central team around the person and
being aware that everyone involved in the care is
there to achieve the same thing. We’ve got to
co-ordinate and have a multi-disciplinary
approach, so for the person coming home,
everything is there. There are some really
bad hospitals where people have been
sent home where there’s been no food in
the house, no furniture, no money. This
situation happens when there has been
no discussion and co-ordination.
The manager - Mandy Sparkes, home care
manager, Bluebird Care Croydon
From a home care provider point of view, it’s to ensure that the
company who will provide the care when the person gets home is
involved in the discharge process, perhaps attending
the meetings to ensure everything’s safe before
going home and also a risk assessment of the
house is really important to make sure the
person can manage at home. I find that a
lot of the time, people discharging clients
have no idea what the home environment
is like.
The director,- Keith
Tancock, operations
director, Mihomecare
The home care
Provider - Sue Apps,
director, ASK Care Ltd
We go and see the client and
usually we get a referral from
the social worker and question
them about the client to give
us a good initial picture about
whether we can meet a client’s
needs. If we can’t, the conversation
ends there. We then go to the hospital with a very
comprehensive assessment tool and we like to meet
the family at the hospital where possible, so they’re
part of the discharge along with us and Social
Services. We involve district nurses if need be.
Discharge times can be unpredictable, so we keep
staff on standby to be there within the hour.
Conclusion
• following procedures
• effective planning
• effective communication
• involving families in discharge
process
The care home Provider - Jennie
Evans, care home manager, LRH
You have to plan it well in advance. Sometimes
I think it can be rushed because of beds – beds
cost money. The best way is to have a discharge
planning meeting so that everything is in place.
It should be planned alongside domiciliary care
agencies and social workers and probably
nursing teams within the community. When it
doesn’t work, someone can go home and die and
nobody know for months. We shouldn’t have to
fight for discharge summaries!
It’s about the details and
doing things properly. It’s
about communication and
following agreed procedures.
There’s nothing in theory
complicated in it, and all the
procedures needed are in
place provided they’re used.
We need information that is
concise and communicable
enough that it’s understood
in every format it needs to
be understood in. Lengthy,
complex notes are not
very helpful to anyone
– it’s basically all about
communication - getting the
information down to the core
essentials.
www.caretalk.co.uk I 21
CHAT - PLANET JANET
How come we have an acute
shortage of clinical staff, especially
nurses in this country?
How come our hospitals are having
to travel to other parts of Europe and
the rest of the world to pinch their
trained nursing staff and induce them
to come and work here? I gather
we’re currently targeting Spain to
fill nursing gaps, and with some
success as the Spanish economy
is sufficiently unstable to unnerve
the staff it has invested in and
qualified, only for their experience
and expertise to benefit another
world economy that happens – at
the moment anyway – to have the
means to offer them better terms and
conditions than their home nation
can.
Why cannot our universities and
teaching hospitals process the
training of sufficient number of staff
to supply our own capacity needs?
It’s an old saw but what would be
wrong with reducing the academic
22 I www.caretalk.co.uk
qualification criteria and admitting
more practically-minded nurses to
full the old State Enrolled Nurse
function. And at the same time,
re-introducing the concept of wardbased teams that old-fashioned
ward sisters and matrons fostered so
effectively in the past. How come our
teaching hospitals and universities
are not processing sufficient number
of our own staff to fulfill these roles
rather than stripping that talent out
of other countries and importing it
here?
The shortage applies equally to
doctors, especially those middlegrade doctors who can substitute
for consultants and make decisions.
In my local area a paediatric unit
is being made day-only because it
cannot recruit sufficiently qualified
middle-grade staff to run safe
services. It’s true the system
was under-utilised and, as such,
unattractive to the sorts of young
doctors still making a name for
themselves and wanting to be at the
‘sexy-end’ of operational and clinical
practice.
Allied healthcare professionals are
also in short supply as the trend
towards specialisation has thinned
out the generic pool to the extent
that waiting times for some specialist
therapies is longer than getting to
see a consultant in the first place.
Times are hard and the money is
getting tighter but surely there can
be no better function than to use
public monies on the training of
home-grown nursing and clinical
staff? I think it was Winston
Churchill who made the boast that
free milk was a sound investment.
The babies whose health and future
he was securing in are now the
baby-boomers who need health
intervention. Surely there is no better
place to invest now?
My vote in the May Elections will
be with whichever party ‘gets’
this. Along with the economy and
immigration – all connected – there
can be no doubt about why the crisis
in funding capacity in healthcare will
be the third platform on which the
next General Election is won or lost.
CHAT - THIS IS YOUR LIFE
This is Your Life
‘My Arthur’s carers were so kind –
now I help them out as a volunteer’
Devoted Margot Whalley is repaying the
kindness of the care centre which looked
after her husband Arthur in the last months
of his life by returning as a volunteer.
and residents – and I feel close to Arthur
somehow whenever I go back.”
Eventually, Margot was persuaded that her
husband needed specialist care.
Margot catches two buses from her home in
Stony Stratford for her volunteer work at the
centre which mainly revolves around helping
the 22 residents with their drinks and meals.
“I feel close to Arthur
somehow whenever I go
back.”
“I don’t get involved in their personal care, of
course,” said Margot, “but I do spend time
sitting and chatting with residents.”
Arthur and Margot met in 1955 when
they were both working on the railways in
Wolverton. Margot worked in the offices, and
Arthur was a coach finisher.
They were married in 1959, enjoying an
idyllic life together, which Margot says was
full of laughter and smiles.
Arthur had dementia and had been
receiving specialist care at the Bluebirds
Neurological Care Centre in Milton Keynes
since September 2011. He died, aged 78, in
January.
“Margot catches two buses
from her home in Stony
Stratford for her volunteer
work at the centre”
Now Margot goes back to Bluebirds as a
volunteer carer twice a week as a ‘thank you’
to the Shenley Lodge centre and its staff for
the kindness they showed her husband.
Bluebirds is owned and managed by
independent care provider PJ Care, the
UK’s leading provider of neurological care,
treatment and rehabilitation.
The centre was recently awarded its Gold
Standards Framework certification for
providing high quality end-of-life care.
“Arthur was so happy during his time at
Bluebirds,” said Margot, who’s 75. “He was
treated with so much compassion, love
and respect, and everyone was so kind.
After he died, I just felt like I wanted to give
something back to Bluebirds.
“I’d made so many friends there – staff
“Arthur was always a lively, happy person
with a big laugh. I remember, before we got
together, sitting in a cinema and listening to
this chap behind us with a very loud laugh,
and thinking ‘I’m glad I’m not with him!’
“Only a few years later we were married!”
Margot and Arthur spent many happy times
together on walking holidays in Wales and
Scotland, and looking after their beloved
dogs.
“It’s difficult to say when Arthur began to get
poorly and lose his
memory, because it
came on so gradually,”
says Margot.
“Because he was a walker, it was difficult to
find the right place for him,” said Margot.
“We tried two other care homes, but they
couldn’t cope, and he wasn’t at all happy.
“He was on lots of medication, and not
himself at all. One day he said to me ‘I think
I’m losing my life, Margot’ – I cried all the
way home on the bus. But it was different
as soon as he arrived at Bluebirds. His
medication was adjusted so he was more
himself, and there was plenty of space for
him to walk.”
Arthur gradually became more and more
frail as his illness took hold, and he died just
before his 79th birthday on January 9 this
year.
“Some people might think it’s unusual for
me to go back to Bluebirds, but I find it very
comforting somehow. I still talk to him, and
tell him what I’m up to. He’ll always be there
for me.”
“He became absentminded, and then
confused about
some things. We’d
be out shopping and
he wouldn’t be able
to pack the bags
properly.”
As his condition
worsened, it became
difficult for Margot
to manage Arthur’s
behaviour. He began
to wander off for
miles from the house
because he liked to
walk.
www.caretalk.co.uk I 23
CHAT - RESIDENT CAT
Care creatures
Thanks to Lorraine Coultas,
registered manager at Meadow
Lodge Care in Kellington for
these lovely pictures.
Lorraine says:
“Meadow Lodge care home have
two dogs five chickens and one
large rabbit.
Our recent new resident was
previously in a care home where
he was unable to take his dog. On
completing the assessment with us
the gentleman was very depressed
and down without his dog who he
had for eight years.
I explained that his dog would be
able to come with him to Meadow
Lodge. I am delighted to say that
this gentleman is now a new man
because he as his dog Lucy with
him.
The chickens belonged to a
resident who had and ran a animal
sanctuary. Residents feed the
chickens and the staff feed the
rabbit.
Animals and activity play a big part
in people’s lives - so why should
people stop doing things just
because they have dementia!”
24 I www.caretalk.co.uk
CHAT - VOICE OVER
What makes a good leader?
Good leadership is key for motivating, developing and
retaining staff in order to provide quality care provision.
We asked a group of care workers “What makes a
good leader?”
Trishna Ruparel
Mediline Carers and Nurses
Marion Davison
North Lincolnshire Council
A good leader is someone who can look at
the quality of the service provided but also
support the staff to enable that to happen.
You need to be flexible but fair and not
discriminatory in any way. You can only expect
from others what you’d be prepared to do
yourself – that’s really important. We believe in
leading by example and keeping up to date
with things in order to deliver the service as
you want it delivered especially with recent
changes within the sector.
