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The Voice of Excellence in Social Care

Let's talk social care!Issue 34Summer 2014£2.50

Focus on technology

PLUS: Up Close and Personal with Ann Chivers Survey highlights managers’ care concerns Company profile - Home Instead Senior Care Values-based recruiting

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Inside Issue 34

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

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Katie MountainImpact investment analystNesta Impact Investments

Des Kelly Executive directorNational Care Forum

Caroline JohnsonDigital marketing manager Care Shop

Samantha CoxTrainee solicitorRidouts LLP

Janet CramptonConsultant2020 commissioning

Shirley Cramer CBEChief executive IHM

Ann ChiversChief executiveBILD

Trevor Brocklebank Chief executiveHome Instead Senior Care

Mark Thomas Managing director CM2000

Jayne RawlinsonDirectorSpecsavers Healthcall

Sharon AllenChief executiveNational Skills Academy for Social Care and Skills for Care

Paul TM SmithAdvanced nurse practitioner Dementia care & services consultant

Andrew WillettsPublic sector and health care services director LloydsPharmacy

News05 Guest Editor06 Caught on camera 08 Retail therapy – shopping around for life-enhancing technology10 Newsround12 Surveyhighlightsmanagers’care concerns13 Cutsandclosures:What’sthereal key to quality healthcare provision?14 Third anniversary editorial board meeting

Opinion15 Data has power to tackle challenges and improve practices16 Greaterefficiencycanhelpalleviate pressures of new obligations17 In praise of time to spend with people who need care

Good Care Week18 Good Care Week 27 April 2015

Stories20 The future is clear for Jordan21 Gina walks and talks for autism

Chat22 Voice over: What makes a good

employer?23 360 opinion: How can we avoid

malnutrition in people living with dementia?

24 Planet Janet25 Up close and personal26 Care creatures27 This is your life28 Mrs Macblog

Celebrate29 And the winner is...30 NationalfinalsoftheGreatBritish

Home Care Awards

Showcase32 Care Talk on the road33 Care groups network at House of

Commons lunch34 Health and care come together to

think differently

Learn36 Helpingemployersfindstaffwith the right values37 How to be a good ... capital works manager38 Re-evaluating what you think you know about dementia care

Special39 Toileting solutions help maintain dignity and independence40 Making learning a meaningful and memorable experience42 New‘outcomes’functionalityfor rostering software 43 Access acquires CareBlox to support careprovisionefficiency44 Putting the care back into eyecare47 Norfolk Disabled-Friendly Cottages

Business48 Innovative technology can help tackle informal care crisis49 Local services for local people50 Business round-up 52 Time and respect at heart of Home Instead care model53 Keep up to date with new inspection regime and provider duties

Welcome to the summer 2014 issue of Care Talk.

This summer, although eagerly anticipated in the UK with the World Cup and Wimbledon, has sadly not provided us with any trophies. Conversely, our sector is full of winners and no more sothanatthefinalsoftheGreatBritish Home Care Awards. Our souvenir spread on page 30 features the very best from across the homecare sector. Care Talk was once again proud to support this event, which highlights best practice and innovation across the sector.

Innovation through technology is the focus for this issue. We all use technology pretty much every day, but some equipment and products can be a real godsend to people who struggle with aspects of daily life because of disability or old age. But how do you know what is likely to be most helpful? Our lead on page 8 aims to answer all your questions.

As the homecare market in particular gears up to face some ofitsmostsignificantchallengesto date, there are many new ways to use real-time care delivery

information to improve quality and transparency. Our article on page 15 provides an overview on how data has the power to tackle challenges while still improving practices.

Innovation is the theme of our story on page 37.

Redesigning a dementia care home while the residents continue to live there, at two sites, over a few short months, is no mean feat. But this is what HC-One capital works manager Gordon Asher has achieved.

As ever, thank you for your support of Care Talk. It has been an honour to be able to report on some truly inspirational people in the sector.

Have a lovely summer and see you in September.

Editor’s Note

Lisa

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GUEST EDITOR

IT and effective medicines management in care homes can be the catalyst for improved accuracy, adherence and patient safety, says Andrew Willetts, public sector and healthcare services director for Lloydspharmacy.

Ensuring that a patient receives safe medicines administration at any stage of the life cycle is imperative; not only does it improve or at least maintain health, it can also save lives. Care home residents have a unique set of healthcare needs as people are living longer – many with long-term conditions that need strict and timely medicines plans. So it’s encouraging to see more innovation entering care homes to enable staff, GPs and pharmacists to work better together and to deliver more effective and safe medicines management.

“We must continue to review and evolve the processes and controls … to ensure that ever-changing patient needs and care plans are supported.”

The ‘five rights’ of medicines management – right patient, right drug, right dose, right route, right time – will still exist and must continue to be the core focus of medicines management. However, we must continue to review and evolve the processes and controls that support the five rights, to ensure that ever-changing patient needs and care plans are supported. The introduction of one patient record and electronic health records is essential in supporting care home staff. It relieves the burden of reams of paperwork, which can be overwhelming and prevent staff having valuable interaction with the residents in their care. Enabling caregivers to have more quality time with the people in their care must be at the heart of everything we do now, and in the future. By logging and managing medicines management and care through an online platform,

organisations can not only view performance and quality of care across their multi-site locations, but also feel more motivated because they are providing more direct care to the resident. The alternative is to spend vast amounts of time manually logging and recording information and having lengthy handovers with colleagues. Our very own CareFirst system, with full EMAR (electronic medicines administration records), has demonstrated that accurate MARs, accessible management of information, automated stock management and a streamlined prescription process dramatically reduce human error. In turn, this frees up care staff time, improves medicines management, provides organisations with more transparency and improves the patient or resident experience. Everything we now do is wrapped around technology. The world has become a lot more accessible and the healthcare industry is gradually coming on board. Secure and remote access of residents’ medicines records by healthcare professionals (GP, pharmacist, the hospital and care home) ensures continuous improvement and performance management; and it is quick. Furthermore, it improves patient safety and empowers the patient and their families to make the right decisions about their health and wellbeing – our collective goal. And while the transformation from paper-based to electronic MAR charts is widely recognised by the profession as a huge step in the right direction, change often comes with challenges. These need to be addressed. Training, for example, needn’t be a huge burden or a drain on resource and time. By working closely with the right partner, change can become more manageable and mutual parameters can be set between trainer and trainee. Likewise, the implementation of new systems isn’t as complex as it may first seem, and the benefits far outweigh any perceived challenges. We ourselves have observed a reduction in error

rates, in some cases as high as 87%. Turnover of care home staff brings with it many challenges also. But by reducing paperwork and implementing centralised and accessible records, new staff can ease into an effective system far more easily.

“Enabling caregivers more quality time with the people in their care must be at the heart of everything we do now.” Stock control can also be simplified. Through an online platform, medicines can be ordered and remain in their original packaging and with the original patient information leaflets – the dispensing label bar codes will already be scanned and logged into the system. Because of this, we have seen instances within care homes where the simplicity of reordering saves on average 15 hours per month per care home in stock handling alone – vital time that can be redeployed to the patient. This automated approach reduces any unnecessary ordering and reduces the high costs of medicines wastage. Not only does electronic medicines management improve patient safety and enhance the relationships between care homes, GPs and pharmacists, it goes a long way to helping a home achieve its operational objectives. A boost in rankings of course means that Care Quality Commission regulations are being met and embargoes are avoided. But it is also important to consider how, with increased safety and accountability and by reducing the costs of medicines management to help achieve 100% occupancy, business growth is made more viable. And, by aligning the integration of new systems and processes to NHS policy, risks to the patient and blue-light scenarios are dramatically reduced, while quality measures and reputation are enhanced.

p Andrew Willetts, Lloydspharmacy public sector and healthcare services director

Is IT improving patient safety in care homes?

CAUGHT ON CAMERA

06 I www.caretalk.co.uk

Sadly this documentary was broadcast at 11pm, rather than earlier in the evening when it would have been more accessible to the target audience. The main point it made is that so many young people remain ‘hidden carers’ who bottle up their feelings and don’t seek help because they are embarrassed and unable to be open about their caring responsibilities. One 14-year-old would only agree to be interviewed anonymously.

It also provided a realistic insight into the day-to-day challenges of juggling schoolwork and leisure activities with as much as 60 hours a week of care provision. Among those featured were Josh, 13, who helps look after his terminally ill and bedridden father, and sisters Clare, 14, and Erin, 16, whose dad is partially paralysed and has vascular dementia, and whose mum is also in very poor health.

“The programme said the number of carers aged 5-7 years old has doubled since 2001.”

Ty-Reece, aged just six, has been carrying out many care tasks for his mum – who has kidney, respiratory and heart problems – for two years. And he is not alone in this; the programme said the number of carers aged 5-7 years old has doubled since 2001.

It is particularly frustrating that the programme was shown so late when it called for better communication, and because it was presented by Ortisé Williams, founder member of boyband JLS, who cared for his mother, who has MS, from the age of 12 and offered a very personal perspective that other young carers could relate to. During a visit to a London carer support group, individuals opened up to him, with several breaking down in tears when talking about the stress and worry of caring for a beloved parent.

Like other young carers featured, Ortisé found the physical, emotional and mental demands of caring and family responsibilities had an impact on his own behaviour. He felt isolated, worried about people’s reactions, especially after getting into fights at school in response to taunts about his mum.

The Children’s Society is campaigning for better support to reduce the negative impact long hours of caring have on children’s education, friendships, health and opportunities to get qualifications and jobs. Clare and Erin’s dad said he has already decided to go into a home when it is time for them to go to college or work, although this is not something the girls want to think about.

According to Professor Saul Becker, a government adviser on care interviewed by Ortisé, there may be as many as 700,000 young carers in the UK.

It is a complex issue, as Ortisé acknowledged, a matter of politics and resources. In the programme he visited two former neighbours who stepped in when they realised how much he was taking on, cooking meals for the family and helping with chores. The most important aspect of success with JLS, formed in 2006, was being able to pay for his mum’s care, he said.

Many of the tasks young carers do might be deemed inappropriate – research has found that children find personal care, like bathing and toileting, most difficult. And many administer medication – in the case of Clare and Erin, this means being familiar with more than 20 different medicines, while Josh also maintains his dad’s feeding tube. Ortisé’s brother was giving their mum injections at the age of 10.

As Professor Becker pointed out, it is only a matter of time before this results in drastic consequences, for both the parent and child. However, the argument is that if young

carers receive proper training in medicines management, this sends out the message that it is acceptable for children to take on such responsibility.

Another issue about getting formal support is the potential repercussions – Ty-Reece’s mum now has help from social services, and he has been allocated a social worker, but she is worried that if she cannot cope he will be taken into care.

“Like other young carers Ortisé felt isolated, worried about people’s reactions, especially after getting into fights at school in response to taunts about his mum.”

On an individual basis, what often helps is simply being among other people who understand, through young carers centres, for instance. The programme featured a scheme in Scotland that brings the topic into the classroom and encourages open discussion. Two pupils were clearly pleasantly surprised by their friends’ reactions on learning that they are carers – first shock, then pride, and finally offers to help and to listen.

And the documentary ended on a positive note, as Ortisé pointed out that new legislation would give carers of all ages more rights, including to a needs assessment. As he said, he would have cherished that when he was growing up, and it could be an indication that “society is finally waking up to the debt that we owe these young people”. His message to young carers is to ask for support, “because you deserve it”.

Vicky Burman

Britain’s Youngest Carers, 9 July, Channel 4

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NEWS - LEAD STORY


We all use technology pretty much every day, but some equipment and products can be a real godsend to people who struggle with aspects of daily life because of disability or old age. As Carers UK says: “The world is full of amazing gizmos to make life easier.”

But how do you know what is likely to be most helpful?

The first step is to cut through the jargon. Assistive technology is the term most commonly used and covers “any product or service designed to enable independence for disabled and older people”. This definition was agreed during a King’s Fund user group consultation meeting in 1991 and recognises the cross-over between mainstream products that are intended to be useful to anyone and technology specifically designed for older and disabled people.

Alternative descriptions include phrases like ‘life-enhancing devices’, ‘personalised technology’ (the preference of learning disability charity Hft, which showcases what’s available to support people in their own home through its Virtual Smart House) or ‘equipment for independent living’.

This last term is used by Rica, which was founded by Which? to carry out consumer research for older and disabled people and, although now an independent charity, still utilises similar methods to those Which? is renowned for in independently comparing different products and services. These include a 250-strong consumer panel, customer surveys, mystery shoppers and focus groups.

All of this underlines the point that you’re more likely to get the best possible outcome if you tackle choosing assistive technology in the same way you would any other product or service.

You wouldn’t buy a car without comparing different models and taking it for a test drive, would you? Or buy a new TV without considering how easy it is to use and what features are important to family members?

So why should investing in technology

that enhances the lives of carers and people they care for be any different?

‘Normalising’ assistive technology can have a positive impact from the outset. As the Innovations in Dementia guide Getting equipped to tackle forgetfulness points out: “We all buy and use gadgets to make our lives easier, such as TV remote controls or alarm clocks.” And as one user of technology said: “When we want something fun, we go and buy a gizmo – we think of this equipment as gizmos that will help us.”

The right tool for the job

First things first. Why do you feel it would be helpful? Occupational therapist Stephen Wey, who wrote the AT Dementia guide The ethical use of assistive technology, points out that “there are many things that may drive us to look for technological solutions but technology is just a tool that can help us to achieve certain ends”.

A professional assessment of individual needs and circumstances is a good starting point, even for identifying simple household gadgets that might make a difference, and also to explore what funding is available and if certain equipment can be obtained at no cost or a subsidised rate.

Assistive technology can have both general and specific benefits, like helping someone remain independent by reducing the risk of accidents

and boosting their confidence. From a family carer’s perspective, the right technology can offer peace of mind and ultimately better physical and emotional wellbeing because they can relax more.

But technology needs to be not just right for the task but right for the individual and their particular circumstances. As Getting equipped to tackle forgetfulness points out: “Equipment is not for everyone. People have different needs, abilities and preferences.”

And these needs, abilities and preferences may change over time, so you need to take that into account, including a person’s ability to make their own choices and to learn new things. Getting equipped to tackle forgetfulness says: “Many people are happy with equipment. It often works best for people who have had equipment for enough time, have got used to it and are happy using it.”

“You wouldn’t buy a car without comparing different models and taking it for a test drive, would you?”

As well as the technology as a whole, and its overall purpose, specific features need to suit the individual. As the Social Care Institute for

Retail therapy – shopping around for life-enhancing technology

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Excellence (SCIE) points out in its Dementia Gateway module on assistive technology, some people with dementia may welcome a verbal reminder (like a talking alarm clock); others may become distressed if they hear an unfamiliar voice. There is a limit to the usefulness of a pendant or pull cord alarm, or a falls detector that clips to a waistband or belt, if someone is easily confused or forgetful and does not remember to wear the device or use it correctly.

The Improvement and Efficiency West Midlands toolkit Maximising the potential for the use of assistive technology refers to a 2003 study that showed that there can be a ‘fall-off’ of the use of equipment of up to 75% for various reasons, including:

• Poor initial assessment of the person’s needs

• Inappropriate choice of equipment• Lack of initial and ongoing support and

instruction (for both the individual and their family carers)

• Equipment not meeting people’s expectations.

