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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 l 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? l CCTV guidance for providers I S T H I R NATIONA B T A E R L G HOME Aw Care ards Don’t miss out on social care’s premier event – book your table now! Join in us in celebrating excellence in social care and paying tribute to the very best in our sector. BOOK YOUR I S T H I R N B ATIONA T A TABLE TODAY! E R L G ME care Awar ds2015 HO Dinner on 24th April Gala Book today by emailing: [email protected] Drinks Reception: 7.00pm Carriages: 1.00am Dress Code: Black tie Associate sponsors: At ICC Birmingham Your Host In association with Steve Walls www.care-awards.co.uk 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. 21 Regent Street Nottingham NG1 5BS T: 0115 959 6134 F: 0115 959 6148 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! twitter.com/caretalkmag facebook.com/pages/ 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 Circulation list Has this month’s Care Talk been read by all your staff? Use our easy circulation list to be sure! Job Chief executive Managing director Registered manager Supervisor Care staff Ancillary staff Service users Families Read? 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 0 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 SUBSCRIBE NOW The Voice of Excellence in Social Care Let's talk social care! October 2012 £2.50 FREE ANNUAL SUBSCRIPTION TO CARE TALK PROMOTING POSITIVE CARE AND OUTCOMES Focus on Specialist Services To get your free copy of Care Talk, register online at www.caretalk.co.uk Please fill in your details below and return to Care Talk for your free subscription to our monthly online magazine. Company: Number of employees: Job title: Name: Address: Email: Website: Type of industry please tick: Domiciliary care Residential and nursing Other (please state) Please tick here If you would be interested in subscribing for a monthly printed copy of Care Talk magazine. Please tick if you do not wish to receive information from other third parties and partnerships of Care Comm. 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