A good leader is an innovative person
who can show flair, motivate people
and take them alongside. That’s half
the battle in these days of austerity making sure people stay motivated in
order to carry out their daily tasks.
Diane Roberts
Enable Care & Support
Services Ltd
Helen Tarling
Radis
Someone who recognises their
own strengths and weaknesses
because if you can recognise
what you can do well and what
you may need support with, then
that’s a start to enable others to do
the same. It creates a culture of
honesty and a good approach to
problems.
Conclusion
•
•
•
•
•
•
•
innovative and motivational
skills
lead by example
flexible but fair
a culture of honesty
passionate about providing
quality care
invests in people
willingness to learn from
others
A good leader is someone who thinks about the
people they’re trying to inspire and puts their
interests first when thinking about what you’re
all trying to achieve, and bring them along with
you. We’ve put in place a Management and
Leadership Programme for all of our management
team because for us it’s very important we’re all
singing from the same hymn sheet. We try to lead
by example, as you might expect.
Paul Sturdgess
Blossoms Care
Services
It takes someone with
passion and drive and
a willingness to learn
and develop all the
time. A good leader
takes insight from the
staff team because
they’re the people
on the frontline who
understand what’s
happening . So you have to be prepared to listen
and lead from them. They will give you all the
inspiration you need to go forward.
Lorna
Stockdale
Cozycare
Ltd
A good leader
is someone
who invests in
people – time
and money.
And someone
who spends
time supporting them and leads from the
front. In my case, I go out and care with the
carers so I lead by example which I think
is valuable. It’s also good in the eyes of the
service user because no one goes out on a
new call without me going first. In this way,
we set the quality.
www.caretalk.co.uk I 25
CHAT - MRS MACBLOG
Mrs
MAC LOG
I’ve had a little stay in hospital again. Infection in my
waterworks apparently. The nurses were very nice to me but
it was all a bit hectic and they were too busy to stop and
chat much. I was glad to get home.
I’ve also got some sores on my legs that won’t heal. I’ve
knocked myself and the scabs keep coming off. The
district nurse comes in to change the dressings every day
and she says it can take a long time for this sort of thing
to heal because my skin is so fragile apparently. And you
know, I have noticed it doesn’t take much to bruise my skin
or for cracks and sores to appear. It’s paper thin!
I wonder why they can’t ask some of the care workers to do
some nursing tasks … ?
g
o
l
B
c
a
M
s
Mr
Mrs Mac is now 92 years old. She has
lived in extra care accommodation for
more than 6 years and she has been
widowed for over 12 years. She gets 4
calls a day.
I like the team of district nurses. They’re very practical and
though they seem to get on with the care staff here, you
get the distinct impression that they see what they do as
something very skilled and very special. I am sure they do
have to train a long time as they’ll never know from one visit
to the next what they’re likely to have to deal with. One of
them is especially good. I think she’s probably ‘old school’ –
a bit starchy but kind underneath.
They’re all run of their feet though. There’s a national
shortage of nursing staff it seems, both in hospitals and
in the community. I don’t know why. It always seemed to
be a very important role and quite well paid. But perhaps
they have to work too many long hours and have too many
clients.
You’d think we would give more priority to recruiting and
training people to be nurses. The whole NHS would grind to
a halt without them.
Challenge for care workers – discuss the
following issues.
1. Has Mrs Mac got a point? Could care workers do more
nursing tasks under the supervision and guidance of
the district nursing service? Would you want to?
2. Why do you think there’s a shortage of nurses? What
could the country do to ensure there are more?
3. Do you have a good working relationship with
the district nurses you come across? Could it be
improved? How might it work better?
4. Mrs Mac obviously has problems with a delicate and
fragile skin. Have you been given training in how to
handle her to avoid problems occurring?
26 I www.caretalk.co.uk
CELEBRATE
Sarah Evans, The Trainer Award,
CMG Ltd
Sarah Evans from CMG Ltd was the proud winner of the trainer award at
the National Learning Disabilities Awards 2014
What the winner said…
I am honoured to have received this award and am really
pleased that the work we do at CMG to try and develop
staff has been recognised at a national level. We are
constantly looking at ways that best practice can be
embedded whether it is through coaching, role modelling
or bespoke training around support for specific individuals.
I personally get great satisfaction from watching people
develop and really enjoy trying to make my courses fun,
interactive and relevant. I want delegates to go away
feeling that they can put into practice what they have
learnt.
The Learning Disability Awards are a great way of
recognising all the hard work that people in the sector do
on a daily basis. I would like to congratulate all the other
nominees and winners they all do such brilliant work.
What the judges said…
A driven and passionate trainer who is focused on
ensuring that training is relevant and embedded
throughout the organisation. Sarah uses a wide range
of tools and methods to maximise everyone’s skills.
Congratulations Sarah!
▲
Host Jeff Braz
ier with winne
r Sarah Evan
sponsor Debra
s and
Meta from C2L
Care to Learn
www.caretalk.co.uk I 27
CELEBRATE
New categories for National
Learning Disabilities Awards
The National
announced
15th May 2015,
ICC Birmingham
Learning Disabilities
& Autism Awards
Hosted by
Supported by
Four new categories have been
introduced to this year’s National Learning
Disabilities & Autism Awards.
The Making a Difference
Award
We are looking for the provider or
person, who has promoted inclusion and
community cohesion through their work or
role in the community – particularly where
this has helped make a positive change
happen in people’s lives. This person or
team may have a learning disability or be
working in the field of learning disability.
We are looking for an outstanding person
who works creatively and passionately to
ensure people with a learning disability
have equal access and involvement in
their community.
The Breaking Down
Barriers Award
We like it when we can see good
access and easy read, as it helps to
include all and encourages everyone
to communicate more clearly and get
around more easily. The award will
celebrate an individual or organisation
who have worked to make sure people
get clear information and are able to
28 I www.caretalk.co.uk
contribute their views and experiences.
The Sporting Chance
Award
Sport is an area where people with
disabilities can be seen as achievers
and winners, and participation in sport or
physical activities can improve people’s
health and wellbeing. We are looking
for a person or team who have worked
creatively to develop sporting activities
in which people with learning disabilities
and/or autism can choose to participate
and enjoy.
The Great Autism Practice
Award
The overriding goal of good autism
practice is to enhance quality of life
for individuals, families and supporters
by making reasonable adjustments or
providing support developing strategies
to increase happiness and wellbeing in
people with autism. This award will be
presented to a team or individual who
demonstrate evidence of good practice in
their services and support to people with
autism.
The National Learning Disabilities Show &
Awards will take place on 15th May 2015
at Birmingham’s ICC. The event is being
supported by the Department of Health
and VODG and are being organised by
Care Talk in association with the British
Institute of Learning Disabilities (BILD).
The awards have been well received
by the sector and are supported by the
Department of Health, National Autism
Society and the Care Quality Commission.
The purpose of the awards is to pay
tribute to individuals or organisations who
specifically support people with learning
disabilities and autism and celebrate
excellence in this area. Categories will
range from support worker, employer,
managers, trainers through to nurses and
best employer of people with a disability.
Nominations are being invited from across
the social care sector; including private,
statutory and voluntary organisations.
Shortlisted finalists will be invited to attend
a judging day and the winner will be
announced at the gala dinner.
Have you made your nomination? Visit
http://www.nationalldawards.co.uk/ to
make your nomination. Closing date for
entries 27th February 2015
SHOWCASE
Care Talk
on the road
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.
Nursing Homes, Care Homes, Assisted
Living, Domiciliary Care Services and Third
Age Housing
Leading change in dementia diagnosis and
support: actions to inform future national
strategy
11 February 2015
24 February 2015
Le Meridian, Piccadilly, London W1
Kings Fund, London W1G 0AN
Moving towards integrated commissioning:
how can we prepare for the future?,
Community health care services: what does
good care look like?
4 February 2015
26 March 2015
Kings Fund, London W1G 0AN
Kings Fund, London W1G 0AN
when it comes to healthcare, we never
miss a beat...
Browne Jacobson offers an award winning heavyweight corporate and commercial practice, combined with
a wealth of expertise in all aspects of health law, gained from our extensive experience in acting for private
sector, third sector, NHS and other public sector organisations. We take pride in working collaboratively with
our clients and are widely recognised as a leading legal advisor to the healthcare sector.
www.bjhealthlawyers.com
t 0115 976 6292
www.caretalk.co.uk I 29
LEARN
Principles for change
That’s why Skills for Care in partnership
with the Association of Directors of Adult
Social Services, Skills for Health, NHS
Employers, Think Local Act Personal, The
Centre for Workforce Intelligence and the
Local Government Association created the
Principles of workforce integration.
The principles underpin the idea that
integrating services alone will not solve the
problems of integrated care and support
but it is the integration of how people work
together which must take priority.
“It is the integration of how
people work together which
must take priority”
The principles suggest that integration
is about more than statutory social care
and health. It is also about how housing
workers, health workers in acute and
primary care settings, social care workers in
local authorities and independent voluntary
sector, people in their local communities
and other industries -such as the arts and
social care sports and leisure industries work together to deliver integrated care and
support.
The principles also suggest that workforce
integration involves the whole system.