These are still issues to be addressed, particularly by care workers advising on assistive technology, and especially with the constant development of new products making it even harder to make valid comparisons and find the most suitable device.

Making choices and decisions

Getting equipped to tackle forgetfulness sums up what can be a bewildering range of choices: “Equipment can be high or low tech, simple or complex, expensive or cheap. Equipment can involve adaptations to the home or a simple purchase on the high street.”

And equipment cannot be forced on people – they and their carers need to be involved in considering what they want it to do and the options available.

For one family carer, ensuring his father still felt in control was an important part of the decision-making process when it came to home adaptations. “He’s not so good with words.

When I needed to buy him a new shower, I showed him pictures of some alternatives … waited for a reaction, and then I knew I’d found the design he might be able to use.”

So before even getting into the practicalities, the concerns and wishes of those involved need to be considered, and ideally discussed among them, to find the right balance between independence and safety, for instance.

As one man with dementia says in Getting equipped to tackle forgetfulness: “We’ve just got a pendant [alarm] system. I’m not ready for it yet. But I’ve agreed that I’ll use it if I’m not well, if my wife is not well or if I’m in the house on my own.”

The ethical use of assistive technology points out that any device can be beneficial in some respect but also have drawbacks that may be hidden or not apparent until later. These might include concerns about:

• how certain devices, such as those mainly used to monitor safety, could affect someone’s privacy or freedom

• whether technology is used to do things a person can still manage to do themselves, which may make their problems worse, or might foster a one-sided focus on where they struggle rather than on their strengths.

It should be about helping someone achieve things they are finding harder to do or that could improve their quality of life and relationships.

The AT Dementia guide advises care professionals and family carers to question, for instance, whether an assistive technology option would even be considered if the person was not elderly or had dementia, and to consider how this reflects on their view of the individual and their abilities and wishes.

Assistive technology should not be seen as a ‘quick fix’. Weigh up the risks and benefits of using or not using equipment – including the fact that not being able to manage technology can have a negative effect on someone’s confidence – and whether there are better alternatives altogether, such as getting more help from other people or doing things differently.

It’s worth looking for simple solutions first. As SCIE points out in its Dementia Gateway module on assistive technology, someone might be falling often because carpets are loose or worn, they’re wearing the wrong footwear or would benefit from handrails. A telecare system that monitors for falls might not be the right response at this stage.

Shopping around

Approach finding the right technology to meet an individual’s particular needs like you would any other purchase. Do your research. You could see what other ‘customers’ think – the Carers UK forum, for instance, has plenty of threads on equipment, typically with very practical tips based on personal experience of things like ceiling hoists.

And hopefully in future there will be more opportunities to view and try out assistive technology in everyday surroundings, like the Gadget Hub ‘pop-up shop’ that brought devices and gadgets – plus expert advice and demonstrations – to a shopping mall in Sutton Coldfield for two weeks. Care Talk hopes to look at this project in more detail in a future issue.

There are increasing numbers of more specialist services that offer detailed advice as well as products and back-up support. The Disabled Living Foundation’s Living made easy website is a good place to start, if only to become familiar with what’s available so you can begin comparing products and matching them to different circumstances.

The foundation’s AskSARA online tool works through specific questions around every aspect of everyday life to really focus on where help is most needed. Hft’s Virtual Smart House will take you through a range of everyday household technology, room by room, and show how it can be used to support independence. The Improvement and Efficiency West Midlands Gadget Gateway includes reviews and price comparisons.

You should be able to try products out – as you would with many other things you buy. The Disabled Living Foundation has a demonstration centre in London. Or hiring equipment may be an option.

And don’t forget the simple stuff – everyday technology that can make everyone’s lives easier and that most of us take for granted.

Carers UK points to shopping and finding health and benefits information online, sharing stories and getting support on online forums, using group emails or shared group calendars, or specialised apps, to coordinate care and staying connected face-to-face through free video-call services like Skype, as just some ways technology can benefit family carers and, in turn, the people they care for. Vicky Burman

SECTOR

CQC to tackle failing care through special measures (Source: CQC)The Care Quality Commission (CQC) has announced it will work together with the adult social care sector to put together a new regime that will tackle failing care through special measures from April 2015.

CQC chief inspector of adult social care Andrea Sutcliffe says: “In people’s homes and care homes across the country, we know that dedicated staff are delivering fantastic care for people. Sadly, this is not always the case and we know that some services are continuing to fail the people they serve.

“I am clear that abuse, neglect and poor care will not be tolerated. We need to shine a spotlight on this poor practice and make sure that services improve. If they do not, they will have to face the consequences.

“I welcome the opportunity to work with service providers, commissioners and most importantly people using services, their carers and families to develop a special measures regime that will call time on poor care.

“Our new ratings regime will start in October and will highlight inadequate services. This will be an unambiguous signal that improvements are needed and we will set out clear expectations, including the timescale to sort out problems and where to go for help.

“People’s confidence in adult social care services has been knocked by shocking examples of poor care. I want to restore confidence by celebrating the good work we do see while also tackling persistent poor performance. Together, we can make sure these services are the best they can be for the benefit of everyone who needs them.”

For more information, visit http://www.cqc.org.uk/content/new-special-measures-regime-adult-social-care

NEWSROUND


NHS chief executive out of touch with the needs of older people (Source: Care England)Care England says a recent statement by Simon Stevens, the new chief executive of the NHS, ignores the reality of social care and the excellent services care homes provide to support citizens with complex needs in the 21st century.

Care England chief executive Martin Green says: “Simon Stevens seems to be at variance with government policy, which claims to want choice and control by the citizen. Yet we see the new chief executive of NHS England calling for the closure of services that provide high-quality care and support, and that are chosen as the preferred service by thousands of self-funders.

“We had high hopes that Simon Stevens would bring new and fresh perspectives to the NHS, but his statement on care homes is indicative of a system driven by dogma rather than need. We would like to extend an invitation to him to visit a Care England member to see for himself how care homes are centres of local communities, providing preventative, intermediate and long-stay care in a compassionate and caring environment. This is a sector that wants to be innovative and is looking at new care models. We look forward to working with the NHS in developing this integrated approach across health and social care.”

For more information, visit: http://www.careengland.org.uk/nhs-chief-executive-out-touch-needs-older-people

New guide to commissioning home care for older people (Source: Social Care Institute for Excellence)As people are living longer, the number of older people with complex needs who live at home is increasing, and the Social Care Institute for Excellence (SCIE) has produced a guide capturing the latest research findings on this important and emerging area of social care.

SCIE points out that the homecare market will have to respond to the needs of this expanding group of older people who use services. A tightening in eligibility criteria for those in receipt of home care means that those receiving care have more complex conditions, including chronic health needs and long-term and multiple conditions.

The SCIE guide Commissioning home care for older people provides some practice examples of good work in this area. It is aimed at health and social care commissioners of home care services for older people with complex needs, but providers of these care services may also find it useful.

For more information, visit http://www.scie.org.uk/publications/guides/guide54/

NEWSROUND


DEMENTIA

Hit songs help memory research (Source: BBC News)Hit songs by Elvis Presley, Abba and the Spice Girls are some of many being used in research that hopes to unlock the secrets of how memory works.

Researchers from the University of Amsterdam have created an online game in an attempt to shed light on why some tunes get stuck in your head.

Fans must identify song clips and compare them by their catchiness. The researchers hope the findings will help the understanding of long-term memory and the treatment for dementia.

For more information, visit http://www.bbc.co.uk/news/entertainment-arts-27938794

Study identifies partnership opportunities to improve antipsychotic medicines use (Source: BBC News)Results of a large-scale audit of a two-year service pilot have revealed the positive role specially trained pharmacists can play in collaboration with GPs, nurses and care home workers in better managing the appropriate use of antipsychotic medicines for people with dementia in care homes.

According to the study, through the use of specially trained pharmacists in a pilot service, over one quarter (26%) of residents reviewed did not have any symptoms that necessitated a regular antipsychotic medication, and in almost two thirds (58%) of cases the risk of the medication was deemed to outweigh the benefit. In addition, the audit resulted in over 20% of residents having their antipsychotic dose reduced, and more than 17% realising antipsychotic medication discontinuation.

The audit was undertaken by selected Boots UK pharmacists, some of whom had received additional Alzheimer’s Society training to enable them to better support people with dementia and carers.

The study was commissioned by Boots UK to demonstrate the potential added value that community pharmacy can offer, and the significant contribution this service could make to the NHS. The pilot service demonstrates how the commissioning of pharmacy services could help further improve the care of vulnerable patients who live in residential care homes, working in partnership with other healthcare professionals.

For more information, visit http://www.bbc.co.uk/news/uk-england-norfolk-28050312

END OF LIFE CARE

Dying need ‘free social care’, cancer campaigners say (Source: BBC News)Free end-of-life social care is needed to save the NHS in England money and improve patient care, according to a report by Macmillan Cancer Support, Can we live with how we’re dying? It concludes that free social care could save the NHS in England £69m a year on the care of cancer patients alone. Its analysis is based on a review of patient surveys, official NHS spending data and interviews with senior decision-makers.

Social care is currently means-tested, but ministers are considering providing it to everyone at the end of life. About half of people end up dying in hospital despite eight in 10 saying they would prefer to die at home. Macmillan’s analysis says this equates to about 180,000 people spending their last days in hospital against their wishes.

For more information, visit http://www.bbc.co.uk/news/health-28151129

Charities launch new report into end of life care provision (Source: Macmillan Cancer Support)A new report commissioned by a coalition of charities has identified some innovative approaches to improving end of life care, but concerns about restrictions on people’s choices in where they are cared for at the end of their lives.

The report How could free social care at the end of life work in practice?, commissioned by Macmillan Cancer Support, the Motor Neurone Disease (MND) Association and Sue Ryder from independent research organisation OPM, looks at the current state of end of life services in England and provides examples of people being able to access non-means tested social care.

It reveals that in some areas commissioners have been able to find innovative ways of integrating the health and social care systems to improve end of life care, including STARS Care Liverpool, which is highlighted in the report.

The report says that although the Continuing Healthcare Fast Track system is in place across the country, there is a concerning gap between official guidance on its implementation and how it operates in practice. Coupled with a lack of awareness of, and clarity about, the established system, this is limiting choices for people about where they can be cared for at the end of life.

Social care can provide much-needed practical support to people at the end of life as well as respite for carers to allow people to remain in their own homes if they so wish. The charities that commissioned the report are part of a coalition that also includes Help the Hospices, The National Council for Palliative Care and Marie Curie Cancer Care, which has been working to campaign for free social care at the end of life to support people to die in the place of their choosing.

For more information, visit http://www.opm.co.uk/wp-content/uploads/2014/06/How-could-free-social-care-at-end-of-life-work-in-practice.pdf

Confidence that continuing reforms in health and social care can deliver improvements for patients is beginning to flag, as managers struggle with the pace of change.

Growing concern among health and social care managers that high quality, safe and compassionate care is at risk as reforms in health and social care continue to unfold is highlighted in a recent Institute of Healthcare Management (IHM) survey.

Financial constraints, the sheer pace of change and the resulting pressures on managers and staff were named as the key culprits in the threat to care.

“We have lost the human being in a human-focused service,” was a poignant

observation made by one manager and echoed by many others. “Cost before care,” observed another, summing up the fear felt across health and care services about the potential impact of more cuts on staffing levels and care quality.

In identifying the major obstacles to improving patient care, respondents lamented the time and effort spent on providing data, preparing for inspections, being inspected and responding to issues in data collected by national organisations. There was a strong plea for fewer targets and less box ticking, and for more of what one manager called “real leaders with a compassionate, empathetic approach to care”.

“Financial constraints, the sheer pace of change and the resulting pressures on managers and staff were named as the key culprits in the threat to care.”

The demands placed on health and care services by an ageing population were also highlighted, alongside complaints about a lack of understanding of recovery times for older people. The health and social care interface did not support step-down care, some said, while others expressed concern that choice was being eroded in social care.

Over half (53.7%) of managers surveyed also signalled doubts that greater integration of health and social care will take the pressure off the health and care system. The findings follow on from recent concerns expressed about the financial credibility of the Better Care Fund, a flagship scheme aimed at encouraging closer working between health and social care.

And while currently 73% of managers across the UK feel ‘very confident’ or ‘confident’ about their organisation’s ability to deliver safe and compassionate care, according to the IHM survey, this figure falls dramatically to just 54% when the question is applied to the next five years, given current changes and trends.

Nevertheless, the survey shows a clear commitment to fight for better care, as well as understanding of the challenges ahead, and identified a plethora of suggestions on how to make improved patient care a reality. The latter includes: improving the quality of management (particularly in the area of leadership); putting people in senior positions who have empathy; listening to patients and carers; treating patients with respect and dignity; and maintaining a higher ratio of staff-to-patient care.

The IHM survey also showed that:

• Only 54% of managers across the UK feel ‘very confident’ or ‘confident’ about their organisation’s ability to deliver safe and compassionate care over the next five years given current changes and trends

• 73% of managers feel that the balance between national and local accountability has not been struck

• 65% see no evidence that the financial situation has started to inspire greater innovation

• 66% of respondents feel services to patients would be improved if there was more communication between public and private organisations.

Commenting on the survey’s findings, IHM chief executive Shirley Cramer says: “Managers are clearly signalling their anxiety about whether the NHS reforms can deliver improved care, as well as highlighting issues over increasing stress in both management and the general workforce as they grapple with change. Many feel a high degree of frustration about their inability to influence and ‘own’ the agenda to improve patient care in the current climate.

“IHM’s mission is to support managers in their commitment to ensure that change does not compromise the key purpose of the NHS – to provide the highest quality of safe and compassionate care to patients.”

Survey highlights managers’ care concerns

NEWS - SECTOR


p Shirley Cramer, IHM chief executive

Maintaining a high standard of quality care provision should be one of the top priorities of any healthcare professional working today. There are systems in place to ensure that care is consistently and rigorously reviewed and assessed, of course, but it seems like there are some significant changes coming that may have a negative impact on these assessments.

Many people have read with concern about Health Secretary Jeremy Hunt’s recent attempt to pass a care bill, part of which would allow him to close local hospitals without consultation. The bill passed, presenting everyone with a future where local hospitals are at the mercy of ‘trust special administrators’ appointed by the minister himself. Even if a hospital is doing well by current care standards, it could still be closed with only 40 days’ notice if it is deemed to be doing poorly on a financial level. A change as significant as this is bound to have an impact on the overall quality of care at such institutions.

“Any changes made to care must be determined by clinical reasons rather than financial.”

The Conservative supporters of the bill have claimed that the measure would help to improve care standards across the board, and this is where a disagreement might arise. Andy Burnham, the Shadow Health Secretary, stated that “hospital closures should be determined by clinical reasons, not financial ones”.

