focus on dementia - careinfo.org · donald macaskill. “mr kilgour’s research has served to...
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November 2018
INTERVIEW:with Target’sKENNETH MacKENZIE
Dementia care inretirement villages
Public provision inScotland draws fire
Questions aboutadministration fees
Staff / recruitment... Property marketplace... Innovation... Expert analysis...
Social care business management
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FOCUS ONDEMENTIAcareinfo.org relaunch – see inside
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MEANINGFUL INTERACTIONS
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“What is taking place is a
blatant misuse of public
money, with tens of millions of
pounds wasted every year.”
Mr Kilgour made Freedom of
Information (FOI) requests to all
32 local authorities for a
detailed breakdown of their
care home operations,
including:� How many care homes they
currently own, lease or hold
under other tenancy
agreement.� Total costs of purchasing,
land acquisition, building or renovating these
homes – and borrowings required for these.� Total weekly costs per resident for each care
home.
– The average annual salary of managers, deputy
managers and assistant managers for each care
home.� Details of any care homes that they have plans to
buy, develop or build in the future.
The responses are available online at:
www.scottishcare.info
“The responses show there is no level playing field
when it comes to funding elderly care in Scotland,” Mr
Kilgour said.
“How can local councils expect independent care
homes to operate on far lower funding than their own
homes? I want to highlight the double standards in
operation. Local councils are not being realistic and
newsNovember 2018
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One of Scotland’s most experienced care home
operators has called on the Accounts Commission,
the public spending watchdog for local government in
Scotland, to carry out an investigation into how much
local councils spend on their care homes.
Renaissance Care chairman Robert Kilgour, who
founded the UK’s second biggest company in the
sector and who currently operates 12 homes
throughout Scotland said it was time that Scottish
local councils were “open and honest” about the
costs of building and running their own care homes –
in comparison to the funding they provide to
independent sector operators.
“Local councils need to address growing
inequalities in funding between local authority and
independent homes,” said Mr Kilgour.
Kilgour accuses Scottish councilsof ‘blatant misuse of public money’
honest in recognising the true costs of care.”
After receiving the Scottish councils’ responses, Mr
Kilgour posed four questions:
1) Why should certain local authorities get away with
spending lots more of taxpayers’ money running their
own care homes? He gave examples from the FOI
responses:� East Lothian Council at Crookston care home in
Tranent - £1055 per week per resident for residential
care;� Fife Council – an average cost across their seven
care homes of £947 per week per resident;� West Dunbartonshire Council from £896 to £969
per week per resident;� North Ayrshire Council from £1,533 to £1,767 per
week per resident;
� Continued on Page 20
ROBERT KILGOUR:
I personally know of
two council-built care
homes that have been
valued by professional
surveyors at a lot less –
millions of pounds less
– than they cost the two
councils to build.