How you integrate the way management
and administration work is as important as
how you integrate the way in which people
work together directly with people with care
support needs.
If you’re going to achieve genuine workforce
integration, it’s important to recognise
and overcome resistance to change and
transition. Integration demands that people
accept changes to their role and also
understand their professional identity will
likely be challenged. If workforce integration
does not take account of culture change
then is more likely to fail.
Confident, engaged, motivated and
30 I www.caretalk.co.uk
knowledgeable workers are far more likely
to actively support integration and far more
likely to engage effectively with their local
communities. The most valuable resource
in any organisation is its workforce and
successful integration implementation
has to look after its workers and engage
properly with its community if it is going to
be successful.
We see how this can work when we look at
the example of a man living in a northern
seaside town who was making numerous
calls to the local ambulance service. When
the care team spoke to him he told he
wanted to die. But when they probed further
to see what might improve his quality of life,
they found he loved fishing. So using their
community contacts they found a fishing
club to take him out. The result was the
man felt better about his life and his calls to
the emergency services
dramatically reduced
as care, health and
the community came
together around his
needs.
The same thinking
applies with projects
we are running with the
Housing Learning and
Information Network
seeing how we can
make sure people with
mental health issues
can get decent housing
when they return to
the community, or
looking at the impact
of an onsite domiciliary
care team in sheltered
housing.
ou can argue that
integration has been
on many people’s
agendas for many
years but we may
have spent too much
time focusing on how
we integrate services
structures and not
enough time ensuring
that workers feel involved, valued and
respected.
The principles are designed to to focus
the skills, knowledge and expertise
services already have in working together
in integrated ways to achieve the best
outcomes for people with care and support
needs.
“It’s important to recognise
and overcome resistance to
change and transition”
Jim Thomas, innovation programme
head, Skills for Care
LEARN
Intimacy in care homes for
people living with dementia
*From the moment we are born we
have a basic need for intimacy and
this need for intimacy remains strong
throughout our lives until the moment
we die.
for intimacy manifests itself differently
as dementia progresses. This is crucial
if teams are to respond in a consistent
and empowering way to people living in
care settings.
Intimacy is not just a euphemism for
sex. Intimacy provides us with an
opportunity to share the range and
depth of our emotions and to experience
emotional connectedness. Intimacy
is fundamental to wellbeing, which, in
dementia care, is at the heart of the
person centred approach. Yet, when
we begin to think about equipping care
home staff to understand how intimacy
is sought and expressed by people
with dementia living in care homes that
simple notion of intimacy can become
overshadowed by complex ethical and
legal considerations. Many high profile
media cases have put the spotlight on
the issue.
*It is helpful to look at intimacy as
an individual process through which
people connect with and relate to one
another, rather than focus on intimacy
as discrete incidences of behaviour.
When we build relationships with other
people this takes place over time. We
gauge the quality of our relationships
by how our sense of intimacy develops.
People with dementia moving into care
homes begin to build new and very
meaningful relationships which may
parallel past and present relationships
they have with family and friends.
No-one would argue with the idea that
capacity, consent and safeguarding
of vulnerable adults are important in
training on intimacy. Discussions about
those concepts play into a wider space
about assuming capacity in people
living with dementia; and challenge
the notion that a diagnosis of dementia
equates with blanket lack of capacity.
So while *training for care home staff
should include legal and ethical
principles surrounding capacity,
safeguarding and consent, it is
equally important that this is not
where training on intimacy begins
and ends.
People give and receive intimacy in a
range of ways, including the expression
of sexuality, and care staff need to be
equipped to create opportunities for
people with dementia to have their need
for intimacy met. Care planning should
be informed by how the person’s search
Supporting a person with dementia
to meet their need for intimacy in a
care home involves staff in helping
close, long-standing and family
relationships to continue while also
providing opportunities for new
relationships to develop. Long-standing
relationships can be supported, and
new relationships can be helped to grow
through involving people in meaningful
occupation that provides an opportunity
to bond through belonging and shared
achievement. Gradually, trust develops
and people feel comfortable sharing
thoughts and feelings with one another
which, in turn, generate emotional
intimacy.
context, but people with dementia
find it hard to reason in that way. For
them it’s the intuitive sense that their
helper is someone close which makes
embarrassing and stressful elements of
care easier to accept.
*Training must enable care
staff to support long-standing
loving relationships and provide
opportunities for people to connect
with one another in care settings.
This is achieved by recognising
opportunities for intimacy in the
broadest sense as an individual process
through which we communicate
closeness.
Jenny Mackenzie, acting business
development manager, Alzheimer’s Training
and Consultancy
[email protected]
*Trust and emotional intimacy are
significant indicators of how well a
person with dementia copes with
accepting personal care and support.
Imagine being helped to use the toilet
by people with whom you feel no
particular emotional bond or trust. That
type of intimate physical care scenario
becomes easier to rationalise if it
involves a professional in a care related
www.caretalk.co.uk I 31
LEARN
Health and social care
qualifications see the
biggest growth in vocational
Health and social care achieved the
biggest growth in successfully completed
qualifications of any vocational subject last
year, according to new analysis of government
data by Prestige Nursing and Care which
indicates a rising level of skills among the UK’s
care workforce.
“Just 5% were attracted by
the future prospects and
progression opportunities.”
A record 917,840 health and social care
qualifications were successfully completed
between October 2013 and September 2014.
This was the highest total since records began
in 2002 and was up 25% from 2012/13. The
182,613 extra achievements were more than
twice the number seen in any other area of
vocational study during 2013/14.
New registrations for health and social care
qualifications also jumped by 74% from
322,201 in 2012/13 to 559,048 last year.
This was the largest number in four years,
since 2009/10 . Performing arts was the only
subject area that saw a greater increase yearon-year in 2013/14.
With business secretary Vince Cable having
announced new ‘trailblazer’ apprenticeships
in adult social care, the growing profile of
vocational training in the industry could help to
combat recruitment challenges that employers
face as demand grows for nursing and care
services.
Recent research from specialist recruiter
Randstad Care highlighted the widespread
view that health and social care is the most
fulfilling profession to work in. But Prestige’s
own research among the 3,000 staff registered
with its business shows that while 63% are
attracted to the industry because they want
to care for others, just 5% were attracted
by the future prospects and progression
opportunities.
Jonathan Bruce, managing director of Prestige
Nursing + Care said: pic
32 I www.caretalk.co.uk
“The country is facing a prolonged period of
rising demand for care support, so it is vital
that we attract new staff and invest in skills
to create a more sustainable workforce. It
is hugely reassuring to see that health and
social care stands out for achieving the fastest
growing success rate in any field of vocational
study.
“A greater profile for training and development
across the industry is essential to expanding
the pool of qualified talent and delivering costeffective care services. For example, our own
Introduction to Care course is helping to give
aspiring care workers a foot in the door at the
very start of their careers. More than 500 staff
have benefitted in the last year alone, and it
is proving invaluable to overcome the limited
availability of experienced domiciliary care
workers.
“We have committed to this as a business
well in advance of the new Care Certificate,
which arrives in April 2015 to ensure consistent
inductions, preparation and initial training
across the industry. With new apprenticeships
also coming on-stream, it is vital that
employers continue build on these platforms
and make staff recruitment and training a top
priority.”
“Anyone considering a
career in health and social
care should be encouraged
by this evidence that support
is out there from employers”
Health, public services and care see the
greatest sector growth
Overall the health, public services and care
sector – which includes nursing and subjects
allied to medicine, public services and child
development, alongside health and social care
– was one of only three to see qualification
successes increase in 2013/14 (out of 15
sectors in total). However, without the boost of
rising numbers in health and social care, the
overall sector would have seen registrations
drop by 49 in 2013/14 while achievements
would have fallen by 24,887.
Employers focused on addressing skills
gap at level 2 and 3
Within health and social care, level 2
qualifications – typically aimed at new entrants
looking for their first care job or existing care
workers carrying out supervised roles – saw
numbers grow the most in the last year.
Registrations at this level rose 185,796 while
achievements grew by 163,974.
Level 3 qualifications – suitable for
experienced staff working with limited
supervision or aspiring to more senior roles –
recorded the next largest growth, with 64,597
extra registrations and 54,167 completions
during 2013/14.
Lesley Blower, learning and development
manager of Prestige Nursing + Care
continued:
“Dedication to skills is the only way that health
and social care services can successfully take
the weight of responsibility to support local
community needs. As well as training and
developing new entrants, it is important we
help existing workers to progress up the ranks
and tackle the skills gaps that exist in senior
roles.
“Anyone considering a career in health
and social care should be encouraged
by this evidence that support is out there
from employers to develop new skills and
competencies. Many people enter the sector
wanting to ‘make a difference’ to those in need
of support and compassion. Matching these
ambitions with the right training and skills is
essential to making the care experience a
satisfying one for everyone involved.”
SPECIALIST SERVICES
Evaluating the Positive Behaviour
Support Model in Practice
Katie Jane Davies, Assistant Psychologist at
Care Without Compromise
At Care Without Compromise (CWC), our aim is to enable adults with
learning disability and challenging behaviour to achieve positive
outcomes. These aims reflect the all-encompassing Positive Behaviour
Support (PBS) model, the primary aims of which are to increase quality of
life, reduce occurrences of challenging behaviour and minimise the use
of restrictive practices.
there would be a higher use of reactive strategies). Based on clinical
experience, it was expected that Penscynor House would be rated the
more challenging house on the ABC. The lower self-report ratings could
be due to the staff becoming desensitized to the level of challenging
behaviour.