This simple theory can also be applied to the processes of care provision as well; any changes made to care must be determined by clinical reasons rather than financial. After all, finance is only a very small aspect of quality healthcare provision. There are the medical aspects to consider, alongside clinical care and the more personal aspects such as bedside manner. All of this worry about money has caused many to forget that what matters are the patients, the people receiving the care in the first place.

Looking at the medical side of things makes one thing abundantly clear: quality of care can be easily improved through the hiring of appropriately trained staff. It’s been a common criticism of the NHS that its hospitals are understaffed and that nurses are underpaid and work exhausting hours, and while this is true in some cases, in no way should it be the standard.

Many have maintained that medical professionals must be allowed to do their jobs unhindered and that there should be more diversification in healthcare roles, but such changes are unseen. For example, it should not be the nurse’s job to ensure that patients get their meals or that the wards are clean, but they are often bogged down with non-medical tasks like this. Hospital standards could improve tenfold with more well-trained staff.

It’s also imperative that hospitals become readily equipped with the latest technology and equipment, something that simply cannot be achieved through forced closures. As it stands currently, you’re more likely to have access to the best equipment throughout private healthcare, which is fine if you can afford it, but it’s quite well established at this point that most working people can’t. All of the NHS reforms that we’ve seen only seem to be focusing on cuts with a complete disregard for the improvement of care, so this is something to be concerned about.

Of course, society must be thankful for the bright spots that do represent high-quality care provision. The NHS prescription system, for example, is something that should be praised more frequently in our media. Easy access to affordable medicine is an incredibly important part of a good healthcare system and sometimes gets forgotten during discussions of this kind. There are an abundance of external suppliers

such as Care Shop for healthcare professionals to use too, allowing for better maintenance of the medical and clinical aspects.

The threat of dark times ahead for the NHS has made the provision of quality care more important than ever. In spite of the Government’s optimism, Jeremy Hunt’s proposed changes to procedure are more likely to have a negative impact on the quality of care across the

country for the simple fact that quality cannot be determined by financial successes alone.

“How is quality of care to improve in any aspect when access could be very suddenly limited?”

How is quality of care to improve in any aspect when access could be very suddenly limited? Does it not just serve to pile more pressure onto the hospitals allowed to stay open? In reality, more money should be going into hospitals rather than them being closed for failures that the Government should be attempting to fix. Financing is important, but only when it is being put to good use. Proper financing from the Government is the key to putting the focus back on the patient, and it’s this focus that will naturally lead to improvements in the medical and clinical aspects of providing quality care. The British healthcare system has always been based on the concept of fairness, so money should be no object.

Caroline JohnsonDigital marketing managerCare Shop

NEWS - SECTOR

Cuts and closures: What’s the real key to quality healthcare provision?


NEWS - SECTOR


It’s been an exciting run up to the summer here at Care Talk as we celebrated the third anniversary issue of the magazine.

On Tuesday 17 June the great and the good of social care came together for the editorial board meeting, which was hosted by the Royal Bank of Scotland at its Bishopsgate offices in London.

The board is made up of significant players in social care, boasting representatives from the Department of Health, sector bodies, including the Association of Directors of Adult Social Services (ADASS,) Alzheimer’s Society, Skills for Care, the National Skills Academy and the Social Care Institute for Excellence (SCIE), professional organisations and care providers among its members. All with one shared objective – to continue to achieve a forward-thinking and all-inclusive magazine, based on communication, positive attitudes and, most importantly, the issues that really matter to the social care workforce.

It was widely agreed that Care Talk had achieved its purpose of being the voice of social care for frontline care workers. Through the feedback and articles we get from our readers

we know the magazine is being read by frontline care staff, who are the key influencers, as well as owner-managers, who are the key decision-makers – a unique opportunity for advertisers!

“Regular nursing and medical and clinical features will reflect the industry’s need to work in partnership with the interface with health.”

By developing the magazine with a new look and new features we continue to keep Care Talk fresh and vibrant. The addition of new regular nursing and medical and clinical features will reflect the industry’s need to work in partnership with the interface with health.

Through Care Talk we look forward to continuing to be the genuine voice of excellence for social care with a lively and innovative publication, so please keep your news and views coming in by emailing [email protected]

Third anniversary editorial board meeting

OPINION

Before joining CM2000, currently celebrating 15 years of providing innovative technology to the care sector, I worked for Nestor-BNA (now Allied Healthcare) and spent a decade growing Westminster Homecare. So I am familiar with the challenges providers face.

“There are many new ways to use real-time care delivery information to improve quality and transparency.”

With legislative, financial, social and political pressures, the spotlight will remain firmly on the care sector in the coming months. We believe technology is the key to unlocking new ways of working.

Like many providers I worked in local authority areas where they insisted on real-time monitoring. I have always been passionate about its benefits and understand the practical issues too. As the homecare market gears up to face some of its most significant challenges to date, there are many new ways to use real-time care delivery information to improve quality and transparency.

Seeing logging data for every visit as it happens is crucial for managing missed and late visits. It is well documented that missed and late visits have a detrimental effect on the quality of the service delivered. In the Care Quality Commission’s consultation, which closed on 4 June, it was proposed that to receive a good rating for a well-led service homecare providers would need to effectively manage missed calls.

Last year alone CM2000 delivered 1.1m real-time alerts to care providers indicating that visits were running late or had been missed. This puts providers in control of what is happening in the community.

As the old saying goes ‘knowledge is power’. Whether you are a small provider or a large local authority, having data available that shows trends in service delivery and helps you plan future needs is extremely powerful. This can also act as an early warning system for potential problems.

Mobile phones are now a part of everyday life, and of data delivery. An article in Mobile Marketing Magazine last year indicated that seven out of 10 people in the UK now own a smartphone. As the cost of issuing mobiles to care staff is still prohibitive for many providers, CM2000 have enabled ‘bring your own device’ (BYOD) communication benefits by installing our CallConfirmLive! App on care workers’ own devices.

“Having data available that shows trends in service delivery and helps you plan future needs … can also act as an early warning system for potential problems.”

Focusing on outcomes measurement has been part of social care policy for many years, but finding meaningful and workable ways of implementing this in practice is still challenging. CM2000 believes the answer lies in combining time/attendance data with progress towards outcomes information gathered at the point of care delivery. This offers a ‘best of both worlds’ solution where you retain the safeguarding benefits of knowing that the care worker has visited service users, but you also get additional insight into the individual’s wellbeing. We

are already working with providers and local authorities to successfully implement this approach. The Care Act is putting greater responsibility on local authorities to give potential service users and their families more information to enable informed choices about their care.

Some local authorities are already sharing key quality indicators such as punctuality, missed visits and continuity of care worker. For example, Central Bedfordshire and City of Edinburgh authorities share information via their websites so the public can see how local providers are performing. This trend is likely to continue as greater emphasis is put on transparency of care data.

We are also helping providers share care visit data with service users and their families in real time. This provides peace of mind, especially where families live remotely from one another. Mark ThomasManaging directorCM2000

Data has power to tackle challenges and improve practices


OPINION

Route Planning

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Service User Details

Tasks & Outcomes

Offline Functionality

Smart Care Made Simple

The PeoplePlanner Mobile App is part of a range of integrated web-based

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visit www.peopleplanner.biz

With spend in social care dropping yet more being expected from providers, it can be hard to comprehend how high standards of care can be maintained. The new Care Act 2014 will mean that person-centred care is a high priority – people will have more choice on what care they receive and how they receive it.

I’m a firm believer that choice, support and dignity of those being cared for should be encouraged. After all, isn’t that what we’d all want for our loved ones? At the same time, it’s easy to see that there will be greater obligations on service providers and local authorities to support this personalisation of care with a more collaborative relationship between the health and care sectors.

Over the years I’ve helped more than 250 organisations to improve their efficiency, I’ve been actively involved in the Great British Care Awards, hosted many local authority care provider events and, as a Dementia Friend, I’ve personally seen how hardworking and dedicated people are in the sector.

Having worked in partnership with the health and social care sector for many years, Access supports some of the UK’s biggest care providers, including City & County Healthcare, Home Counties Care and Age Concern, so the team have first-hand experience in helping organisations to focus on delivering high-quality care in a cost-effective and efficient manner.

It’s about eliminating the unnecessary, value-draining activities that take attention away from care giving, and ensuring that funds are spent in the best possible way. By integrating and automating processes within – and across – the different areas of the organisation there is less manual intervention in administrative procedures, saving a great deal of time and effort.

For instance, using software to manage rotas, with any subsequent changes being communicated via mobile and SMS, means staff in the field remain up-to-date without any need to print, post or collect paperwork. Integrate the domiciliary or care home management system with payroll, invoicing,

expenses, HR, document management and business intelligence and suddenly, not only are you reducing mistakes and inefficiencies, but data is available to understand where and how funds are truly being spent, alongside monitoring and managing care provision.

This is particularly key with the move away from task-based care to outcome-based care, making it easier to record measurable results. By taking a systemised, integrated approach providers can make a visible drive towards quality, and can evidence to the local authority that their focus on quality will, for instance, reduce returns to hospital. Good systems create efficiencies where they matter most, enabling organisations to focus on their core mission – providing quality care to those they support and serve.

Paul PatarouDivisional manager, health and social care divisionAccess Group

Greater efficiency can help alleviate pressures of new obligations

OPINION

I recently had the privilege to be a national judge for the finalists in the Great British Care Awards in the homecare worker category. It was an inspiring day (as they always are!) and rather reassuring to be reminded of the truly committed people who work in the care sector, trying their best, day in and day out, to support people to live independently.

Somewhat ironic therefore, that on the day of the judging interviews the media was reporting yet another incidence of poor practice brought to light through covert filming.

I’ve been on judging panels many times and I like to believe that I can spot those people who have been prepared and rehearsed to the point where there is no spontaneity and passion in their response to questions. You don’t get to see the genuine person with such candidates or get any idea of what they are really like. Not so this time, as there was plenty of passion and commitment and enthusiasm. There was also quite a range of experience and knowledge. They were all worthy finalists and wonderful ambassadors for the homecare sector.

It is difficult to do an assessment simply on the basis of completed applications or references of support, and so interviewing candidates is necessary and the process can be intense – believe it or not, on both sides of the table – but I always find such occasions uplifting. It is a humbling experience to witness up close the personal stories and motivations that people bring to the task of providing hands-on care and support.

There was one thing that stood out for me, in a way in which I haven’t witnessed so strongly before, and that is the extent to which homecare workers believe that there is insufficient time to care as they would want. Being able to have time to be with people was an issue that was raised over and over again.

There was a clear resistance to the notion of task-oriented ways of working, which is great to know. However, the fact that such practices remain at all serves as a reminder of how much remains to do if care and support is to be consistently ‘personalised’. How can we possibly deliver person-centred care unless frontline care staff feel that they have the necessary time? I suppose this

debate goes to the heart of concerns that contracting for care in allocated 15-minute slots of time can never be truly personalised.

“Being able to have time to be with people was an issue that was raised over and over again … There was a clear resistance to task-oriented ways of working.”

Having time is partly about making time (I’m reminded of the saying that if you want something doing, ask a busy person) but surely it starts from the very culture of leadership and management. If you are a manager, do you set an example in the way that you use your time? Do you trust and encourage staff to value the time they spend with people they support?

Des KellyExecutive directorNational Care Forum

p Des Kelly, executive director, National Care Forum

In praise of time to spend with people who need care


“There was plenty of passion and commitment and enthusiasm … all worthy finalists and wonderful ambassadors for the homecare sector.”

Celebrating the good care behind Great Britain

Good Care Week 2015 takes place from 27 April next year. 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 within their wider community and beyond.

The UK-wide annual awareness campaign, in association with Care Talk magazine, saw a range of local initiatives in 2014; some are highlighted here.

/Sector support

www.goodcareweek.co.uk

Good Care Week 27 April 2015

/Stocks Hall, Ormskirk, Lancashire

Students put on a performance for care home residents

The Stocks Hall Nursing & Care group has welcomed four students from Edge Hill University into its Ormskirk care home to help residents enjoy ‘a night at the flicks’.

The four students –Pip, Laura, Melissa and Kim – are studying on a Performance and Health BA course at Edge Hill.

They provided plenty of entertainment for Stocks Hall Ormskirk residents,

actively involving people in reliving a night out at the cinema.

With music, dancing, popcorn and the chance to dress up for the occasion, people living at the home have enjoyed reminiscing, and going back in time has stimulated conversation as well as memories. As one resident said: “This is wonderful, it’s just like it used to be; we had so many good times.”

Get involved and champion good careBe 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

Bluebird Care (South Gloucestershire) sponsored an extremely popular Ever Changing Sodbury presentation as part of the 10-day Chipping Sodbury Festival in June.

More than 200 people packed into the town hall venue to discover more about Chipping Sodbury’s history and character.

Bluebird Care (South Gloucestershire)’s managing director Sophie Rowland-Jones said: “We were pleased to be able to support this exhibition as part of the wider festival.

“Local historian Jim Elsworth led a fascinating evening, giving us all an insight into the history of the town, the people that have lived here and events that have helped shape our community today.”

www.goodcareweek.co.uk

Celebrating the good care behind Great Britain

We will be publishing Good Care Week initiatives in every issue of Care Talk ... so why not make every week a Good Care Week?

/Care provider sponsors festival history event

Bluebird Care (South Gloucestershire)

Local creative arts students have provided residents at Rogers House in Gillingham, which is run by the Abbeyfield Kent Society, with a day of pampering and photography. After having their make-up professionally done by make-up artist Joanne Relf, they had their pictures taken by photography student Holly Young.

Holly, who is studying at the University for Creative Arts, chose to photograph the residents of Rogers House for a unit about older people that is part of her course.

Holly said: “I feel really lucky to have had the chance to photograph the residents of Rogers House and in such a lovely environment. When I showed the residents the finished photographs, they were absolutely delighted with the end result, which I found really rewarding.”

The photographs will be on display at a public exhibition at the Rochester campus of the University for Creative Arts as well as an exhibition in Brick Lane, London.

Lorraine Laker, care coordinator at Rogers House, said: “The residents thoroughly enjoyed the day, particularly the make-up aspect. After all, who wouldn’t like to spend their morning being pampered? They were absolutely elated to see the finished photographs.”

/Residents enjoy makeover and photography day

Rogers House, Gillingham, Kent

Stocks Hall Skelmersdale care home invited the local community in for lunch in June.

This was part of the annual Big Lunch campaign, which aims to bring as many people together on the same day as possible to enjoy a meal and promote community, fun and friendship.

Chef Mike Woods served up a delicious lunch, served in the gardens of the

Skelmersdale home, which is part of Stocks Hall Nursing & Care Group.

Everyone enjoyed the beautiful weather and chatting to one another. Care home manager Sue King said: “The day has been an excellent opportunity for people of all ages to socialise and get to know one another more. The Big Lunch has given us a great excuse for a party and an opportunity for all generations to come together.”

The small talk that happens in communities is a lifeline for many and The Big Lunch campaign wants everyone in the UK to boost the conversations happening in streets and gardens nationwide.

/Lunch is served

Stocks Hall, Skelmersdale, Lancashire

Residents at a Shropshire care home have been pulling together the pieces needed to create colourful mosaics in a project funded by Telford town council.