Abbeyfield Southern Oaks . . . . . . . . 34
Avante Care & Support . . . . . . . . 27
Avery Healthcare . . . . . . . . . 9
Balhousie Care Group . . . . . . . . . . 27
Barchester Healthcare . . . . . . . . . . . . 42
Birchgrove . . . . . . . . . . . . . . . 34
Care Concern . . . . . . . . . . . 16
Care UK . . . . . . . . . . . . . . . 34
Caresolve Operations . . . . . . . . . . 45
Caring Homes . . . . . . . . . . . . 16
Cinnamon Care Collection . . . . . . . 20
Community Integrated Care . . . . . . . . . . . . . . . 28
Elizabeth Finn Homes . . . . . . . . . . 30
Erskine . . . . . . . . . . . . . . . . . . . 0
Evolve Care . . . . . . . . . . . . . . . . 25
Exemplar Health Care . . . . . . . . . 34
Hill Care . . . . . . . . . . . . . . 27
Ideal Carehomes . . . . . . . . . . . . 16, 45
Meallmore . . . . . . . . . . . . . . 27
C O M PA N Y I N D E X
Middleton Hall Retirement Village . . . . . 38
National Care Group . . . . . . . . . . . 39
Nightingale Hammerson . . . . . . . . 8
Omega Elifar . . . . . . . . . . . . 34
Optalis . . . . . . . . . . . . . 39
Orders of St John Care Trust . . . . . 32
Priory . . . . . . . . . . . . . . . . 16
Regard . . . . . . . . . . . . . . . 37
Renaissance Care (Scotland) . . . . . 4
Retirement Villages . . . . . . . . . 22, 32
Right At Home . . . . . . . . . . 27
Royal Star & Garter . . . . . . . . . 8, 20
Shaw healthcare . . . . . . . . . 42
Solar Care Homes . . . . . . . 37
Stocks Hall Nursing & Care . . . . . . . . 27
Sunrise Senior Living UK . . . . . . . 25
Wellington Support . . . . . . . . . . 39
Whiteley Village Trust . . . . . . . . . . . . . 34
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November 2018
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‘blatant misuse of public money’� Orkney Council from £1,039 to £1,230 per week
per resident;� Perth and Kinross Council from £920 to £1,825
per week per resident;� South Lanarkshire Council from £919 to £1,572
per week per resident;� South Ayrshire Council - £1,379 per week per
resident;� Shetland Council from £1,338 to £1,789 per week
per resident.
“All of these are far more than they pay the
independent sector per resident per week – which is
£594 for residential care, and even much higher than
the £690 paid for full nursing care,” said Mr Kilgour.
2) Why should certain local authorities get away with
spending lots more of taxpayers’ money building their
own care homes? Examples from the FOI responses:� East Lothian Council at Crookston in Tranent -
£175k (in 2015) per bed plus land costs;� West Dunbartonshire Council at Crosslet House in
Dumbarton - £157k (in 2017) per bed plus land
costs;� Aberdeenshire Council at Bennachie View in
Inverurie - £193k (in 2015) per bed plus land costs;
� Continued from previous page
and at Edenholme in Stonehaven - £130k (in 2012)
per bed plus land costs;� City of Edinburgh Council at Drumbrae in
Edinburgh - £135k (in 2013) per bed plus land
costs.
“All of these are much more than the current (in 2018)
independent sector spend - circa £90k per bed plus
land costs,” said Mr Kilgour. “What are council care
homes now valued at compared to what they cost to
build with taxpayers’ money?
“I personally know of two - Ostlers House in
Kirkcaldy in Fife and Crookston in Tranent in East
Lothian that have been valued by professional
surveyors at a lot less – millions of pounds less - than
they cost the two councils to build. Many more will see
the same waste of money.
“I’d like to understand why some authorities feel the
need to own and operate their own care homes at a
very expensive cost to the taxpayer as opposed to
other councils who don’t feel the need.”
3) Why are some local councils charging higher fee
rates to private funders than they are paying to the
independent sector? Examples from the FOI
responses:
� Fife £954 for residential care per week per resident;� Argyll and Bute £1244 for residential care per week
per resident;� Western Isles £1,028 for residential care per week
per resident;� Midlothian £915 for residential care and £1,010 for
nursing care per week per resident;� Perth and Kinross - £904 for residential care per
week per resident;� Shetland - £1,198 for residential care per week per
resident.
“These local councils seem to be subsidising their
care home costs with charging private funders higher
fees,” said Mr Kilgour, adding that reassurance was
needed that elderly people were being offered real
choice as to which care home they wished to enter,
rather than being pushed into going into local
authority homes.
“Despite clear underfunding there is nevertheless a
high level of quality in the independent sector, but if
properly funded the quality would be even greater.
“Independent care home companies have to pay
the Scottish Carers Living Wage, which I’m happy to
do as care workers fully deserve it, but they are
expected to do this with substantially lower funding
than Council care homes.
“They also face other matters like the
Apprenticeship Levy and uncertainty over Brexit which
could result in loss of experienced EU-born staff. At
the same time, they are expected to continue to invest
in improved facilities. It’s simply not sustainable.”