CWC commissioned a formal evaluation of its services and recruited two
postgraduate psychology students for this purpose (Katie Davies and
Matthew Hodder) which focused on how well the company performed
on these critical outcomes for the people that it supports. Our inspiration
to conduct the evaluation stemmed from the findings of Winterbourne
View and the detrimental effect excessive physical and pharmacological
restraint have on service users and their quality of life.
A central characteristic of the PBS model is that it takes into account
the mediators for behavioural interventions; therefore this evaluation
sought the views of the staff team on how they thought the company
was performing as well as the views of external stakeholders (family
members, care managers and supporting clinicians).
The evaluation focused on five key areas including:
•
•
•
•
•
Service user characteristics i.e. the level of challenging behaviour
was measured using the Aberrant Behaviour Checklist (Aman &
Singh, 1994)
Service inputs (as measured by a bespoke tool, Service Receipt
measure)
Service user outcomes were measured using the Guernsey
Community Participation and Leisure Assessment (GCPLA) (Baker,
undated)
Staff views were obtained using a bespoke measure, the Staff
Satisfaction Evaluation Tool (SSET) containing items regarding
confidence in managing aggressive behaviour derived from
Thackeray (1987)
Family and care manager views were gathered through interviews
The evaluation looked at two homes within CWC (Nant Leiros House and
Penscynor House) and spanned over a five month period.
What did we discover?
All the residents had long-term histories of presenting with serious
challenging behaviours and had typically experienced multiple
placements and placement breakdowns. When conducting the Aberrant
Behaviour Checklist (ABC), results showed that the service users in
CWC are comparable to other populations with learning disabilities and
challenging behaviour albeit to a slightly higher level. Nant Leiros was
rated higher on the ABC than Penscynor House in terms of severity of
challenging behaviour.
It was interesting to note that the trend in the use of reactive strategies
was the opposite to what we predicted from ABC scores (i.e. Nant
Leiros residents score more highly on the latter therefore we predicted
We found there was a remarkably low rate of use of reactive strategies in
the first two years of the service, and then an accelerated frequency of
use just after Penscynor House opened (May 12). This perhaps reflects
the settling period with new residents and a new staff team.
When comparing the GCPLA Data (community participation and leisure
activities), the results were comparable to that of other individuals with
learning disability but not challenging behaviour (comparison data from
Baker, undated).
Feedback from the staff measure reflected that most staff felt confident in
supporting people that challenge, but a consensus emerged that there
was a need for improved supervision within the service.
It was possible to conduct interviews with 7 out of the 9 residents. The
majority expressed positive views about living at CWC, and identified a
number of positive features about the service.
Future directions
The overall conclusion from the evaluation is an extremely positive one
and the desire to seek an external review of the company is positive and
should be applauded. The evaluation has identified a number of ways in
which we can improve the service that we deliver in terms of quality of
supervision and training, developing PBS plan/functional assessments,
staff responses to challenging behaviour (sensitisation) and support.
As a result of the utilisation of the PBS model and as an indirect result of
this evaluation, CWC was awarded a Social Care Accolade for ‘Improving
lives in residential care through restraint reduction’.
An 18-month follow up evaluation will take place with a broader sample of
12 residents from 3 houses. The aim is to see if the areas of improvement
from the original evaluation are being addressed proactively and
efficiently. Service user and carer involvement is paramount in order to
deliver a service that truly meets the needs of the service users, carers
and staff team.
www.caretalk.co.uk I 33
SPECIALIST SERVICES
Improving the quality of training for
staff supporting people who challenge
The BILD Code and Accreditation
Scheme
The issue of the use of physical
restraint on people with learning
disabilities in residential homes and
hospitals has increasingly hit the
news in recent years, the most high
profile example being the BBC’s
secret filming at the Winterbourne
View hospital outside Bristol,
broadcast by Panorama three years
ago. This resulted in the closure of
the hospital and the prosecution of
many of the staff involved.
We’re also seeing an increasing public
debate about the use of restraint in schools.
A parent-petition to the Scottish parliament
on the need to establish clear guidance for
schools and staff around restraint and the
use of seclusion and misuse of ‘time out’
rooms is currently gaining media attention
and lots of public support. This petition
calls for the use of restraint to be one of ‘last
resort’, to be done only by trained staff and
that those staff should be trained by BILDaccredited training providers.
the training, as well as preparations
for successfully implementing restraint
reduction initiatives.
The Code also asks for any physical
techniques to be accompanied by a
full biomechanics, physiological and
psychological risk assessment for use of the
techniques in a training environment, as well
as information on what additional factors
should be considered during an individual
risk assessment for the use of techniques
with a specific individual.
“The BILD Accreditation
Scheme has long been seen
as an indicator of quality
and good practice for those
providing training”
Both the Code and Scheme have been
tried, tested and improved over the last
12 years. They have made a significant
contribution to improving the quality of
training for staff and the development
frameworks of organisations supporting
people
The BILD Accreditation Scheme has long
been seen as an indicator of quality and
good practice for those providing training,
and for those commissioning training in
their service. A key aim of the scheme is
to minimise the use of restrictive physical
interventions and to promote the use of
positive behaviour approaches in the
support of people who can experience
difficulties in communication or managing
their emotions and use behaviour as a way
to express themselves.
The BILD Accreditation Scheme isn’t
compulsory, it is a voluntary scheme and
while BILD wouldn’t say that there aren’t
good training providers who are not BILD
accredited, the fact that an organisation has
been through a robust process of submitting
their work to external scrutiny and testing,
by a panel of experienced professionals,
does suggest a standard has been proven.
The BILD Code of Practice acts as an
evidence based assessment framework
for the Accreditation Scheme. It requires
organisations to demonstrate their own
framework for developing and delivering
34 I www.caretalk.co.uk
“We were delighted when we were awarded
BILD accreditation,” says Simon Plummer,
Clinical Lead for Learning Disabilities,
South West Yorkshire Partnership NHS
Foundation Trust, “Although it’s not a
required accreditation within the NHS, it’s
an indicator of quality and good practice
within our service.”
“The Scheme offers both an
effective framework with a
strong values base, and a
clear accreditation process
overseen by experienced
professionals”
Working together, the Code and
Accreditation Scheme offer both an effective
framework with a strong values base, and
a clear accreditation process overseen by
experienced professionals, which can be
applied in organisations and to the training
and development of staff supporting
children, young people and adults in a
range of settings across education, health
and social care.
The BILD Accreditation Scheme is seen by
many as a clear indicator of a commitment
to minimising the use of physical
interventions and restrictive practices, and
to the application of positive behaviour
support approaches in the lives of people
being supported. Significant improvement
in the quality of their lives is the ultimate
purpose of all this work.
Phil Howell is Manager of the BILD
Accreditation Scheme, he can be
reached via [email protected] There
is more about the scheme at www.bild.
org.uk/accreditation, and about the Code
of Practice at www.bild.org.uk/Code
WELLBEING
Advertorial
Specsavers Healthcall:
a name you can trust in the
eyecare service
At Specsavers Healthcall we believe that
everyone is entitled to the best possible
eyecare service, including those who cannot
visit an optician unaccompanied.
It is a new part of the business, and one that
Specsavers founder Dame Mary Perkins is
very proud of.
Dame Mary spent much of her early career
as an optician doing home visits. And with
Specsavers in its 30th year she is delighted
that Specsavers is now taking its great value
eyecare to people at home.
“It very much matches up with our vision of
eyecare for everybody. After 30 years some
of our longstanding customers are now
housebound or in care homes so this enables
us to continue our care for them.”
The same great service as in our
stores
Specsavers Healthcall opticians conduct care
home visits, delivering a service that focuses
on the specific needs of the individual while
also offering unparalleled value and choice.
It’s all about making life easier for you and
better for your residents. They will have access
to a wide range of frames and lenses and
our opticians will be able to explain to each
individual exactly what’s available and which
offer is the best value for them.
laboratories than any other care home service
provider, so your residents will receive their
glasses in the quickest possible time.
The frame was available in dark tortoiseshell,
light tortoiseshell, light blue, pink, crystal and
black.
Care home visits – then and now
“All the men tended to opt for dark tortoiseshell
or black and most women preferred pink.
Ironically this style of glasses is now very
popular again and we stock several similar
frames to NHS 524, including several designer
styles.”
Dame Mary, 70, grew up in the Bristol with her
parents. Her father spent many years working
in a chemist before re-qualifying as ophthalmic
optician. He went on to run his own practice
in Bristol for 10 years before retiring. Through
word of mouth he established a lot of requests
for home visits and from a young age Dame
Mary joined him to help.
“He made regular visits to several retirement
homes, an unmarried mother’s home and a
closed convent. It was very varied.
“When he retired my husband Doug and I
bought out his business and I took on the
home visiting work alongside testing in-store. I
continued doing this until we sold the business
in 1980. One of her regular stops was a huge
care home based in an old workhouse called
100 Fishponds Road.
“There were hundreds of elderly residents in
there. It was nothing like the care homes of
today, but, just like today, the residents were
very grateful for the eye care.”