Mosaic and glass artist Sarah Markopolous led the community project at Coverage Care’s Chillcott Gardens home, which saw residents put their nimble fingers to work to create a lasting piece of art.

The sessions, backed by the home’s care team, were designed to improve fine motor skills, decision

making and creativity in a social environment.

Sarah said: “Working at Chillcott Gardens has been so rewarding. I’ve made friends with some lovely people and we’ve spent time together working and chatting.

“One thing that has really stuck with me while working with this group of people is how thoughtful and considerate everybody is to each other’s needs.

“We have also laughed so much together, as the regular sessions give people the opportunity to develop friendships and make new ones. The preliminary designing sessions really gave individuals the opportunity to express themselves and be heard, inspiring a real sense of ownership over the finished piece.

“The work produced is an absolute credit to them. Their attention to detail and strong views on design and colour have really shone through.”

Sarah is currently discussing new ideas with the residents as many of them have expressed a desire to keep the project up and running.

/Residents put pieces together for art project

Chillcott Gardens, Madeley, Telford

Life at visual impairment charity SeeAbility is all about moving out of a comfort zone. The people it supports are encouraged to live the life they want and pursue their aspirations, whatever they may be. Staff find a way to make real a dream or wish in the safest way possible.

When one young man, Jordan, wanted to purchase a bike to strengthen his muscles, his carers helped him buy a tricycle. Now he is frequently seen out and about locally on his tricycle, popping to the shops or enjoying a cycle run.

Shirley Saunders, regional service manager for the charity, says that running a specialist service means that risk-taking becomes the norm.

“We take risks every day because you can’t wrap people in cotton wool. We listen to people and what they want to do. We ensure that all the risks are looked at and make sure that we have covered all aspects, but there comes a point where you just have to do it,” she says.

All the people supported by the charity have a visual impairment but many have additional health problems such as learning disability, hearing loss, diabetes, mental health needs and epilepsy. But, regardless of their health problems, each individual is encouraged to lead the life they want.

This means that staff need to have a particular outlook on life. Having the right values is crucial, as it is for many care organisations, but in addition they need to be comfortable with enabling rather than doing.

But Shirley admits that it can be difficult, even after years of working in a culture that is all about making independence and a fulfilled life a reality. She recalls feeling

worried when a manager spoke about someone they support who was keen to go on an adventure break.

“This person has dual sensory loss – they can’t hear or see – and a learning disability and they’re going on an activity holiday that involves them in their wheelchair up in the air on a rope. Even now, I think ‘Oh my!’ But it’s what that person wants to do.”

The charity, which covers the south of England, works hard to help each individual pursue their interest, whatever that might be. For one woman with a large collection of folk music, it was a desire to go to a folk festival. So, this summer, to her enormous excitement, she will attend her first festival with a support worker.

It is a far cry from the founding principles of SeeAbility, which started out in the 1700s as a school for the blind and, in 1911, was granted royal patronage to become The Royal School for the Blind. In the early years, the residents were cared for in an institutional manner, living in dormitory-style accommodation and forbidden to mix with members of the opposite sex. There was little incentive to learn even basic daily living skills as everything was done for them.

By the time the charity changed its name to SeeAbility in 1994, it was practising its ethos of ‘seeing beyond disability’, with residents actively involved in making decisions about

how to run their home and their lives.

This was a novel concept for one young man who came to SeeAbility after living in a residential children’s home for many years. He attended a learning disability department in a mainstream college and desperately wanted to travel there by bus on his own with cash in his wallet for lunch and expenses. It involved travelling from one town to another then getting to the college – quite a challenge for someone with a visual impairment and learning disability.

“It was an eight-month journey of little steps that first involved staff sitting at the back of the bus while he sat at the front, then, from there, a staff member being on the bus behind him,” explains Shirley.

When he did it on his own for the first time, the pride in his achievement was evident. And now, says Shirley, it is the norm: “He has continued to make that journey and lead the life he wants.”

Julie Griffiths

The future is clear for JordanSTORIES

“We take risks every day becauseyoucan’twrap people in cotton wool.”


“When he did it on his own, the pride in his achievement was evident.”

“En route, she is offering free consultations to parents and families in exchange for food.”

Practical advice and guidance on managing life with young children with autism is available this summer to those living on the route between Somerset and Kent – in exchange for a packed lunch or meal.

Autism consultant Gina Davies will travel on foot from Wells in Somerset on 21 July and arrive in Canterbury in Kent on 14 August, walking old pilgrim routes and footpaths. En route, she is offering free consultations to parents and families in exchange for food.

Gina, who is an independent specialist speech and language therapist and autism consultant, was looking for an adventure that involved helping the community. In the past she has volunteered in South America and Romania, but has long held a desire to offer support closer to home.

A walk that incorporated appointments with families who had pre-school and primary-aged children with autism and who might feel they would benefit from her 30 years of expertise seemed like the perfect solution.

This is in part because summer holidays can feel daunting and exhausting for families with children on the autistic spectrum.

Gina says: “I hope that by offering direct support to families in their homes along the route, my little bit of volunteering might go some way to help. The consultations can only be one-offs but I can offer the chance to think through practical daily challenges of things like sleeping, eating, behaviour, and a host of strategies. I am also more than happy to offer free talks to groups of parents and carers.”

The idea was inspired by poet Simon Armitage’s book, Walking Home, in which he writes about exchanging poetry readings for overnight accommodation. Then, three months ago, Gina attended a talk given by adventurer and explorer Dave Cornthwaite,

who urged the audience to ‘say yes more’ in order to have a small adventure every day. The next day, while out on a walk, Surrey-based Gina came up with the idea for her trip.

Gina’s route from Wells will take her to Glastonbury, then Salisbury following the Monarchs Way, Winchester following The Clarendon Way, Eastbourne following the South Downs Way, Hastings, Rye, Lympne and finally Canterbury via the North Downs way route. She plans to walk about 15 miles each day and stay overnight at local B&Bs and hostels.

Gina says that, ideally, families will live close to the route or, alternatively, be willing to pick her up and drop her back after their appointment. The appointments can be morning, afternoon or evening with the only limiting factor being the need to get to her accommodation each night.

“Appointments are very informal so there is no need for complicated preparation or anxiety,” she says. “A few people have asked if they could walk with me and chat about autism as we go, which is another option.”

“I hope that by offering direct support to families in their homes … my little bit of volunteering might go some way to help.”

Within 10 days of making her plans known, Gina had received requests from eight parents and several organisations asking her to give group talks. As she estimates

time will only allow her to see one or two families a day, anyone who is interested in booking a slot is urged to get in touch soon. She aims to confirm days and appointments once she has worked through the applications, but priority will go to families on a first come, first served basis.

Gina plans to write a blog to share her ideas and experiences, though no names will be posted without the permission of families. She is hopeful that if her walk proves successful and interesting to readers then others may be inspired to undertake their own adventure in which they share their own skills and knowledge with communities along the way.

“Families really need help and often can’t wait months for a clinic appointment,” she says. “This is a wonderful way to give a bit of support.”

For more details of the route/dates or to book an appointment please email [email protected] or visit www.ginadavies.co.uk to find out about Gina’s work.

Julie Griffiths

Gina walks and talks for autism

STORIES


What makes a good employer?Recruitment and retention continue to be major issues for the social care sector. Being a good employer is key in maintaining a highly motivated and dedicated workforce, ensuring consistency of care for the service user. We askedagroupofcareworkers,‘Whatmakesagoodemployer?’

Debra Mehta

Rio Fisher, Greensleeves Home TrustA good employer is someone who works hard, involves a lot of person-centred care and provides a lot of training to help boost employees’ confidence. They will also provide very good support, the environment is very good and the training is kept up-to-date. Employees want to be well looked after.

Conclusion• A supportive culture• Good motivators• Good training programme• Good communicator and

a good listener• Approachable and

understanding

Tanya Garner, Baylham Care CentreGood support and praise for what you do, plus good training programmes offering the support we need to do the job, and feeling we can go and speak to them if we have any problems. There should be a good atmosphere and noticing that service users are happy.

Joyce Edwards, Anchor TrustThey’ve got to be approachable and understand the job and actually come out onto the floor and work with staff so they can see what everyone’s doing. It’s no good them sitting at a desk all day and the residents not knowing who they are. My manager is very frontline, and if you knock on the door she’ll come out and help you with breakfasts. She sits and talks to the residents. We can all go and talk to her anytime.

Kevan Smallman, Choices Housing Association LtdA good employer is someone who’s obviously reliable, confident, understanding, and a good listener with good communications. They’d be supportive, especially if you go to them and say you might feel lacking in some part of the job; they’d support you with extra training.

CHAT - VOICE OVER


Jennifer Bliss, New Century CareA good team to work with so you can go and talk to the managers – there’s no inequality. You can go and talk to the managers about anything and it’s all open. There should be an equal level of respect and plenty of training to advance skills.

The dementia body

Angie Newing, operations director, Alzheimer’s Society

That depends on whether they’re living on their own or with a carer, or in another kind of care setting. Make sure it’s food they like and can recognise as much as possible rather than slop on a plate. When someone’s on their own it’s much more difficult and depends on whether they have a care plan and if whoever interacts with that person makes the time to eat with them. It’s individual. Don’t dish up sludge if you want anyone to eat it. It has to look appetising. You have to give them food they’ve indicated they like. Also, you need to recognise that taste buds change with some dementias, so it’s about trial and error. It’s not different to what we all want, really.

How can we avoid malnutrition in people living with dementia?We all know that good nutrition is essential for a healthy mind and body and general wellbeing. According to a recent report commissioned by Alzheimer’sSociety,hundredsofthousandsofpeoplewithdementiasufferfrommalnutrition.Weaskedagroupofstakeholders,‘Howcanweavoidmalnutritioninpeoplelivingwithdementia?’

Conclusion• Ensure food is recognisable

and aesthetically pleasing

• Look at likes and dislikes from life histories

• Ensure choice about where, when and how to eat

• Get feedback from residents and staff through observations

The specialist care providerNeil Russell, managing director, PJ CareFirst of all, don’t put them in a hospital because they won’t get fed! In care homes, it’s about spending time and getting to know the individual. What do they like to eat, how do they like to eat and when? Do they like to sit at a table or eat off a tray on their lap? It’s about finding out those things. People with dementia sometimes want to pace and won’t stop to eat – so give them a plate they can drop and they can eat as they walk. If they won’t carry it, walk alongside them with the plate! Make sure you work with the dietician and speech and language therapists and nutritionists so that you understand what calorie intake they need from a clinical perspective and then find ways of making that attractive to them.

The residential care homeCamilla Trimble, managing director, Nazareth Lodge

I’m passionate about what we do at Nazareth Lodge and food is so, so important. You’ve got the building blocks in place if you look after your residents well, feed them well and give them loads to drink. Everything else just falls into place from then on. I’m really lucky because as I’m the boss, I have no fixed budget and can spend what I like. The residents eat really well and love trying new dishes. We have a system whereby they score every new dish we give them and if they don’t like it, we don’t do it again. You have to look at the individual and look at their eating habits – little and often; masses of cream and sugar, smoothies and blended food if necessary. Just spend a lot of time with them and make very detailed observations. Talk to them! We have a fresh homemade soup for supper every single day of the week. The nutritional content of our food is very high and that’s important.


The charity

Jan Lovett, manager, Fremantle Trust

We can ensure that we have smaller, highly nutritious meals and regular snacks available for everyone. It’s important to look through their life history, their likes and dislikes – making sure that food is

fortified, not relying on medical intervention-type drinks, but using natural fortified drinks that we

make ourselves.

CHAT - PLANET JANET


Thereisn’taquickwayofprovidingservices that really and truly treat people with respect, and dignity, and empathy–unlessyou’reluckyenoughto have been born with a saintliness that affects everything you do – and evenMotherTheresawas,I’vebeeninformed, a tough little body with a ruthless streak to get what she wanted for her patients and those in her care.

For most of us, we mean to do well butwedon’talwaysfeelwehavethenatural talent to do so without a little bit of help.

I was talking about this recently to the Life Story Network, an organisation created to promote the value of using real life stories to improve the quality of life and wellbeing of people and communities, particularly those marginalised or made vulnerable through ill health or disability.

Thenetwork’sphilosophyissimple– to educate, empower and enable staff, relatives and clinicians in order to encourage and embrace relationships builtonempathy.It’swhatismissingsometimes when we treat people as a set of conditions, or identify them by thethingstheycan’tdoorbyfocusingontheproblemthey‘cause’.

Whatever the issue, if we can focus on thepersonthemselvesratherthan‘theproblem’–whateverthatproblemis,or

the deficit – then we are more likely to connect and value the humanity we all share.

Thisappealedtomebecauseit’snot about equipment or products orservices–it’saboutattitudeandbehaviour, and the old adage is probably true that changing the way wethinkaboutthingsdoesn’tcostusanything but it creates a better set of circumstances in which we all – the patient/client, and ourselves – come out of the situation feeling better. We have connected, we have begun a relationship(evenifit’sinthemostobjective sense) and we are using every ounce of our emotional and cultural intelligence in a way that benefits everyone.

There are many organisations offering training that will considerably enhance the quality of care and support we deliver and better equip us to deal with compassion, humanity (and sometimes sheer common sense), and this training is to be applauded (and, even better still, taken up). There are also products, devices, books, reminiscence tools, checklists and toolkits, scorecards and outcomes spiders – but you know the one thing that we should be issued more of, the one thing that would make all the difference, is TIME.

If only we had more of it – more time to sit with someone and really listen

to what they have to say, more time to work alongside someone doing the ordinary and everyday things (like making lunch or a cup of tea). More time to sit and find out about the amazing life someone has had and the amazing insights they can still offer.

Timeissoelusive.There’snotenough of it around, it disappears in a flash; it evaporates on things when spent on the things that really don’tmatter.Wehavetovalueitand nurture it and not just count it; and those people who commission services have to make sure that they allow for it and allow for enough of it to enable people like us to do our jobs better. After all, you can be as skilled asyoucanbe,butifyou’reonwheelsscooting about from one person to the next, you cannot possibly spend the timethat’sneeded,whereit’sneeded,andwhenit’sneeded.

Commissioners and managers everywheretakenote.Let’snothave15-minutecalls,let’snotdefineeverything by time and task. Let us instead give people time to do the job they want to do and spend the time they know is necessary, and to give people receiving care a better chance of enjoying the time they have left!

There’snothinginnovativeaboutthis.We all know you have to put in the time to get the job right.

p Ann Chivers, BILD chief executive

“In the not too recent past it was unthinkable for society to imagine that people with learning disabilities would live independently.”

People with learning disabilities and their families are beginning to be more ambitious about what they can achieve, and the learning disability sector – a very small part of the health and social care sector – has recognised this and is beginning to examine services and support to help enable ambitions to become realities.

In the not too recent past, it was unthinkable for society to imagine that people with learning disabilities would live independently, get a job and have relationships. Many individuals were locked away, hidden away or living with families until parents died. Many people ended their lives in residential homes with few connections to the outside world, their lives dictated to by managers and staff.

Some homes were very good, with kind and caring staff, but many residential settings were poorly run, poorly managed and, in the worst instances, they abused and degraded residents. We hope much has changed.