The testing equipment she used in the 1960s
and 70s was very primitive compared to
the state of the art mobile that Specsavers
Healthcall uses today.
“I performed a simple sight test with a chart
on the wall and did basic retinoscopy. I could
help ensure they could see well enough to
read the paper and that was about that.
“Today our mobile optometrists carry out very
thorough eye examinations.”
Full circle fashion
Once a resident has chosen their glasses,
they will want them as quickly as possible.
Specsavers Healthcall has more optical
36 I www.caretalk.co.uk
Everyone in those days had a free NHS sight
test and almost everyone opted for the free
NHS glasses, which were the thick-rimmed
plastic rectangular style known as NHS 524.
Ensuring staff are fully informed
Dame Mary recalled: “Specsavers Healthcall
offers awareness training to all care home
staff, to help equip you and your colleagues
with an understanding of a number of common
eye conditions and how they might affect your
residents in their day-to-day activities.”
A familiar face
One of the first benefits of the service is that
Specsavers Healthcall customers will have
consistent teams, meaning that your residents
get to know their optician. They will have
access to two-person teams, comprising an
optician and a customer services director.
Dame Mary concludes: “We are in the
business of caring and know that strong
personal relationships have a big part to play
in providing an effective service. Having a
dedicated team also means that you’ll only
need one telephone number for all enquires
and that the optician is able to deliver a very
personal service to every resident.”
Need more information? To book a visit from
your local Specsavers Healthcall team, call
0800 198 1135 or visit specsavers.co.uk/
home-eye-tests.
NURSING
How ‘special’ does ‘Specialist
Dementia Care’ need to be?
Caroline Baker, director of dementia care, Four
Seasons Health Care
and ambassadors for dementia care such as Christine Bryden, Peter
Ashley and Kate Swaffer who are all living with dementia are keeping
us all on our toes. We may be the ones helping to provide the
expertise but our expertise can only be learned from the people who
can tell us how the experience of living with dementia is.
Largely, the people who have been diagnosed with dementia and
speak at conference are in support of the work of Tom Kitwood
(Kitwood 1997) and his thoughts about person centred care but
we still have a long way to go. Kate Swaffer has a regular blog and
is quite rightly pushing for some of the terminology to change that
continues to demean and demoralise people living with dementia –
how many of us would want to be referred to as a wanderer?
But how do we measure that we are doing a great job? Is it what our
regulators tell us? What our relatives tell us? Or is it (and should it
be) what our residents tell us? Sometimes it can be difficult to truly
involve our residents who have an advanced cognitive impairment
in evaluating their own care but if the person is not able to tell us, we
should be carrying out observational assessments such as Dementia
Care Mapping (Bradford 2005) to ensure that we are helping to
maintain or raise a resident’s well-being and if we are not, what are we
going to put in place to make sure that we do all that we can to make
that happen?
Look in any brochure for any care home providing dementia care and
you are likely to see the term ‘specialist dementia care’ but what does
it mean?!
Does it mean that that dementia care in itself is a specialist type of
care (agreed) or does it mean that the people providing the care are
special (in the main) or does it mean that the service itself is providing
the most up to date evidence and research based practice (not
always).
If it is the latter and we describe ourselves as providing specialist
dementia care, how do we as providers evidence that?
In 2008, we piloted a programme called PEARL (Positively Enriching
And enhancing Resident’s Lives), involving the implementation of one
hundred evidence and research based criteria, along with specific
training and support for ten homes. Within those ten homes, we
found that there had been an average of 52% reduction in antipsychotic medication over a one year period, a result so incredible
that I had to revisit the data that we had collected.
It seemed we had found a ‘winning formula’ to assist our residents
living with dementia to experience a higher quality of life and a
process that would help our staff to become specialist within their
field, moving away from task orientated care to a truly person centred
approach, keeping the residents at the heart of the home.
Dementia care has progressed significantly over the past decade
38 I www.caretalk.co.uk
Following the pilot programme, we worked with Professor Dawn
Brooker (Brooker 2007) to develop PEARL and align it to the much
acclaimed VIPS criteria (Valuing, Individual, Perspective, Social
Psychology) and each year, we review the criteria, revise our policies
and adapt our training to ensure that we are delivering the most recent
thinking in dementia care.
We now have 80 homes that have accredited PEARL specialist
dementia care units, many improving their score year on year and
a further 60 developing on the programme. We continue to see
incredible outcomes for residents such as increases in weight,
reductions in falls and reductions in depression scores to name but a
few (for full report please see http://www.fshc.co.uk/binary/CFh.pdf )
So do we provide Specialist Dementia Care? Yes we do.
References:
Brooker, D. (2007) Person-centred Dementia Care: Making Services
Better. London:
Jessica Kingsley Publishers.
Brooker, D. and Surr, C. (2005) Dementia Care Mapping: Principles
and Practice.
Bradford: University of Bradford.
Kitwood, T. (1997) Dementia Reconsidered: The Person Comes First.
Buckingham:
Open University Press.
Kate Swaffers Blog: http://kateswaffer.com/daily-blog/
TECHNOLOGY
Technology’s role in quality care
The issue of quality is a topic that continues
to be hotly debated in the care sector.
Whether this is around the quality of care
provided, the quality of education and
welfare of staff, the list goes on. And with
good reason, because quality counts in
every area of life and no more so than when
you’re dealing with people.
We apply the same approach in our own
area of expertise, that of technology. It’s
engineered with efficiency and compliance
in mind and designed to support growing
care providers. Having a solid integrated
system in place that is robust and reliable
provides a vital foundation to support the
improvement and consistency of quality
care and ensure the effective running of
the organisation. Within a people-centred
sector, making the right efficiencies do
matter, because they help to shape the
experience of the care receiver.
“It is critical to capture
intervention as it happens
so that any actions can be
promptly recorded.”
Technology ensures that nurses and care
staff don’t have to decipher hand written
notes or find mis-filed documents. That’s
frustrating and doesn’t serve anyone.
Handheld barcode scanning devices
means the care reporting can happen
there and then whilst the carers are with
a client in the care home. It is critical to
capture intervention as it happens so that
any actions can be promptly recorded. It’s
always difficult after the fact as we’re all
prone to forget - and that forgetting can
have a huge impact on the client.
care home group without having to trawl
through endless handwritten notes and
spreadsheets that can easily get lost,
accidentally deleted or misplaced, is much
more efficient. A single system where all
information is stored therefore makes sense.
Being able to see everything from client fee
payments to client admission details and the
ability to track hospitalized clients enables
better organisational management. Even
something as simple and being alerted
at the rostering stage if a member of staff
doesn’t have the correct qualifications
makes it easier to ensure the provider
remains compliant.
“Being able to see
everything from client fee
payments to client admission
details and the ability to
track hospitalized clients
enables better organisational
management.”
Care providers and their care staff have a
difficult job to do and face so many issues
from funding constraints and regulatory
burdens to pressures upon service
provision, staff shortages and training
issues. Managing these with the right
software will make it easier to organise
courses, juggle staffing requirements and
generally make better use of resources.
It also makes it easier when it comes to
planning and forecasting for the future.
Of course, it needs buy in from everyone
in the organisation but when people can
see the value that it will add to them and
their working environment, as well as the
benefits to the care receiver, they are more
likely to get on board. It will be important to
recognise that, for some however, this is a
total shift in the way they’re used to doing
things. Such change can be frightening
so it’s important to have the right support
mechanisms in place to help staff through
this change process. With time even the
most resistant will see the value of this new
way of working – particularly where it offers
up greater opportunities to improve the
quality of care for clients.
By Paul Patarou, divisional manager,
health & social care division, Access
Group
The data collected can then be downloaded
automatically to a central system where it
can be securely accessed by authorised
staff and management. Information like this
is invaluable to gain a deeper understanding
of care performance, care requirements,
and to report to other stakeholders. It
enables domiciliary care providers and care
homes to take a closer look at the issues
and trends so that they can take the most
appropriate action.
Being able to manage a domiciliary or
www.caretalk.co.uk I 39
Advertorial
TECHNOLOGY
Innovative Nurse Call
Technology from Aid Call
For thirty-five years Aid
Call has been leading the
way in the manufacture
of wireless Nurse Call
technology. They offer a
wide range of products
and bespoke solutions
that are designed
specifically for the Care
Home environment.
A wealth of industry
experience and a focus on
development secures Aid
Call’s wireless Nurse Call
solutions as the best on
the market.
Despite being packed full of the
latest technology, all Aid Call
devices are designed to be easy
to use by both staff and residents.
This will reduce the need for training
and will lessen the time taken to use
the device on a day to day basis;
allowing your staff to be where they
are needed and improving resident
care.
Efficient
Their range brings innovative,
powerful features to your Care Home
without compromising on safety or
reliability. Improving the speed of
call responses and increasing the
depth of information available to both
staff and management will heighten
team performance and support staff
in providing the most effective care.
40 I www.caretalk.co.uk
Flexible
An Aid Call wireless Nurse Call
system will offer complete flexibility
and mobility. Without having to
rely on cables and stationary
wiring points, installation is quick,
undisruptive and is specific to each
site. Furthermore, the system can be
adapted easily and added to over
time.