There are over a million people with learning

disabilities in the UK; ensuring people are not just cared for but supported to make their own choices is one of the biggest challenges for the sector.

The workforce needs to be better paid, better trained and, not least, better led. The care sector is undervalued as a profession, and I doubt anyone would describe the sector as sexy, but the role that the sector plays – taking care of some of the most vulnerable citizens in our society – is vitally important and should be recognised and celebrated by us all.

In my view there are three key challenges for the sector. Firstly, recruiting and retaining staff. Caring for and supporting individuals is a tough job; ensuring that people are served with dignity and respect takes persistence, purposefulness and passion. Employers that design career paths, pay decent wages and offer robust learning and development opportunities for all will help attract and keep committed staff, and help create a workforce that is both proficient and competent. Support staff who take pride in their jobs need to be, and feel, valued.

The second challenge is to improve leadership. The key characteristics of good leadership in our sector are the ability to motivate and to create the right culture in organisations. But the secret of great leadership is to inspire both the workforce and people with learning disabilities to achieve extraordinary things. Great leaders are ambitious, they work in partnership with people with learning disabilities and their families to design and develop services and they demonstrate great insight when involving the wider community.

Leaders in social care have complex roles. They are not just accountable to their organisations, to their boards of trustees and directors or to stakeholders, but to society as a whole. They need to be given the opportunity to invest in the medium and long term, not just the short-term planning that most governments think is important.

Leadership in the sector has not been recognised as a vital ingredient to make positive changes. Boards have a key role in ensuring we

all get this right. They need to be courageous and bold and recruit people with learning disabilities onto their boards – this one single change would lead to improvements throughout the sector.

The third challenge, which may be the most complex of all, is the ‘cost of caring’.

I would argue that the more important question to ask is, ‘what is the cost of not caring?’ Future generations may look back on these times as the dark ages. They may forgive some of the mistakes we make, but I doubt they will forgive us for not caring for some of our most vulnerable citizens and not listening and supporting what can be achieved.

“We have the capability to develop financial models that can be more liberating for individuals and their families.”

We have the capability to develop financial models that can be more liberating for individuals and their families, and we have the funds in the system to do this; we just need to be more efficient and more effective in managing the finances and develop better models. We know local authorities can achieve so much more by working in partnership with the sector and with individuals with learning disabilities and families, and giving them decision-making powers.

Otherwise, we continue to allow some people with learning disabilities to live impoverished and isolated lives. That is wholly unacceptable and, as a nurse said to me recently, ‘not on my watch’.

The challenges are complex and finding solutions is important and urgent. In my experience of working with people in the sector, I know that by working together we can change the face of the learning disability sector and improve people’s lives today, tomorrow and for future generations.

Up close and personal with... Ann Chivers, chief executive, the British Institute of Learning Disabilities

In association with Care Talk, the British Institute of Learning Disabilities (BILD) recently hosted the inaugural National Learning Disabilities Show and Awards. We caught up with BILD chief executive Ann Chivers to find out about her thoughts on the sector, current challenges and her vision for the future.

CHAT - UP CLOSE AND PERSONAL



Care creaturesGentle giant Bentley brightens everyone’s dayA gentle giant is proving to be a great hit with residents at a Sanctuary Care home in Worcester.

Pets As Therapy (PAT) dog Bentley regularly visits Cranham Residential Care Home in Warndon and the team at the home and the PAT charity are keen to highlight the therapeutic value of animals for people of all ages. Home manager Cindy Hawkins initially contacted Pets As Therapy because she thought one particularly shy gentleman would benefit from visits by a PAT dog.

Bentley the Bernese Mountain dog, who tips the scales at eight-and-a-half stone, was so popular that a year later he still visits the home every week.

Cindy says: “The residents absolutely love him and it is amazing to see him with them. Every Tuesday morning they ask if he is coming in and really look forward to his visits – of all the activities they enjoy here, seeing Bentley is a real highlight for them.

“The therapeutic value of animals is undeniable – stroking him is so relaxing. Some of our residents owned dogs before they decided to move here so Bentley gives them a wonderful sense of continuity and comfort.”

Resident Irene McCartney, who has lived at Cranham for over two years, says: “Bentley is so handsome and is absolutely beautiful. Everything lovely you could say about an animal – that’s Bentley. He is a lovely dog, a real beauty and very good therapy – he could brighten anyone’s day.”

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

Good written communication:

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

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

• Shows potential new recruits what a great

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

regulators.

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

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

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

CHAT - RESIDENT CAT

Julia pens poem on her care home moveA care home resident has shared her experience of moving to her new home in a very creative manner – by telling her story in rhyme.

Julia West, aged 72, originally from Aberdeen, travelled all over the world before deciding to settle down in the north east of England in the town of Yarm, Stockton-on-Tees.

When Julia recently made the move to nearby Mandale House, part of the Hill Care Group, she decided to use her love of verse and put pen to paper to share her journey to the place she already sees as her home.

She explains: “I have always loved reading poetry, and since moving into Mandale House I have been encouraged to try my hand at writing and take up this activity, which I really enjoy.”

Home manager Chris Reason adds: “Julia’s poetry is wonderful – it is a great way for her to share her experiences and really express her creativity.

“As a home, we love to encourage our residents to continue activities they may have enjoyed in their younger days and even try out new hobbies that may interest them.

“We want our residents to feel as at home as possible, so we support and listen to any suggestions our residents wish to share.”

CHAT - THIS IS YOUR LIFE


This is Your Life

Julia’s poem

Water gushing everywhere All I could do was stand and stare

The stopcock I could not reachHelp I need I do beseech

A call for help to repairWas put on hold to my despair

All I could do was stand and cryBut my priority was getting dry

In the bedroom I went and fellAll I could say was ‘Bloody Hell’An emergency call I had to send

Care Call came to save and mend

My saviours said I could not stayBut we will help you if we may

They got on the phone and called aroundUntil a care home they had found

To Mandale House I have comeAnd this is now my happy home

Everyone here is helpful and kindThat has given me peace of mind!

Julia West

I’m in a bit of a bad mood. All I wanted was for someone to sit and explain something to me, and to take the time to help me understand things.

It’s not hard, is it? To take a bit of time and sit and talk things through?

There are going to be some changes here – I’m not sure what they are exactly because no one seems to know or isn’t saying. Something about the staff rotas. I want to know if Annie and the others are still going to be here every day. “Of course we are, Verona,” they all say, but then they say something like, “And when we know how it’s all going to work out, we’ll let you know”.

What can they mean? It’s all very worrying.

I know something is going on because they’ve been having staff meetings and some woman from head office came out to speak to all the staff. They used the training room upstairs so they weren’t in our way but some of the girls looked a bit worried. One of them was overheard to be saying something about “getting her numbers”, and another that she was sick of being treated like sh*t! So something must be up.

One of my neighbours said her daughter seemed to know what was going on – the contract for the care is up for renewal and they have to put a bid in to get the work again.

What does that mean? It’s all a mystery to me and I don’t know what to think …

CHAT - MRS MACBLOG

Mrs MAC LOG

Mrs MacBlog

Mrs Mac is now 91 years old. She has lived in extra care accommodation for nearly six years and she has been widowed for 12 years. She gets four calls a day.

Challenge for care workers – discuss the following issues. 1. What do you think is going on? Sounds like the

contract for care is being renegotiated and the staff have started to talk about it, but not openly yet. They mightbeworriedbutit’sbeginningtobenoticed.

2. Howdoyouthinkpeoplefeelwhentheyknowthere’ssomethinggoingonbutthey’renotintheloop?Howdo you think it will affect their behaviour?

3. How do you think the situation can be better handled? Have you got enough time to sit and begin to explain what’sgoingontopeoplelikeVerona?


▲ Host Patrick Monahan with winner Madeleine Moll-Harrach and sponsor from Specsavers Healthcall.

What the winner said…“I am very proud and honoured to have represented Safe Harbour and the team in receiving this prestigious award, as well as representing so many committed home carers across the country who face a rewarding, but sometimes challenging, role daily. Our clients are part of our team and it is wonderful to see their spirits lifted by this news. Having worked in care for over 28 years it is a wonderful achievement and very hard to believe that out of so many

excellent carers, I was chosen. . ”

What the judges said…“The way Maddy talked about personalised care really emphasised the importance of knowing the client and their family, their preferences and aspirations well. She has extensive experience and provides sensitive care focused on the individual. Her modesty belies an outstanding commitment to ‘satisfying each and every client’.

She clearly loves her job and goes the extra mile.”

The UKHCA Home Care Worker Award – Madeleine Moll-Harrach, Safe Harbour HomecareMadeleine Moll-Harrach from Safe Harbour Homecare was the proud winner of the Home Care Worker Award at the national finals of the Great British Home Care Awards.

CELEBRATE

Community Integrated Care is proud to have had 3 fantastic winners at this year’s Great British Care Awards Finals, as well as 18 amazing nominees recognised at the regional events!

Find out more about our award winning services at www.c-i-c.co.uk

We’re Proud of Our People

CELEBRATE

National finals of the Great British

Home Care Awards 6 June,

Grosvenor House, Park Lane,

London hosted by


www.care-awards.co.uk

presented by Patrick Monahan

The Care Employer AwardThe UKHCA Home Care

Worker Award The Care Newcomer Award

The Home Care Registered Manager Award The Dignity in Care Award The Dementia Carer Award

Tania Sutlieff & Julie Crawford - Eternity Care

Madeleine Moll-Harrach - Safe Harbour Homecare Ltd

Carla Hainsworth - Carefound Homecare

Amanda Pettitt - Active Assistance

Sharon Hirshman - Rotherham Metropolitan Borough Council

Ann Colterell - Alzheimer’s Society

2014

CELEBRATE

The Care Team Award The Care Trainer Award The Care Innovator Award

The Frontline Leaders Award

The Putting People First Award The Unpaid Carer AwardThe Outstanding Contribution

to Social Care Award

Reach the People - Chinese Domiciliary Care Team

Kirsten Barnacle - Mobile Care Services

Dave Whittock - Housing and Support Solutions

Marek Dziankowski - Community Intergrated Care

Community Opportunities Team – Dudley MBC

Faith Jaggard Mike Rogers - Mears


The Home Care Co-ordinator Award

Mark Bushell - Home Instead Senior Care

and not forgetting the runners-up!Let’s celebrate social care and help it get the recognition it deserves

SHOWCASE

Care Talk on the road

Coming up

BILD Annual Conference

Aston University, Birmingham

17 October 2014

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

National Children and Adults Services Conference 2014Manchester Central29 - 31 October 2014

Care England, Better Together. The Road to Integrated Church House Conference Centre, London 13 November 2014

Care budgets can be more effective and the quality of care given enhanced - just by changing a toilet.

So claims Clos-o-Mat, Britain’s leading provider of toileting equipment for elderly and disabled people. Its Palma Vita automatic shower (wash and dry) toilet enables people who would need the help of a carer to go to the WC without help.

Thus care workers can be redeployed to spend time on other duties. It also ensures users can go to the toilet when they need, without having to ‘hold on’ until their carer arrives. Users are always cleaned after toileting to the same, consistently high standard; it further gives them enhanced dignity, independence and privacy, and can help enable them to remain in their own home longer. Further, the adaptability of the Clos-o-Mat, with its raft of accessories, means it can be easily adapted to accommodate changing needs, extending its lifetime fitness for purpose.

The cost of a Clos-o-Mat is quickly recouped. Elaborates Claire Haymes, Clos-o-Mat’s care & nursing home specialist: “We go to the toilet on average eight times a day. Helping people ‘go’ therefore takes up a significant amount of care worker time. Even at basic minimum wage for one

carer, dealing with one person, a Clos-o-Mat pays for itself in under three months.”

Looking like - and capable of being used as - a conventional WC, the Clos-o-Mat includes built-in douching and drying, triggered simply by hand, elbow or body pressure on the flush pad, or optional soft-touch pad or infra-red proxy switch. The user does not have to deal with intricate or complex operating buttons. After toileting, retained pressure on the flush triggers simultaneous flushing and douching, followed by warm air drying. The douche has been specifically engineered to ensure accurate spraying and efficient cleaning.

A range of accessories including lateral and body supports, soft and bariatric seats, which can be added initially or retro-fitted, means the Clos-o-Mat can be easily adapted to accommodate the user’s changing needs, extending its useability. Further, uniquely, Clos-o-Mat offers a recycling scheme whereby if a unit is no longer needed it can be factory-reconditioned and installed at a new location, additionally optimising use of budgets.

The Clos-o-Mat Palma Vita is the only unit of its type developed specifically for disabled and elderly people. Since Clos-o-Mats were first introduced, over 40,000 have been installed, many of which

are still in daily use over 30 years after first being fitted. The Palma Vita and Lima Lift are also the only automatic shower toilets made in the UK, and supported by in-house installation, commissioning, and after-sales service and maintenance. Full details plus technical information and case studies are available on Clos-o-Mat’s website www.clos-o-mat.com.

“Bringing dignity and independence to toileting”

hygiene beyond expectation

For toileting in a care environmentOne of the main regulatory criteria for nursing and care homes, and

a basic human right, is to ensure the dignity, privacy and independence

of their residents, particularly with regard to personal care and using

the toilet. This is where Clos-o-Mat’s shower toilets come in.

Clos-o-Mat’s Palma Vita is an automatic wash/dry toilet that, via a

retractable douche, allows the toilet user to independently clean

themselves after toileting. The system puts the toilet user in complete

control of their own toileting routine.

� restored dignity and independence for toilet users

� little or no reliance on carers to assist

� consistency of care and cleanliness when toileting

� enhanced hygiene and feeling of wellbeing for users

� accessories available to make the Palma Vita useable by most people

� full after sales and servicing options available

Clos-o-Mat’s Care Package delivers...

Total Hygiene Limited • Bank House • 182-186 Washway Road • Sale • Cheshire • M33 6RN • Fax: 0161 973 2711

www.clos-o-mat.com Tel: 0800 374 076 Email: [email protected]

care_package_advert:Layout 1 29/05/2014 09:29 Page 1

GET BETTER VALUE FROM CARE WORKERS AND GIVE BETTER, CONSISTENT QUALITY OF CARE IN ONE


SHOWCASE

Care groups network at House of Commons lunch

Raising the positive profile of social care continues to be a key challenge facing the sector. How can we continue to develop a high calibre workforce and the dedication of care staff to provide high quality care? The independent sector is key to this and must have a powerful voice.Representatives from care associations acrross the country attended a Care Association Networking Lunch on 10 July at the House of Commons. The event was hosted by Lillian Greenwood MP on behalf of Care Talk and the Great British Care Awards supported by the Department of Health.

The event brought together representatives from care associations from throughout the sector and provided a platform to debate the issues of the day, giving care associations a national voice. The Department of Health’s director of social care leadership and performance, Dr Glen Mason, chaired the event.

“There is something special about going to the House of Commons and everyone I spoke to thought it was very worthwhile.”Erica Lochart, chief executive, Surrey Care Association

More than 7,600 healthcare professionals congregated from all over the country to hear the latest political developments and educational and business updates in two packed days at the Health+Care event (incorporating the Commissioning Show) 2014.