Affordable
Aid Call systems are built in
consideration of the huge financial
pressures facing Care Homes.
They are future proofed and are
easy to maintain. This, combined
with innovative features and proven
functionality, positions them as
a hugely cost effective solution.
The adaptability of their systems
amplifies this as they can be tailored
to suit different budgets.
Usable
The Touchsafe® range is designed
to be easy to use by both staff and
residents. This will reduce the need
for training and will lessen the time
taken to use the device on a day to
day basis; allowing your staff to be
where they are needed and giving
your residents confidence in using
the system.
Aid Call are positioned as a unique
supplier within the increasingly
competitive nurse call market by
TECHNOLOGY
offering flexible, highly adaptable devices that provide
effective care solutions. They boast a wealth of useful
features without the need for prolonged or complicated
training. Through improving staff productivity they
significantly improve levels of care and they instil
confidence in patients who are reassured that help is
always nearby.
For more information visit www.aidcall.co.uk or call 0800
052 3616 to arrange a meeting with a product specialist.
mes and the Care Quality Commission (CQC) is
tightening disciplinary measures to try and prevent
deterioration. A quality, affordable Nurse Call system
can support staff in offering a high level of care without
necessitating huge, ongoing financial commitments. This
will help to reduce the gap between the growing needs
for care services and the insufficient funds available to
provide effective care.
Let’s remove
the stress
Supporting over 100,000 residents nationwide,
Aid Call wireless nurse call systems are…
�
�
Efficient
Reliable
Powerful
�
�
�
Simple to use
Future proof
Cost effective
0800 052 3616
www.aidcall.co.uk
0 220 (20
30
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7)
EN
�
Quote Ref: CTALK
TECHNOLOGY
Advertorial
How can mobile technology
improve both care worker
safety and data security?
To find out how
Advanced are
helping over
36,000 care
workers be
more efficient,
contact them
now on 01233
722670 or visit
www.advanced
computer
software.com/
android.
When implementing
a mobile strategy it is
important to ensure
that care workers are
safe whilst working out
in the field and that all
confidential data is kept
secure.
Julie O’Connor, head
of mobile products at
Advanced Health & Care
(Advanced) comments
why introducing mobile
technology such as
iConnect on Android to
the workforce can help to
improve both the safety
of care workers and data
security.
Organisations such as
the NHS, Ministry of
Justice and Kent Police
have all experienced data
security breaches and
received substantial fines.
These instances are not
just restricted to larger
organisations.
A Welsh home care
provider was found to
be in breach of the Data
Protection Act after
the paper files of ten
vulnerable and elderly
people were found lying in
the street. The Information
Commissioner’s
Office found that the
organisation failed to
provide its staff with
42 I www.caretalk.co.uk
guidance explaining
how sensitive personal
information should be
handled and kept secure
when taken outside of the
office.¹
Mobile solutions reduce
the need for care
workers to carry hard
copy files containing
sensitive information.
Whatever device is used
to access the secure
data, sign-in procedures
and verification points
will ensure that only
authorised personnel can
access the information.
With data being held on a
device, mobile technology
also allows for an office
team to remotely wipe the
device of all data in the
event of loss or theft.
It is estimated that there
are over six million people
in the UK working as
lone workers² and it is
imperative that these
workers feel safe whilst
working alone or out in the
community.
A survey found that
only 38 per cent of lone
workers feel positive
about the speed at
which their employer is
alerted if they were to
miss or be delayed for
an appointment². This
is an obvious concern
for organisations who
are not only bound by
law but are also morally
obligated to ensure that
their employees feel safe
whilst at work. Introducing
mobile technology
can help to reassure
organisations that alarms
can be raised discreetly
by setting time limits
to appointments or for
missed appointments.
Mobile solutions can also
be set up so that a panic
alarm is raised discreetly
if a worker feels in any
danger.
Improving the safety
of care workers and
ensuring that data
is secure are further
examples of the direct
benefits which can be
seen from implementing
mobile technology. By
embracing the mobile
revolution organisations
can ensure they are
providing the highest
standards of support
to people who rely on
their care whilst offering
reassurance to frontline
carers who want to make
a difference.
¹The Information
Commissioners Office
²The Orange guide to
working alone safely 2011
Care delivery
goes mobile
Advanced Health & Care have launched
mobile working solutions designed
specifically to support care workers gain
access to data and record care provided
at the point of care.
Whether you provide care within a residential home, in
a community setting or both, Advanced Health & Care
have the mobile solution to ensure your care workers
can operate efficiently and effectively.
To find out how your care delivery can go mobile
please contact us on 01233 722670 or visit
www.advancedcomputersoftware.com/ahc
Advanced Health and Care Limited is part of Advanced Computer Software Group. Registered in England.
Company number 02939302. Registered office: Munro House, Portsmouth Road, Cobham, Surrey, KT11 1TF
CareTalk full page Feb 15.indd 1
09/01/2015 16:34:34
BUSINESS ROUND-UP
Business round-up
Movers and
shakers
New appointment at
Glen Care
New chief executive for
Look Ahead Care and
Support
Care England
announces new Chair
Specialist care provider Glen Care has
appointed qualified learning disability nurse
Beverley Clancey to head up its Coulsdon
based Care Home with nursing service.
Bringing with her 24 years of both
clinical and managerial experience in the
healthcare / social care sector, Beverley will
be the new service manager at Glen Care’s,
Ballater House.
Care England, the largest representative
body for care providers, has announced
that Avnish Goyal, Managing Director of
Hallmark Care Homes, has been elected as
the new Chair of Care England.
Beverley holds a diploma in Nursing,
Learning Disabilities and is currently
working towards her level five diploma in
Leadership and Management in Health and
Social Care.
Professor Martin Green OBE said:
Beverley’s main focus will be working with
service users to develop their individual
skills and help to integrate them into the
local community.
“Avnish has been associated with Care
England and its predecessor body, for over
five years and is a well-known figure within
the social care sector. We are delighted at
his appointment as Chair and are very much
looking forward to working with him over the
coming years.”
Avnish Goyal commented:
“I am delighted that the Board has chosen
to elect me as the Chair of Care England
and I am pleased at the prospect of working
more closely with the Chief Executive,
Professor Martin Green, going forward. We
are in a period of major change and I am
excited at being able to play my part helping
to shape the future of the care sector”.
44 I www.caretalk.co.uk
Beverley, said: “I am really looking forward
to taking on the role of service manager at
Ballater House. I have a lot of new ideas
and after meeting the team I can see we
all share similar ambitions. Empowering
individuals to take an active part in their
daily routines and their wider lives is key to
supporting them to lead fulfilled lives.”
“Glen Care is always looking for new ways
to enhance its services and I am pleased
that I can share my knowledge and
experience of the social care sector with
them to enhance the lives of the people we
support.”
Stephen Alexander, board chairman
of Look Ahead Care and Support,
announced the appointment of Chris
Hampson as its new chief executive
today as long-serving incumbent,
Victoria Stark CBE, steps down.
Victoria, Look Ahead’s first and only
chief executive since the organisation
was founded 41 years ago, has served
the organisation for 34 years, having
taken over responsibilities from the
organisation’s founder Mary Jones.
Chris joined Look Ahead in 2000,
having previously worked for both
public and voluntary sector providers
within housing and social care, as well
as the National Housing Federation.
For the last ten years he has been on
the organisation’s senior management
team, most recently as deputy chief
executive.
Chris Hampson commented: “It is a
privilege to be appointed the new chief
executive of Look Ahead. I want to
pay tribute to Victoria Stark and all that
she has achieved for Look Ahead, its
customers and staff. I know that this
is an excellent organisation and look
forward to leading it into the future as
we continue to deliver innovative and
high quality services for our customers
and commissioners.”
Business round-up
CLS appoints Sheila
Wood-Townend as
head of service
Sheila (centre) with colleagues from
CLS Homes - winners of the Care
Employer Award at the Great North
West Care Awards.
Sheila Wood-Townend has been
appointed head of service at CLS
Homes, having worked as the care
home provider’s operations manager for
almost 12 years. Sheila began her new
role following the departure of longstanding managing director; Robert
Black.
As head of service, Sheila will oversee
18 CLS homes across the North West.
Speaking of her new role, Sheila said:
“I am absolutely delighted to become
head of service at CLS Homes. Being at
the head of an organisation that places
quality above all else is an opportunity
that most people never get. I will
ensure that CLS remains committed to
delivering quality, person-centred care
as a top priority.”
Sheila went on to say: “As a group
we are improving all the time, both in
terms of the service we provide and
the support that we offer our staff. I
am confident that my colleagues and
I can continue to provide the highest
standards of care for our residents.
We will also continue to help our staff
develop in what is often a difficult and
BUSINESS ROUND-UP
challenging area of work.”
CLS is a not-for-profit organisation
committed to providing high-quality
care for older people at affordable
prices. The group has become
synonymous with the highest standards
of staff development, last year winning
the Care Employer Award at the Great
North West Care Awards. The group
also consistently achieves outstanding
results in the Your Care Rating Survey
published each year.
Property
Caring Homes
celebrates ‘topping
out’ of newest Care
Centre
A local purpose built care home moved a
step closer to completion this week as the
team behind the development celebrated
the traditional ‘topping out’ ceremony at the
Ivy Road property in Norwich.
Ivy Court is the latest state-of-the-art care
centre to be built by the award-winning
independent provider Caring Homes and
will offer residential, nursing and dementia
care for up to 71 residents, who will benefit
from an on-site bistro, hair salon and cinema
room.
Sue Glanz, regional operations director
from Caring Homes said:
“Caring Homes is synonymous with high
quality care delivery, which extends to the
care and attention we put into building new
care homes.
We focus on providing our residents
with specialist care, centered around
their individual needs, whilst maintaining
their independence. This wonderful new
property will enable our residents to live in
homely surroundings, with the benefit of our
exceptional standards of care.
Every aspect of Ivy Court has been
designed with its residents in mind, from
the carefully considered layout of the living
accommodation to the safe, accessible
landscaped gardens.”
The home is already generating interest and
is due to open in early Summer 2015. It
is run by the family-owned Caring Homes
Group, which was founded in 1994 by
mother and son team, Helena and Paul
Jeffery and has since grown to become one
of the leading independent providers in the
UK.
McCarthy & Stone
secures new £200m
bank facility to support
growth strategy
Retirement housebuilder, McCarthy & Stone
has announced that it has agreed a new
£200m bank facility to support its exciting
growth strategy.
The five year £200m revolving credit facility
is being provided by Barclays, HSBC, RBS
and Santander and is repayable in full in
December 2019. The facility replaces an
existing £160m term loan and provides
the Group with working capital flexibility
to support McCarthy & Stone’s strategy to
create an efficient and scalable business
capable of building and selling more than
3,000 units per annum over the medium
term.
Nick Maddock, group chief financial officer,
commented: “We are very pleased to
have agreed this financing with our new
banking partners. The revolving credit
facility provides a flexible and efficient
debt structure which will help support the
Group in its next phase of growth, with the
attractive terms agreed reflecting McCarthy
& Stone’s leading market position. The
Company delivered a strong set of results
for 2013/14, which saw the business
generate profit before tax* of £63.2m (2013:
£12.5m), with legal completions up 10% to
1,677 (2013: 1,527). The new facility delivers
on one of our stated objectives to bring
our capital structure and financing costs in
line with our housebuilding peer group and
ensures we have the appropriate platform
to underpin further growth through this
financial year and beyond.”
www.caretalk.co.uk I 45
BUSINESS AND FINANCE
Success for care homes
across North Yorkshire
Award winning law firm Hempsons has helped
achieved successful court proceedings for the
Independent Care Group (ICG) and care home
providers across York and North Yorkshire. The
advice and support the firm gave assisted the
providers in achieving a fairer price from York
City Council and North Yorkshire County Council
for the provision of care in care homes.
The claim was based in North Yorkshire and
was raised by residential and nursing homes
together with the ICG, their representative.
The claimant challenged the decision of North
Yorkshire County Council which was announced
on 24 February 2012, to set the fees for council
placements at residential and nursing homes for
2012/13.
The claimant asserted that the council had
mistaken the law by failing to consider the actual
cost of care when setting the fees for residential
and nursing home placements. The council
alleged they had consulted with the providers,
although failed to provide them with sufficient
information to enable them to properly engage.
Having failed to calculate the actual costs of
care, the council was unable to comply with its
public sector equality duty.
ICG and its members had strong concerns
about the levels of the council’s fees for a
number of years and had constructively
raised the issue year on year. In 2004 the ICG
and council worked together on the Joseph
Rowntree Foundation model, (Laing & Buisson)
Fair Price for Care, but the work was ignored
and left a legacy of distrust. Fee increases
also reduced year by year, culminating in a 0%
increase for 2010/11, at a time when costs were
increasing significantly.
The level of consultation for the 2012/13 fee
was so poor that ICG and its members - being
mindful of success in judicial reviews in other
areas of the country - issued judicial review
proceedings against North Yorkshire County
Council in May 2012, shortly after Hempsons’
instruction that March. Almost immediately, the
council came to the negotiating table and an
extensive mediation led to a detailed settlement
agreement, whereby both parties secured an
independent sector provider to carry out a
formal cost of care exercise, which resulted in
significant uplifts in fees for providers.
The process involved a judicial review, a full
day mediation led and supported Hempsons,
an independently commissioned cost of care
exercise and extensive negotiations, resulting
in the recent implementation of a new contract,
46 I www.caretalk.co.uk
coupled with new rates which more fairly
reflect the significant costs faced by providers
in delivering care to this ever-increasing
market. Hempsons advised throughout the
whole process from the issue of judicial review
proceedings, to the eventual conclusion of the
contract.
With the new contract now in place, the working
relationship between the parties has benefitted
from the candid discussions that have taken
place, as well as the increased levels of
engagement. Discussions are anticipated in
the very near future regarding the cost of care
exercise for the next three year period.
What is clear from all the case law is that when
a local authority is going through the process
of setting fees, it has to have regard to the
guidance issued in 2004 to local authorities, one
element of which describes; “this cost should
be set….to be sufficient to meet the assessed
care needs of supported residents in residential
accommodation.”
It also states: “In setting and reviewing their
usual costs, councils should have due regard
to the actual costs of providing care….” A
local authority can only depart from the 2004
guidance for good reason and it cannot be said
to have had due regard to the actual costs in
providing care when setting its rates, if it has
not considered what the actual cost of providing
care is.
Once providers raise the issue, that they
believe they are underfunded, a local authority
is required to undertake an analytical and
arithmetical exercise in collaboration with the
providers to establish the actual costs of care.
Providers who work together can achieve far
more than individuals in isolation. Having the
benefit of the ICG (now in its 10th year), as an
overarching supportive trade association for
its members has allowed strength in numbers
to secure a positive outcome. An increase in
fees shows real recognition by the council to
the sector, and to the hard work providers put
in to delivering quality care to North Yorkshire
residents.
Since there have now been sufficient judicial
reviews, there is no longer the requirement to
take such issues to court as the position is now
established. It was regrettable that ICG and its
members had to issue court proceedings to
secure the engagement of the council, but they
are delighted with the eventual outcome.
Mike Padgham, ICG chair and individual
claimant in his own right, said: “The support
and advice provided to the ICG by Hempsons
was outstanding. They showed a dogged
determination and tenacity that was inspirational
and the eventual outcome was a fantastic result
for both social care providers in the area and
the many thousands of people who benefit from
their care.”
At Hempsons we feel this was an excellent
demonstration of what can be achieved when
a group of providers unite, and determine to
challenge decisions made in relation to funding
that affect them and those they care for. A
provider acting in isolation may have struggled,
and the ICG are to be commended for their
foresight and resilience in seeing the challenge
through to a very successful conclusion. The
council were prepared to talk and entered
meaningful discussion which was pleasing, but
perhaps inevitable when faced with a united
challenge from providers. The whole process
of fee setting has been put onto a platform
for the future that should ensure fairness to all
stakeholders. It was a pleasure to work with ICG
in achieving this end.
By Adam Hartrick and Philippa Doyle of
Hempsons
Adam Hartrick and Philippa Doyle both work
Hempsons solicitors, specialising in the care
sector. Adam is a Partner and Philippa an
Associate.
BUSINESS AND FINANCE
HC-One makes senior
appointments to strengthen
local government partnerships
HC-One, the UK’s third largest care home
provider, has strengthened its senior team
with the appointment of three new members
as it enters the next phase of its Turnaround to
Transformation programme.
Bruce McLernon, John Ransford CBE, and
Richard Jones CBE, have been appointed to
the senior management of HC-One, bringing
extensive experience and expertise in the care
sector.
At a time when public spending on care is
under unprecedented pressure, HC-One
has added expertise to its team to ensure it
continues to work in an open and accountable
way in partnership with local authorities and
other key stakeholders in the healthcare
sector.
The appointments also reiterate HC-One’s
commitment to working hand-in-hand with
Clinical Commissioning Groups, Health and
Wellbeing Boards and central Government in
order to understand their needs at this critical
time for social care provision. Bruce, John
and Richard will work closely with Bob Lewis,
head of the quality and safeguarding board
and former president of the Association of
Directors of Adult Social Services (ADASS).
Bob has been integral to HC-One’s success
since its inception in 2011, helping to ensure
that HC-One continues to provide the kindest
possible care.
Bruce
McLernon
(left), who took
up his position
as a special
advisor on
1st November
2014, brings
a wealth of
experience in
social care. He
was previously
director of
social care,
Health and
Housing at
Carmarthenshire County Council and
president of the Association of Directors of
Social Services Cymru (ADSS Cymru).
John Ransford
CBE, a former
honorary
secretary of
ADASS, joined
HC-One as a nonexecutive director
on 1st December
2014, and has
had a career in
public service
spanning over
40 years. He is a
qualified social
worker, and has
served as director
of social services and chief executive for both
Kirklees Metropolitan and North Yorkshire
County Councils. John also spent fourteen
years at the Local Government Association
(LGA), and was chief executive for the three
years until his retirement at the end of 2011. He
has advised Ministers and senior civil servants
across the UK and Europe.
Richard Jones
CBE, also a
former president
of ADASS, will
assume his role
as a special
advisor on Health
and Social Care
Interface in April
2015. He is a
qualified social
worker, a previous
director of social
services in St
Helens, and was
an assistant chief
inspector at the Social Services Inspectorate.