Over 350 speakers in 14 theatres at the ExCel London delivered informed legislation and policy lectures, live debates, case studies and keynote sessions on issues ranging from integrated care, clinical commissioning group (CCG) business and long-term conditions to care commissioning, public health and care home and residential care business.

Some 400 exhibitors were on hand to demonstrate the latest services, products, equipment and innovations on the market and to network with delegates. The move towards a more integrated and collaborative health and care system was a key theme of the event.

Care and Support Minister Normal Lamb told delegates: “This type of conference, the largest of its kind, represents the sort of change we need to see in our health and care system. We need to think beyond the bricks and mortar and separation between health and social care to collaboration at local level between all of the players. When I spoke at the conference here last year we were in the planning stages of what this more integrated service would look like.

“At the time we were sifting through a remarkable 99 applications from all over the country to become integrated care pioneers. To me, the level of interest in wanting to become a pioneer when the Government was not offering a single penny of support demonstrated the pent-up energy in the system to do things differently, to take control and show what you could do without being dictated to from on high.”

He said the 14 pilots chosen to pioneer integrated care were already having an impact by leading change and

improving care.

“What is really exciting is the innovation and experimentation that is going on all over the place,” said Mr Lamb.

Health Secretary Jeremy Hunt told a packed lecture theatre that the second key innovation in the last year had been the launch of the Better Care Fund, which gave CCGs and local authorities a leadership role in jointly commissioning care. “We are seeing discussions happening as a result of the Better Care Fund that have never happened before.”

Mr Hunt also spoke about the new opportunity for CCGs to co-commission primary care with NHS England. He told health and care commissioning leaders: “You are now in the driving seat to deliver a completely new vision for integrated care in your areas, and you have the powers and freedoms and the clinical leadership in a way that people at local levels have never had before to break down barriers. Many of you are already starting to use those freedoms and I want to support you to do it.”

Stephen Dorrell, former chair of the Health Select Committee, said: “Conferences like the Health+Care and the Commissioning Show are important because they enable the community of commissioners and providers of health and care services to meet and share each other’s experiences. Too often you find that good ideas are deployed in one area and even 20 or 30 miles away their neighbours may be entirely unaware of what is happening on their doorstep. It’s like a cross-pollination process that allows people to see how good ideas might work for them.”

In a controversial debate in the homecare stream of the conference,

SHOWCASE


Health and care come together to think differently

SHOWCASE


about whether 15-minute care visits are acceptable, three out of the four speakers agreed that they were not.

“If we are looking at a service where people have got to make a decision between having a bath or having breakfast, then it’s not safe, it’s not caring, it’s not really effective and is certainly not responsive to people’s needs, and no well led organisation should be letting it happen,” said Andrea Sutcliffe, chief inspector of adult social care at the Care Quality Commission.

“The real focus has got to be, not is this right or wrong per se, it’s actually ‘what is it we are doing to focus on the needs of people who are using the service?’ and ‘how do we put together something that is person-centred and actually meets the ‘my mum’ test?’”

Jane Harris, managing director of campaigns and engagement at Leonard Cheshire Disability, said research it conducted last year revealed that 60% of councils now use 15-minute visits. But since then, three have reviewed their policies and five said they had stopped commissioning them.

Leonard Cheshire Disability’s recommendations were that: councils should move towards outcomes-based commissioning; commissioners should be held to account; national policy should insist on some form of evidence-based pricing when tenders were put out; the views of service users should be included when contracts were drawn up; and there should be a push for more sustainable funding.

However, Mike Webster, assistant director of partnerships and quality assurance at North Yorkshire County Council, argued that 15-minute visits were acceptable when commissioned as part of a wider care package.

Speakers are already being booked for next year’s Commissioning Show and Health+Care event on 24-25 June 2015.

Compassion, dignity, integrity, respect and responsibility. These are all core values that define great care managers and workers, but how does our sector find people with those values when recruiting new people?

There is no easy answer, which is why Skills for Care, the National Skills Academy for Social Care and service provider MacIntyre have joined forces to pilot a values-based recruitment toolkit to support employers.

The idea is to help employers not only find enough people to fill vacant posts, but to help them make sure potential recruits have the aptitude for demanding, but rewarding, roles in our sector, and are then likely to stay, develop and progress their careers in our growing sector.

“The toolkit is designed to help employers make sure that when they appoint someone, they have the core values that always underpin high-quality care.”

This is particularly critical as Skills for Care’s National Minimum Dataset for Social Care estimates that by 2025, adult social care in England will need to find enough new people to fill up to a million extra job roles driven by the demands of our ageing population.

Skills for Care and National Skills Academy chief executive Sharon Allen says: “I know from my own experience as an employer how hard it is to establish the values of a person sitting in front of you at interview.

“The toolkit is designed to be a practical response to recruitment and retention issues, helping employers make sure that when they appoint someone, they have the core values that always underpin high-quality care.”

The starting point is the Skills Academy’s Leadership Qualities Framework, which sets out what good behaviours look like at every level of the social care workforce, from care assistants to registered managers.

The toolkit incorporates methods that other sectors use successfully, like a simple online personality profiling questionnaire for candidates. The easy-to-complete questionnaire helps employers establish a general profile of a candidate’s values and areas to discuss with them at interview.

Employers can also access Skills for Care’s Finders Keepers tool, which is based on four key principles to help employers not only find the right people, but keep them too, by supporting their employees with learning and development opportunities. The toolkit also offers examples of

job adverts and interview questions so when employers are advertising they are clear about what they expect from potential recruits, and know what to ask when they shortlist.

The findings from the pilot projects will be rigorously evaluated to support the development of the toolkit.

q Sharon Allen, chief executive, National Skills Academy for Social Care and Skills for Care

LEARN

Helping employers find staff with the right values


Redesigning a dementia care home while the residents continue to live there, at two sites, over a few short months is no mean feat. But this is what HC-One capital works manager Gordon Asher achieved last summer.

Gordon, who has now been at the company for a year and a half, took on the job of providing a turnaround to two failing care homes in South Wales. Both were previously run by Southern Cross and were under threat of closure or numerous embargoes. Together with the dementia team at HC-One, Gordon set to work.

“It was a challenge to work in an environment where people were living and an added challenge that they had dementia.”The two homes – Abergaru in Bridgend and Plas Cwm Craw in Port Talbot – needed a lot of work done quickly. An added challenge was that all of it needed to be completed while the residents were still in situ. Gordon says this was one of the trickiest elements of the project.

“It was a challenge to work in an environment where people were living, and an added challenge that they had dementia.”

There was also a need to make the contractors understand the environment, explains Gordon. “I needed them to know that they could not leave their tools around and their housekeeping had to be spot on.”

By working closely with the care home managers, the refurbishment took place in a way that caused minimal disruption to the day-to-day activities of the facility. For example, they would work on a corridor between 9.30am and 12.30pm then again from 1.30 to 4.30pm. This would allow the home time to move residents to and from the dining room for meals. The contractors would move the dustsheets away to give residents easy access. These ways of working were an added burden in a project that was already tight on time.

“It was really detailed logistics and it could be a nightmare. But it’s all about building relationships,” says Gordon.

He adds that having respect for the residents was of paramount importance. The respect was vital in the contractors’ day-to-day dealings with them, but also in the quality of the work.

“I would say to the contractors, we are not working in a care home, we are in someone’s home. I’d ask them to work to the same standards as if it was their own home or their mum’s home,” explains Gordon.

The work undertaken was considerable. New wet rooms and bathrooms were created, sensory gardens were designed and planted, lounges were redesigned, entrances refurbished and corridors decorated.

The attention to detail for the dementia residents is evident everywhere, even in the colour of doors. Doors that are not used by residents, such as those to store cupboards, are painted the same colour as the walls so as to blend away distractions. In contrast, bathroom doors are painted blue or yellow for easy identification. Likewise, signposting and signage, lighting, and making the end of corridors into turnaround features, were installed to benefit the residents.

“I would say to the contractors, we are not working in a care home, we are in someone’s home.”It is all the more impressive that the redesign and refurbishment was completed in three months.

Gordon had previously completed a carers’

course on Alzheimer’s to help him better understand dementia. Since then, he has added to his qualifications by doing a dementia design course at Stirling University and another run by the King’s Fund. The courses, combined with his experience of the South Wales homes, mean that Gordon has been able to contribute to an evolving design manual for people with dementia at HC-One.

At Abergaru and Plas Cwm Craw, closure threats have been removed and embargoes lifted. For Gordon though, the best part about the project has been the effect on residents. The design has reduced incontinence and challenging behaviours.

“I’m pleased that we have increased their wellbeing and enjoyment. We’ve created an environment that’s very nice to live in and has made people happier. That’s something to be proud of,” he says.

Julie Griffiths

LEARN

How to be a goo d... capital works manager


q Gordon with interior designer Helen Chalmers and procurement category manager Paul Tennick

LEARN


Re-evaluating what you think you know about dementia careIn my book The Adaptive Response I begin to outline a stress reductionist bio-psychosocial model of caring for people living with a dementia in a nursing home-type setting, and I expose stress recognition and regulation as a major factor in successful care outcomes.

Considering the emerging evidence base of individual accounts of what it means to live with brain trauma or with progressive brain insult, and after over 30 years of working with people living with a trauma or insult, their friends, families and paid carers, I am convinced that stress is one of the major factors in living well or merely surviving the experience of dementia.

“Short periods of recognised stress are helpful in that they may lead to adaptation and coping.”In our modern world, it is natural to assume that for a person with a dementia living in a care home – where moment by moment demands are made on the their physical and psychological resources, where the social impact is challenging, where corridors and rooms leave no clue as to where they lead or how to find a way ‘home’, where those others who live there remain strangers and where day and night seem to stretch out forever – daily living presents as an undulating series of challenges. Some of these will be met, some may not, but each event is laying down layers of stress upon stress.

Short periods of recognised stress are helpful in that they may lead to adaptation and coping, but chronic or repetitive stress, consciously recognised or not, leads to harmful physical responses such as heart disease, high blood pressure, ulceration and disorders of the bowel; and prolonged stress also causes neurological and psychological changes. These include short and long-term confusion, raised and then reduced acuity, and, in psychiatric terms, loss of confidence and lowered and distorted self-image and loss of self-belief.

These findings are critically important for us as carers in that these ‘effects’ are a result of stress, not dementia, but are often seen as

personal detractors and signs of ill-being as a result of a dementia in the person-centred approaches prevalent across the UK (first championed by Kitwood and the Bradford dementia group in the early 1980s).

In effect this means that even in generally good care regimes some individuals will remain highly vulnerable to environmental toxicity, even when others in the same environment thrive. It is this understanding – that each person’s unique and individual response to social and built inputs and their stressful impacts is theirs alone – which has such profound implications for us as carers of people living with a dementia. It allows us to see that if we deliver individually tailored care then every single person can have an increased quality to their lives – and that you, the carer, can directly impact on this.

I believe that we must first understand, and then seek to deliver, regimes of caring that are (a) individualised, stress aware and stress reductionist, but that are also (b) corrective and future protective, and that when a person’s disability effects their ability to thrive, then the role of the carer is to provide the successful adaptation the person seeks and requires for optimum fulfilment – whatever that may be at this time.

Understanding and applying only one model or approach will not meet the adaptive needs of every individual, even though it may

apply to many. So I ask, is it time therefore to reassess and re-evaluate our approach to caring for some of the most vulnerable in our society?

“Even in generally good care regimes some individuals will remain highly vulnerable to environmental toxicity, even when others in the same environment thrive.”Paul TM SmithAdvanced nurse practitioner, dementia care and services consultant and chief executive of Dementia.REP

www.dementiarep.com

C2L Care to Learn provides excellent learning, development and support to the social care sector.

It can offer a variety of learning courses, which are required to cover the statutory requirements of the sector, along with the specialist areas where the sector needs to develop skills and knowledge further.

C2L can offer bespoke advice, development and support to assist individuals and organisations to become more confident in their delivery.

What’s important to C2L is that you get the right learning for your staff and the most out of your learning journey, so regardless of whether you book a one-off learning course or commission them to develop your whole organisation, as a minimum you will receive:

• Mini learning needs assessment• A course overview, outlining learning

outcomes and supported Qualifications and Credit Framework (QCF)

• A reaction evaluation analysis• Learners who have reflected on their learning

experience, and return to you with this recorded

• Employees who have experienced learning that was meaningful, creative and memorable

• Access to person-centred learning resources.

It is important to C2L Care to Learn that learners experience learning that is meaningful, creative and memorable.

Delivery of learning and development

C2L Care to Learn offers a bespoke and flexible approach to the delivery of all programmes

and developmental support. Some of the more specialist areas can be delivered through a module approach, with modules lasting four hours each. C2L is happy to look with organisations at the best way to support them and their learners – for example, two modules in one day or a rolling programme over a period of time.

The delivery of learning will be agreed in continuous consultation with the commissioning person, and C2L promises continuity, flexibility and reliability through frequent communication and meetings.

What’s important to C2L is that everyone who’s involved with learning and development is happy, relaxed and ready to learn.

Evaluation

As a minimum, C2L will provide the commissioning organisation with an analysis of the reaction evaluations. These are completed by learners at the end of the learning programmes. This will allow you to see how your learners felt about the learning experience.

Evaluation of learning has an important part to play in individual learner’s continuing professional development (CPD), as well as producing valuable intelligence that can inform the workforce development plan.

Social Care Commitment

C2L Care to Learn is fully committed to the Skills for Care Social Care Commitment.

“We commit to providing high-quality learning and development that allows social care organisations to fulfil their social care commitments. “We will do this by providing thorough and

meaningful learning in line with current standards and beyond, using our vast knowledge and experience. C2L is committed to offering bespoke learning and providing learning that has been designed by the employer, while assisting them to identify those who would benefit from further development. We will also ensure that C2L learning facilitators support and encourage social care organisations to commit to the employee’s commitment and encourage the use of reflective practice every day.

“We will always be transparent in what standards the learning we deliver covers and ensure the learning we provide is up to date within an ever-changing sector. C2L Care to Learn is very committed to being a person-centred learning organisation that is known for providing creative, enjoyable and memorable learning, which supports the social care workforce to improve the quality of services they deliver.”

For more information about what C2L Care to Learn do, visit its website www.c-2-l.co.uk or call 01636 703386.

TRAINING


Making learning a meaningful and memorable experience

Advertorial

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TECHNOLOGY


Webroster’s new ‘outcomes’ functionality for reablement care providers is being launched this summer. In response to the shift in Department of Health policy, councils are now actively pursuing a policy of reablement to provide short-term care packages of home care following patients’ discharge from hospital or entry into the care system following a crisis.

Webroster have worked closely with homecare providers to understand what they need from their rostering and scheduling software to enable the successful management of reablement and rehabilitation services. The ‘outcomes’ functionality, being built into the existing Webroster.net rostering system, will log the progress of a patient over a short period of time, scoring them on their ability to perform agreed tasks with a view to becoming gradually more independent.

Homecare staff visiting a number of clients with very different reablement care packages will be able to use Webroster.net to log in at the client’s location using their mobile phone. The client’s record will show them the required information straight away and they can record a patient’s progress and scores for key tasks.

Managers will be able to manage individual client reablement care and communicate changes and updates to staff quickly and easily. As the client progresses, care managers will be able to reduce the number of visits allocated or, if they need additional support, they can roster the appropriately qualified member of staff to give them extra help. A number of new reports are being created with reablement in mind to give care managers access to information required to manage this type of service.

“The ‘outcomes’ functionality is being designed to be as flexible as possible,” says Darren Evans, commercial director at Webroster Ltd. “Webroster.net will be able to aid the management of a reablement care package as the client progresses towards more independent living.”

The latest Webroster.net software release also includes many enhancements to the main product and its additional modules, such as the introduction of real time mapping, near field communication (NFC) technology and management information system reports.

New ‘outcomes’ functionality for rostering software to support reablement

TECHNOLOGY NEWS


Access acquires CareBlox to support care provision operational efficiency Access Group has announced the acquisition of care home management solutions provider CareBlox.

The strategic move takes the group’s healthcare customer base from 400 to 550. The news comes in the wake of Access Group’s launch of its health and social care division to support care providers in removing operational inefficiencies.

CareBlox, a web-based software system for care home management that speeds up administration and provides greater control, will bolster Access’s offering to the sector, which includes rostering, payroll, HR, finance, customer relationship management (CRM), and a suite of ‘software as a service’ (SaaS) based products. The move will provide an enterprise solution for residential and domiciliary care providers to help automate business processes, reduce costs and improve the efficiency of operations.

Steve Sawyer (pictured right), divisional director of the health and social care division at Access Group, explains: “Within the care industry, which is based on staff service, it is essential that workforce planning, staff rotas and contract and service management run like clockwork. Yet far too often providers work with disparate systems, which can aggravate the inefficiency of operations. Our aim is to enable them to work with one provider to deliver a series of integrated solutions to run across the organisation and deliver complete efficiency.

“The health and social care market is by no means new territory for us – we are already working with over 400 businesses in this area. The acquisition of CareBlox, and the decision to launch a new division focused on servicing health and care professionals, is based on a recognition of the support needed to ease inefficiencies in day-to-day operations so providers can focus on doing what they do best – delivering high-quality care.”

Some of the UK’s biggest care providers use Access, including City & County Healthcare, Home Counties Care, and Age Concern. CareBlox has more than 1,000 care homes across 150 companies using their cloud-based solutions.

Ian Hargreaves, managing director of CareBlox, says: “As part of Access we’re going to be able to take CareBlox to a wider audience. The portfolio of products we can offer will enable us to do something the competition can’t; provide a range of best-of-breed integrated solutions to help care providers operate more efficiently.”


WELLBEING

Putting the care back into eyecareWe all know how important our eyesight is to us, and it can be worrying and frustrating when it deteriorates. The care that an older person needs when it comes to their eyesight is particularly specific.

As we become older we can find ourselves relying more on our eyesight than ever before. Many of life’s pleasures rely on being able to see as clearly as possible, from recognising friends and family to watching television and enjoying the sights outside. So caring for eyesight is part of both life-maintenance as well as life-enhancement.

“All our opticians are experienced in domiciliary eyecare.”

All our opticians are experienced in domiciliary eyecare. We understand that an eye examination can be a confusing event for some people, especially those with dementia. Our opticians have undertaken training about dementia and its effects and are experienced in making the whole process as easy as possible for every patient, whatever their needs.

In domiciliary care it’s especially important for patients to get to know their optician. Seeing the same optician each time builds confidence, trust and understanding. Our opticians get to know exactly what each patient wants and needs, and this means we’re able to deliver a very personal service to every patient. And feedback about this aspect of our service shows how highly valued it is.

We understand that the most important aspect of eyecare is the care; what, as a provider, you don’t want to have to worry about is the administration and paperwork. So we’ve made this as easy as possible. The only thing we will

sometimes need you to do is share our quotations with family members.

“Seeing the same optician each time builds confidence, trust and understanding.”

For the patient: simply request a sight test and we will visit at a time that’s suitable, help the patient choose their glasses (if they’re needed), and deliver them.

For the care home: we complete any paperwork that’s needed.

It really couldn’t be simpler.

All patients have access to a wide range of frames and lenses. There are hundreds to choose from, and we help our patients choose the glasses that are most suitable for them. Prices start from as little as £25, and of course, many will be eligible for free glasses using an NHS voucher. All patients are able to take advantage of the same great offers that are available in store, including 2-for-1, and we explain everything to make sure everyone gets the best value for them.

“All patients have access to a wide range of frames and lenses.”

We’ve only been successful in the high street because we’ve listened to what our patients want. And our domiciliary services are only successful because we listen to what you want. We’re determined to continue to improve, so we would really like to hear what you have to say.

In fact we would appreciate your feedback so much that we will donate £5 to the Care Workers Charity for every

completed customer satisfaction survey. Following our visit we will email you the link to the questionnaire, it will only take a few minutes to complete.

We would like to offer you a free sight test in one of our high street stores so you can experience our services for yourself, and see just why we’re rated so highly by care home managers. Please use the voucher from our advert in this issue for a free sight test or money off glasses.

Jayne RawlinsonDirectorSpecsavers Healthcall

“I couldn’t believe how easy Specsavers made this for me. Our residents love their optician, they see the same person each time so they really get to know each other, and there wasn’t any paperwork for me. I’m so pleased I changed our opticians.” Julie Arrowsmith, director of nursing services, Century Healthcare Ltd

Advertorial

©2014 Specsavers. All rights reserved. Source: YouGov Plc online survey, 2013.

Specsavers Healthcall is committed to providing domiciliary eyecare services of the highest quality to care home residents.

Which means that the people in your care can have access to the service, value and choice that have helped make Specsavers

the UK’s most trusted optician. And we want you to have complete confidence in our service, so we’d like you to experience it

for yourself. Use the vouchers below to get a free eye test and money off glasses at any Specsavers store.

To book a care home visit, call 0115 933 0823 or go to specsavers.co.uk/home-eye-tests

We’re still putting our opticians into care homes

Valid for one test booked on or before 30 September 2014. Present voucher at time of test. Cannot be exchanged for cash, used with other vouchers or redeemed by customers already entitled to a free NHS eye test. One per person. CODE 10825

FREE EYE TEST £20 OFF GLASSES or £40 OFF DESIGNER GLASSES£20 off: Applies to a complete pair of glasses from the £69 range or above. CODE 11167. £40 off: Applies to a complete pair of glasses from the £99 - £149 ranges. CODE 10863. £20 and £40 off: Valid until 30 September 2014. Present voucher at time of purchase. Cannot be exchanged for cash or used with other offers. One per person.

Care staff can be more effective and the quality of care given enhanced - just by changing a toilet.So claims Clos-o-Mat, Britain’s leading provider of toileting equipment for elderly and disabled people. Its Palma Vita floor-mounted or Lima Lift height adjustable automatic shower (wash and dry) toilet enable residents who would need the help of a carer to go to the WC without help.

Thus care staff are freed to spend time on other duties. It also ensures users are always cleaned after toileting to the same, consistently high standard; it further gives them enhanced dignity, independence and privacy - in line with Regulation 17 of the Care Quality Commission’s Essential Standards of Quality & Safety.

Even if used by just one resident every day, the Clos-o-Mat pays for itself within three months.

And it is not just Clos-o-Mat claiming the equipment makes a difference: care/nursing home management that have already installed the toilet support the company’s view. Garry Gavigan, owner of Glenashling Nursing Home, explained: “It ticks all the boxes: it gives our residents the ability to go to the toilet with little or no help, giving them greater independence and a feeling of dignity, and it addresses health and safety issues regarding lifting and handling for the staff.”

Adds Claire Haymes, Clos-o-Mat’s care

& nursing home specialist: “We go to the toilet on average eight times a day. Helping residents ‘go’ therefore takes up a significant amount of care staff time. Even at basic minimum wage for one carer, dealing with one resident, a Clos-o-Mat pays for itself in under three months.”

Looking like - and capable of being used as - a conventional WC, the Clos-o-Mat includes built-in douching and drying, triggered simply by hand, elbow or body pressure on the flush pad, or optional soft-touch pad or infra-red proxy switch. The resident does not have to deal with intricate or complex operating buttons. After toileting, retained pressure on the flush triggers simultaneous flushing and douching, followed by warm air drying. The douche has been specifically engineered to ensure accurate spraying and efficient cleaning.

The Clos-o-Mat Palma Vita is the only unit of its type developed specifically for disabled and elderly people. Since Clos-o-Mats were first introduced, over

40,000 have been installed, many of which are still in daily use over 30 years after first being fitted. The Palma Vita and Lima Lift are also the only automatic shower toilets made in the UK, and supported by in-house installation, commissioning, and after-sales service and maintenance. Full details plus technical information and case studies are available on Clos-o-Mat’s website www.clos-o-mat.com.





















GET BETTER VALUE FROM STAFF AND GIVE BETTER, CONSISTENT QUALITY OF CARE IN ONE

Norfolk Disabled-Friendly Cottages

Norfolk Disabled-Friendly Cottages is a family-run business based in the beautiful area of North Norfolk, approximately five miles from the Royal Sandringham estate and seven miles from the north west Norfolk coastline, where there are beautiful beaches and towns such as Holkham, Hunstanton and Wells-next-the-Sea to explore.

We have eight accessible cottages, all of which are beautifully converted barns that boast stunning views of rolling countryside. There are two-bedroom, three-bedroom and five-bedroom properties sleeping 2-10 people. We are situated on a converted farmyard, once farmed by my family, and can accommodate up to 42 people on site, making us perfect for group holidays. We are family-friendly and pet-friendly. There is ample off road parking.

All of our cottages are wheelchair accessible, having level access and an open plan room layout, including en suite roll-in wet rooms and purpose built low-level kitchens, especially designed for wheelchair users, their family and friends. Our two largest properties have a second floor, accessible via a through-floor lift for wheelchair users.

We provide wireless access to the internet and have a selection of equipment such as hoists, wheelchairs, profile beds and recliner chairs to hire.

The cottages were designed by my late

mother, who lived with Parkinson’s disease for 20-plus years and knew how difficult it was to find family-friendly yet accessible holiday accommodation. She passionately believed that a family should be able to holiday together and so started up the business. She passed away in December 2012 and my father and I are carrying on her good work in her memory. I am a trained nurse by trade and, as manager, live on site.

We are proud to include among our previous guests the Great British Paralympic rugby team, who used us for several years as the base for their training camps. We are perfect for all, from couples and families, through to residential homes bringing their residents away for a holiday; we have many care homes that come back year after year.

There is an abundance of things to do in the area for all ages if you wish, or you can simply enjoy the peace and tranquillity that Norfolk has to offer. I have set up a blog showcasing what Norfolk has to offer its visitors so please check it out at www.northnorfolkskies.blogspot.co.uk.

Lavinia KingNorfolk Disabled-Friendly Cottages

Please visit our website www.nd-fc.co.uk, email: [email protected] or ring 01485 578354 for more information.

TRAVEL AND LIFESTYLE


Advertorial

BUSINESS AND FINANCE


Innovative technology can help tackle informal care crisis

There has been increasing attention and pressure on the care sector over the last few months. The recent Panorama programme revealed shocking cases of extreme poor care delivered in some care homes. A recent Institute for Public Policy Research (IPPR) report predicted that by 2017 there could be as many as 2m older people living without support from family. Our own report, Who Cares?, reveals that in 10 years’ time as many as 9m older people will be in need of some kind of ‘informal care’ from friends, family and the local community.

With two-thirds of all health resources already devoted to older people, and with this population set to double in the next 25 years, it is clear that public spending will not be able to increase in line with demand.

“Some great innovations use technology to make informal caring more efficient and easily managed.”This is leading many people to fear that a ‘care crisis’ is looming.

News headlines around the care of older people capture the attention of the public so deeply because it is something that will affect us all in some way. At some point, we will either need care ourselves or have to deal with organising support for a family member. That’s what makes this such an important issue to address.

In Who Cares? we argue that what is needed is system-wide change. Council budgets are under strain and the result is that state support is now only targeting those with the highest care needs. Currently, 87% of local authorities are only funding those older people with ‘substantial’ or ‘critical’ care needs, and further budget cuts mean this will only continue. Anyone who works with older people will recognise these pressures and the budget constraints that services are under.

Yet, too much attention is focused on the lack of provision from the state. In our report, we argue for the need to create new ‘models of care’ that help to improve quality of life at an early stage in order to increase healthy life

expectancy and delay the need for expensive professional care. To avoid this care crisis we need to prepare now, and that means engaging with new solutions.

Technology can make a difference. At Nesta Impact Investments we are seeing some great innovations emerging that use technology, which can help us to:

• Increase engagement from family, friends and the community in providing informal care

• Make informal caring more efficient and easily managed

• Make the transition between informal and professional care as smooth as possible.

Hometouch is a great example of a communication and care management tool that enables more efficient self-care. Simple functions such as video messaging and photo sharing can increase meaningful connections between families living apart, providing emotional support and reducing loneliness. Its medication reminders, wellbeing tracking, specialist advice and emergency nurse call enable people to feel confident and safe living independently with declining health or a long-term condition.

“For new technologies to be effective and have a real impact, we have to ensure that investors fund them so that they can grow and reach more people.”Casserole Club is another digital tool, which connects people online who are willing to share a plate of food with neighbours less able to cook for themselves. This is more than just community food sharing; it is about creating community networks that are vital to support our older population live a good quality of life. The community is a relatively untapped supply of support, and platforms such as Casserole Club help to unlock this potential support by making it easy and accessible for people to get involved.

So, what does the future of care look like? There is no doubt that the care landscape will look very different in 10 years’ time. More

responsibility will fall to friends, family and the community, and technology is going to play an important role in encouraging more people to get involved. It will also play a crucial role in managing and coordinating the provision of care.

But for these new technologies to be effective and have a real impact, we have to ensure that investors like us fund them so that they can grow and reach more people. Commissioners and healthcare professionals need to work with social entrepreneurs to ensure these products get into the hands of the people that need them. Finally, it’s important to remember that these are just tools and that care will always need to be provided by people – so as a society we need to be open to new models of caring and recognise the opportunities they offer.

If we respond now, and prepare for what’s on the horizon with coordinated and systemic action, hopefully the landscape will look much different in 10 years’ time and we will avoid the threat of a care crisis. Katie MountainImpact investment analystNesta Impact Investments


BUSINESS AND FINANCE

In April 2014 Lighthouse Healthcare opened a new community-based intensive residential service in the Lincolnshire village of Welton – The Cottage.

The Cottage is a registered care service for adults aged between 18 and 65 with a learning disability, autistic spectrum condition and/or complex co-morbid conditions such as mental health problems, challenging behaviour, personality disorder and autism.

Lighthouse Healthcare offer three levels of service at The Cottage for those individuals who:

• Are currently living in the community, who due to crisis require a period of person-centred intensive care and support in a

community-based settled service• Want to avoid hospital admission

but have a high support need requiring a structured environment and intensive care and support

• Are currently or have previously been in hospital and require further support to progress to a robust community service.