Richard has also been director of social
services in Lancashire County Council and a
director of NHS England since 2013. Richard
was involved in the creation of the “Think
Local, Act Personal” partnership. He has
also served on several taskforces and was
represented on the Demos Commission on the
Future of Residential Care alongside HC-One’s
chairman and acting chief executive officer,
Dr Chai Patel CBE. Richard was also part
of the expert reference group for the Dilnot
Commission.
These appointments come as part of HCOne’s growth and investment programme
which will also see an extensive refurbishment
programme to invest more than £100 million
over five years to continue improving HCOne’s homes and services. HC-One is also
seeking to acquire high quality care homes
and home healthcare companies, developing
specialist services in their own homes that will
reduce the need for hospital admissions and
enable rapid discharge for older people in the
community.
Dr Chai Patel, chairman and acting chief
executive officer, said:
“On behalf of all colleagues at HC-One I would
like to extend a warm welcome to Bruce, John
and Richard.
“This is an incredibly exciting time for the
company following the success of the
recent sale, which has brought stability and
investment for the future.
“All three bring a wealth of experience and
expertise to HC-One that will be invaluable
as we strive to continue to provide the kindest
possible care and make a real difference to
the lives of older people in the UK.”
Head of the quality and safeguarding board,
Bob Lewis, said:
“The appointment of Bruce, John and Richard
is fantastic news for HC-One. Their knowledge
and experience will be indispensable in
helping HC-One, in partnership with local
authorities, to address the issues facing the
care sector including an ageing population
and funding pressures.
“Their insight and experience will form an
integral part of HC-One’s future as we aim to
provide the highest quality care to Residents,
and support to their relatives.
“I look forward to working with all three of them
closely as we seek to build on the success we
have experienced so far.”
www.caretalk.co.uk I 47
BUSINESS - PROPERTY
Over 50s get ‘moor’ at
Lightmoor extra care scheme
An innovative extra care housing scheme in
the heart of Telford has gone from strengthto-strength since opening as it continues to
meet the growing need for housing solutions
for the over 50s.
Designed by Bournville Architects - the
architectural arm of Bournville Village Trust the scheme was delivered as a joint venture
between Telford and Wrekin Council,
Bournville Village Trust and the Homes and
Communities Agency.
The extra care scheme - Bournville House
– initially opened its doors in 2011 providing
59 self-contained two-bed, three person
apartments which make up an integral
part of the Lightmoor Village development.
Since then, the development has remained
oversubscribed as would-be owners seek
homes which match their aspirations and
provide that additional care when the time
comes.
“With an increase in the UK
population forecast and a
need to find sustainable
long-term care, extra care
housing is leading the way.”
Executive director at Bournville Architects,
Ian Tipton, says: “There is an increasing
demand for well-designed, extra care
facilities which provide independent living
but give peace of mind that round-the-clock
48 I www.caretalk.co.uk
care is available when necessary.
“The project at Lightmoor wasn’t just about
building a home to meet the growing
housing demand of the over 50s– it was
about creating quality lifestyle choices for
those who currently need care or may need
care in the future.
“With an increase in the UK population
forecast to rise to 23 per cent by 2034 and
a need to find sustainable long-term care,
extra care housing is leading the way.”
As well as comfortable and secure
accommodation, Bournville House provides
a number of communal facilities for its
residents including shared lounges, a
restaurant, gym, hairdresser, activity
room and IT suite, as well as landscaped
gardens, a bowling/croquet lawn and
greenhouse.
All building work at Lightmoor interprets
the aesthetics of a traditional Shropshire
community, creating a typical village feel
with closely packed streets with the use
of traditional construction and decorative
materials, particularly in the village centre
where Bournville House is situated.
Innovative design features were used to
break down the scale of Bournville House,
including stepped roof lines and separate
frontages to create the appearance of a
number of individual buildings rather than
one large single building.
Fair faced brick masonry and render
finishes were used in conjunction with
reconstituted stone cills and lintels, plain
clay and natural slate lead detail roofing to
help complete the traditional village feel and
provide an aesthetically pleasing finish to
the design.
“The scheme for Bournville House was
designed with both community and
sustainability in mind, providing functional
and valuable housing alternative for local
elderly residents,” says Ian.
As well as maintaining high quality design
and architectural features, the scheme was
developed with a number of environmental
benefits in mind. Sustainable design
features include 450mm thick external
walls, solar thermal roof panels, LED light
fittings, rainwater harvesting, low-flow taps,
mechanical ventilation with heat recovery,
SUDS attenuation system, permeable
paving and a building management system.
The extra care scheme along with all other
homes in the Lightmoor development are
designed to meet BREEAM ‘Excellent’
standards – one of the world’s most
comprehensive and widely recognised
measures of a building’s environmental
performance.
As a result of its innovative and ecofriendly design features, Bournville House
was shortlisted in the 2012 Housing
Design Awards, a nationally recognised
annual award promoting excellence and
sustainability in home design.
BUSINESS - LEGAL
CCTV guidance
for providers
now published
In December 2014 the Care Quality
Commission (CQC) CQC published guidance
on the use of surveillance in care homes. The
guidance ‘Using surveillance: Information for
providers of health and social care on using
surveillance to monitor services’ sets out
some of the key issues providers should take
into account to help ensure any decisions
about the potential use of surveillance are
informed, appropriate and lawful.
Separate information for families, carers and people who
use health and adult social care services is expected to
be published in January 2015. The provider guidance is a
good indication of what will be included in the guidance for
carers.
Surveillance is not by any means a requirement in care
homes, it is a decision for providers to make in consultation
with service users, their families and staff. CQC do not want
an over-reliance on surveillance to deliver key elements of
care. The focus should be on ensuring staff are well trained
and supported.
“Information gathered using surveillance for
one purpose must not be used for another
incompatible purpose”
The guidance states that providers may wish to use
surveillance for more than one purpose. If so, providers
must identify each purpose and each one must be identified
as necessary and proportionate in its own right. This means
that information gathered using surveillance for one purpose
must not be used for another incompatible purpose.
For example, recordings made for the sole purpose of
protecting vulnerable people from abuse should not be
used as a record of staff time-keeping for disciplinary
purposes.
Privacy
Privacy is a key issue to take into account when considering
surveillance. The more personal and sensitive the
information collected from surveillance, the more likely it is to
impact on people’s privacy.
The guidance explains that consultation with people likely
to be affected by surveillance is the best way to understand
their privacy concerns. Consultation should not be a ‘one off’
exercise, it should be repeated throughout the process of using
surveillance. Where a decision is made not to consult on the
use of surveillance, CQC expect the provider to be able to
explain and justify that decision.
CQC state that: ‘To remain lawful we would expect any covert
surveillance to be limited in time and purpose. It should be used
to deal with an identified problem, not put into regular ongoing
use.’
Consent
Any use of surveillance must meet relevant conditions for
processing personal or sensitive personal data under the Data
Protection Act 1998 (DPA).
“The more personal and sensitive the
information collected from surveillance, the
more likely it is to impact on people’s privacy.”
Any surveillance that is used in a non-public place for the
purpose of capturing more sensitive personal data about
an individual (such as information about their health, sexual
life, race or religion) is likely to require explicit consent of that
individual to be lawful. This is also the case when gathering
information that is particularly intrusive of a person’s privacy.
Mental capacity issues also require careful consideration in the
context of consent.
This article acts as an overview of the CQC surveillance
guidance. I would recommend reading the guidance in full and
obtaining specialist legal advice if you are in doubt about any
specific issues.
www.caretalk.co.uk I 49
C2L Care to Learn is currently
recruiting freelance facilitators to
help us to undertake learning in
the health and social care sector
We are looking for motivated, creative and
innovative (powerpoint free) facilitators to cover
the following subject areas:
Common Induction
Standards
Dementia
Deprivation of
Liberty
Person Centred
Care
Moving and
positioning of
Individuals
Mental Capacity
Act
Nutrition and
Hydration
End of Life
Medication
Safeguarding of
Adults
Basic Life Support
To apply
Please send your CV, a recent photo, two references and a
covering letter answering the following questions:
• Whatdoyouthinkmakesagoodfacilitator?
• Provideuswithanexampleofcreativepracticeusedwithin
yourlearningsessions?
• Ifyouweretoreflectonyourownperformanceinyourlast
learningsession,Whatfeedbackwouldyougiveyourself?
• Howimportantisevaluationinthesessionsyoufacilitateand
howdoyoumakethemmeaningful?
Please email to [email protected] or post to
C2L Care to Learn, 18a Baldertongate, Newark, NG24 1UF
For More information about what we do. visit our
website www.c-2-l.co.uk
or call us on 01636 703386
The Voice of Excellence in Social Care
www.caretalk.co.uk
ISSUE 16 October 2012
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Coming up in the next issue of Care Talk
• Nursing
• Guest editor - The reality of integration
• National Heart Month
Celebrating excellence in supporting people with learning disabilities
The National
Learning Disabilities
& Autism Awards
Hosted by
Gala dinner on
Friday 15th May 2015
at The ICC, Birmingham
A Day & Evening of Celebration
for the sector
Supported by
For more information about the awards or to nominate
call 0115 959 6133 or visit
www.nationalldawards.co.uk