The Cottage is set in its own grounds in a quiet residential area and provides a homely and spacious environment that replicates domestic living to encourage individuals to be responsible for maintaining their own living space.

The Cottage provides numerous opportunities to help the individual socialise and forge relationships with others living in the service. Lighthouse Healthcare has developed this service

with the aim of preparing individuals for living more independently through a programme of activities within the service and the local community.

The service is staffed 24/7 by a dedicated team of highly skilled and experienced staff who support and encourage individuals to engage in a balanced lifestyle, to include: domestic activities, skills development, community participation, structured daily activities, building relationships with family and friends, leisure and hobbies, and regular commitments.

To find out more about Lighthouse Healthcare’s intensive residential service in Welton or any other of its learning disability services, please visit our website www.lighthouse-healthcare.co.uk or call 0844 4172983.

Local service for local peopleAdvertorial

Business round-up


Business round-upMovers and shakers CBE for founder of PJ Care

Jan Flawn, founder and chair of leading neurological healthcare provider PJ Care, has been made a CBE in the Queen’s Birthday Honours List.

Jan, who set up PJ Care in 2000, was

honoured for “services to the care home business and charitable fundraising”.

She says: “As you can imagine, I’m absolutely overwhelmed and honoured to be receiving this award. I went into nursing quite late in life, at the age of 30, after leaving school with no qualifications at 15. Since then, all I have ever wanted to do is care for people in the very best way I can. And this wonderful recognition from Her Majesty the Queen is a lovely way of confirming that I have been able to do just that.”

PJ Care owns and manages three specialist neurological care centres that provide treatment and rehabilitation for a range of conditions, including motor neurone disease, young onset dementia, Huntington’s disease and acquired brain injuries. It also cares for people with spinal injuries.

Knight Frank healthcare team continues to expandThe healthcare team at property consultancy and estate agency Knight Frank has appointed Sam Wright as associate.

Sam previously worked at professional services firm PricewaterhouseCoopers (PwC) within the transaction service team. Within his new role, Sam will be concentrating on healthcare valuation and

consultancy.

He will report into Julian Evans, head of healthcare at Knight Frank, who comments: “Sam’s mergers and acquisitions background perfectly complements our team and further

strengthens our ability to service major providers.”

Care providersNational care specialist creates 1,350 new jobs in growth strategy

Paul Humphreys, Care UK group finance director

Independent sector health and social care provider Care UK is on track to achieve ambitious growth plans that have already created

around 870 jobs. It expects to create another 480 during the next 12 months as it pushes ahead with a major care home building programme. The 1,350 full and part-time jobs include career opportunities for carers and nurses as well as positions in support services and management.

Over the past 15 months Care UK has opened 10 new, state-of-the-art care homes that represent an investment of approximately £76m. Another 15 homes are currently, or will shortly be, under construction, bringing with them additional investment estimated to be in excess of £95m.

Many of the new homes will feature day care clubs that provide activity and companionship services for local people who are living in their own homes. Care UK envisages that these complementary services will help to create and support dementia-friendly communities, which are

integral to the Government achieving the dementia challenge launched by the Prime Minister in 2012.

Paul Humphreys, group finance director of Care UK, says: “Our programme of new home openings is evidence of the dedication we have to raising standards in the care sector through an investment in our care environments, the services we provide and the people we employ.

“Our new care homes have been specifically designed to meet a wide range of care needs. By creating modern and stimulating environments we can offer older people who are unable to stay in their own homes high-quality, personalised care and the support they need to maintain as much independence as possible.

“In two and a half years we have increased our number of care homes beds by 74%, and we predict that by 2016 we will provide places to more than 8,000 people. Our ability to commit significant resources, combined with attracting substantial investment from our funding partner, shows genuine confidence in the expertise and vision of our team.”

Investment success for homecare service

Big Issue Invest, the social investment arm of the Big Issue Foundation (publisher of the Big Issue magazine), is hailing the success of Northumberland-based homecare provider Bell View Help at Home, following its launch earlier this year.

Bell View Help at Home is a social enterprise dedicated to providing high-quality home care to older people in north Northumberland, and was launched with the help of a loan from Big Issue Invest.

BUSINESS ROUND-UP

BUSINESS ROUND-UP

Business round-up


Business round-upBig Issue Invest is the social investment arm of the Big Issue Foundation. It supports and extends the work of the Big Issue, with self-help and prevention at its core, by backing business-like solutions to help tackle poverty and inequality.

PropertyWork begins on new £7.5m home in Norfolk

Care UK has begun construction of a new £7.5m care home being developed at Cringleford in Norfolk. Upon completion, the new 80-bed home is set to create 100 jobs.

Representatives from building partner Metnor Construction joined forces with Care UK to mark the start of work on the new care home near Norwich.

The home is set to open in summer 2015 and will offer residential, nursing and specialist dementia care, as well as palliative, respite and end of life care. Facilities at the home will include a cinema, hair salon and café.

Designed to support residents to live active and fulfilled lives, the state-of-the-art care environment will provide a welcoming ‘home from home’. Each individual bedroom will have an en suite wet room, flat-screen television, adjustable profile bed and a 24-hour nurse call system.

Construction underway on Canterbury care home Work has begun on a new state-of-the-art care home in Canterbury. Sanctuary Group is developing the 60-bedroom care home in Hersden, on empty land at the junction of Blackthorn Road and Island Road, in a £6m project due for completion in summer 2015.

The new Sanctuary Care home will be

built by Sanctuary’s Construction partner Castleoak and will offer high-quality care for older people. It will also include a range of communal facilities to enhance the quality of life of future residents, with shared lounges and dining areas, a garden room and terrace on the first floor as well as landscaped gardens.

To celebrate the start of construction of the new care home, Sanctuary Group held a ground-breaking ceremony at the site in May, attended by Sheriff of Canterbury Councillor Tony Austin and other local partners.

Following a look at plans for the new development and a tour of the site, the Sheriff was invited to dig the first spade into the ground to mark the start of the scheme, which is set to provide much-needed care accommodation for Canterbury and the surrounding area, as well as new employment opportunities on completion.

McCarthy & Stone announces record new planning consents Leading retirement housing builder McCarthy & Stone has announced a record 31 planning consents in the five months from January to May 2014. The new consents will deliver a total of 1,102 units, with a forward sales value of £250m, and set a record for the company since it built its first retirement development in 1977.

The latest consents include sites in Chichester, Walton-on-Thames, Kidlington, Drayton, Letchworth, Wendover, Upminster and Old Stevenage for the company’s South East region, Romsey, Bridgewater and Tetbury in the South West and Walsall, Dorridge and Cromer in the Midlands. In the North, new consents include Morecambe, Hexham, Harrogate and Gosforth, and Bishopbriggs, North Berwick and Paisley in Scotland. For the South East region, one week saw seven new planning consents

alone.

All in attractive urban locations, the approved brownfield sites have a range of former users, including a redundant police station, former car showroom, a derelict former nursing home and a petrol filling station, and range in size from 0.5 to 1.25 acres (0.2 to 0.5 hectares).

The company says that the record planning approvals over a five month period demonstrate that McCarthy & Stone is succeeding in its ambitious growth plans, and are part of a total planned investment up to 2017 of £1.5bn across 250 sites.

AcquisitionsShropshire care home sold to growing multiple operatorFriendly Care Group, operator of four care homes in the West Midlands, has added a fifth to its growing portfolio with the acquisition of Netherwood care home in the market town of Shifnal, Shropshire. The care home was acquired by the group in a sale brokered by the specialist care property adviser Christie + Co.

Netherwood is registered with the Care Quality Commission for 31 residents across 19 single and six ‘companion’ bedrooms. There is believed to be room to expand the home by a further 10-12 rooms, subject to the necessary consents.

Martin Gould of Christie + Co, who sold the home on behalf of previous owners Ann Alexander and David Harrison, says: “Netherwood was acquired by Ann and David in 1995 and they have developed and expanded the home from a 20-registration set-up into the high-quality and successful 31-resident registration of today.

“Moreover, the home has strong occupancy, good fee income and a higher than average proportion of privately-funded residents — the holy grail for all care home operators — so Friendly Care Group is to be congratulated on this excellent acquisition to its expanding empire.”

p Trevor Brocklebank, Home Instead Senior Care chief executive and co-founder

From a standing start in 2007, Trevor Brocklebank and his wife Sam are well on their way to achieving their stated aim of changing the face of ageing for the country’s elderly population.

And that’s what their company, Home Instead Senior Care, is all about. Ask Trevor and he’ll tell you that they are first and foremost a care organisation and a business second. The entrepreneur will also tell you that: “Profit is the reward for what you do, but it’s not the reason.”

Having sold a business in the IT sector, the Brocklebanks were looking for a new opportunity. Having experienced difficulty accessing the right sort of care for Trevor’s grandfather, and seeing the reality of what

was on offer, it was a serendipitous moment when a business contact presented the couple with the idea of setting up Home Instead in the UK.

“Home Instead originated in the United States and now operates in 17 countries across the world.”

Home Instead originated in the United States and now operates in 17 countries across the world. The company specialises in providing high-quality non-medical care to elderly people in their own homes. The care they provide is a blend of companionship services as well as personal care.

Trevor is now running a business with a network of over 150 independently owned and run offices across England, Scotland and Wales (and the Isle of Man) and believes their model of delivering care is unique.

For a start, they focus on personalised care packages rather than local authority block contracts as they believe block contracts drive down the quality of care, forcing providers into delivering short duration calls, putting their carer workers in untenable situations and jeopardising the health, safety and dignity of elderly people across the country. Home Instead has a minimum care visit time of one hour.

Commenting on this, Trevor says: “Care is not a commodity and neither are carers.

“The commissioning of care in block contracts, with providers fighting to offer their services at the lowest rate, is wrong on all counts. It’s bad for the providers, who, in my opinion, are part of the problem – they should refuse to work in this way. It’s dangerous for the recipients of the care and it’s bad for carers.”

And this brings Trevor onto his next mission,

which is to change the face of caregiving. He says: “If we are to cope with our rapidly ageing population, we are going to need a legion of caring, compassionate people who are opting to care because they wish to give something back, enjoy the company of others and have an empathetic nature.

“We need to treat carers with respect and professionalise their role. We are able to do this at Home Instead because we are not operating under the constraints of block contracts.

“So our model sees us matching caregivers and clients and, with a minimum call of one hour duration, the company’s caregivers have time to properly meet their client’s needs. And this is helping us to become the employer of choice in the sector.”

“Our model sees us matching caregivers and clients and with a minimum call of one hour duration.”

But there is an even more fundamental issue hampering the care sector in Trevor’s opinion, and that’s the lack of joined-up thinking between health and social care.

It means that instead of celebrating our population’s longevity, too many people are worrying about what their future will hold.

“We need better integration between health and social care and we need to move more money into social care. By keeping people safe and well in their own homes with a quality care service we can help to prevent them entering the more costly health system.

“There is no doubt in my mind that by providing quality social care we can keep more elderly people at home, living a healthy and independent life, and this has got to be a more cost-effective option.”

Time and respect at heart of Home Instead care model


BUSINESS - COMPANY PROFILE

BUSINESS - LEGAL

Huge changes are taking place across the health and social care sector, including the Care Quality Commission (CQC) inspection regime and the introduction of the Care Act 2014. This article outlines future plans for the health and social care sector as a result of changes in legislation.

CQC inspection regime and ratings

CQC continues to consult on huge changes to the inspection regime for all of the services it regulates. The main focus of the consultations has been on the introduction of new ‘fundamental standards of care’, intended to replace the current outcome-focused inspections, through CQC’s new inspection regime.

The process by which CQC inspects services, such as residential adult social care and mental health services, will differ slightly depending on the type of service. However, all inspections will be based around the new fundamental standards as set out in the draft Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (‘draft Regulated Activities Regulations’). The intention is that the new fundamental standards will come into force and be applied by CQC through the new inspection process in October 2014.

From October onwards, CQC will focus on asking five key questions for all inspections: Is the service safe, effective, caring, responsive and well-led? Each question is judged on a standard set of ‘key lines of enquiry’ (KLOEs).

“CQC will focus on asking five key questions: Is the service safe, effective, caring, responsive and well-led?”KLOEs are essentially high-level questions, some of which inspectors must answer during an inspection, with others being discretionary. There are approximately seven or eight KLOEs per ‘key question’. Details of KLOEs can be found in the consultation documents on the CQC website.

Only four years after the old ‘star rating’ system was abandoned, CQC is again introducing a proposed rating system. The ratings will judge services to be: outstanding; good; requires improvement; or inadequate.

Ratings will be informed by inspections, intelligent monitoring data, local information and other local sources (for example, from local authorities, CCGs and public opinion). Services will be rated at two levels. Firstly, a separate rating will be found for each of the five questions. Secondly, CQC will aggregate these separate ratings up to an overall location rating. CQC plans to have all adult social care services rated by April 2016.

From June to August 2014, CQC will embark on a formal eight-week

Keep up to date with new inspection regime and provider duties

consultation on new guidance for all providers on how to comply with the new regulations. CQC will also be consulting on a new enforcement policy covering the new regulations. Providers should keep an eye out for publication of these consultation documents. This is a chance for providers to have a say in how CQC will be regulating their services in the future.

The Care Act 2014

The Care Act 2014 (‘the Act’) received royal assent in May 2014. The Act has been produced to reform the law surrounding health and social care. In particular, the Act provides for the introduction of a duty of candour and personalised care.

“Professionals will be required to engage with service users when unanticipated things happen that cause harm.”In practice, the duty of candour means that professionals will be required to engage with service users and, where appropriate, their families when unanticipated things happen that cause harm above a set threshold. CQC will set out the statutory duty of candour through regulations that are intended to come into force in October 2014. Whenever the duty of candour is engaged, providers will be required to provide an apology, an explanation of what happened, all necessary practical and emotional support, and assurances about continuity of care.

The Act provides that the individual should be placed at the very heart of the health and care services they receive. Regulation 4 of the draft Regulated Activities Regulations introduces person-centred care for providers registered with CQC. CQC’s consultation on its new approach to regulating, inspecting and rating services highlights the need for person-centred care and how inspectors will be judging this in the future.

It is important that providers and staff keep up to date with the changes. Providers should arrange appropriate staff training to ensure that their service can operate in accordance with the new requirements.

Samantha CoxTrainee solicitorRidouts


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ISSUE 16 October 2012The Voice of Excellence in Social Care

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LUCY IS HERE FOR YOU ON YOUR RAINY DAY, WILL YOU BE THERE ON HERS?All of us will call on Britain’s 1.8 million care workers at some point. They are our largest workforce, but also one of the lowest paid. By fundraising or donating just a little you can help The Care Workers’ Charity provide support to care professionals going through tough times.

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GREAT EAST of EnglandCare AwardsThe Great South East Care AwardsGala Dinner: 8th Nov 2014Venue: Hilton Metropole Hotel, BrightonNomination closing date: 15th Sept

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The Great Yorkshire and Humber Care AwardsGala Dinner: 31st Oct 2014Venue: The National Railway Museum, YorkNomination closing date: 18th Sept

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