Provider representative body Scottish Care
has commended Mr Kilgour for undertaking
the FOI requests.
“For some time now, Scottish Care has been
working with colleagues in COSLA and the Integrated
Joint Boards to determine the real cost of caring for
the 33,000 individuals who will spend tonight in a
care home,” said Scottish care chief executive Dr
Donald Macaskill.
“Mr Kilgour’s research has served to shine a light on
the inequality at the heart of how we fund care home
places in Scotland.
“People will rightly be shocked that local
authorities are using public monies to deliver care
at disproportionately and substantially higher
costs than they are prepared to pay independent
sector providers.
“This behaviour threatens the sustainability of the
sector. At its worst it could put those who live in a care
home at risk of losing their place of care. Local
authorities, I suspect, are delivering care home provision
at much closer to what the real cost of care is. It is a
credit to the sector that the quality of care in
independent care homes is as high as it is given the
historic underfunding this research has revealed.”
Caring Times and the Journal of Dementia Care
are delighted to announce the launch of our
completely redesigned and renewed website
www.careinfo.org which offers a bright,
attractive mini-portal into the many publishing
activities we offer our much valued customers
and business partners.
Many of the care home sector’s biggest and
most loved awards and events, such as the
National Care Awards, the National Dementia
Care Awards and Europe’s largest annual
dementia conference, the UK Dementia Congress
are displayed in an-easy-to-use format, as well
as, of course, social care’s longest established
publication, Caring Times, and the much valued
Journal of Dementia Care.
In addition we have responded to the biggest
current challenge in social care – recruitment and
retention of staff – by introducing a completely
new section devoted exclusively to these
issues. The section includes career
advice, training information, recruitment
blogs and recruitment success stories.
We would particularly value readers
sending in positive stories about how
New www.careinfo.org website launchrewarding they have found working in the care
home sector to be, or how they have risen from
humble beginnings to positions of management
responsibility. We want to build up a really
impressive bank of real stories to counter the
often negative general perceptions of care
homes and dementia care. Emails to
[email protected] please.
We greatly value the feedback of our readers
and business partners, so if you have any
suggestions to improve any areas of
www.careinfo.org, please drop an e-mail to
[email protected] to give your
feedback. And don’t forget, you can always
suggest new material to our editor, Geoff
Hodgson at [email protected].
And be sure to send those positive stories which
will encourage people to enter and stay in social
care to [email protected].
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news DIGESTNovember 2018
www.careinfo.org
ELDERLY HOSPITALADMISSION RATESCONTINUE TO SOAR
NIGHTINGALE EXCELS ATEND OF LIFE CARE
NO CONSENSUS AMONGACTUARIES ON SOCIALCARE FUNDING
CARE HOME OPEN DAY
KING’S FUND: CQC REQUIRES IMPROVEMENT
8
Friday, 28 June is the chosen date for
Care Home Open Day 2019.
Now in its 7th year, the event
encourages care homes to open their
doors to celebrate a different theme each
year, with a few key values at its heart:
friendship, making connections and
celebrating older and vulnerable people.
Struggling to do the smallest tasks because your vision has failed. Finding it
impossible to follow what’s happening around you because of the confusion
going on in your head. This may sound like a nightmare, but it’s actually everyday
life for many people living with dementia.
The Virtual Dementia Tour rolled into The Royal Star & Garter Homes –
Surbiton, recently, giving staff an eye-opening insight into what life is like for many
of the older people who live there. Residents’ relatives were also invited to
experience life as their loved ones do.
Wearing ill-fitting gloves, glasses, headphones and insoles, I experienced
unease and discomfort, confusion and helplessness. Yet despite all of this, I’m
pretty certain there was a hint of a smile on my lips – because I knew I was in a
simulated environment. I knew this experience – though uncomfortable and
claustrophobic – would soon be over.
And then I thought what it must be like for people who can’t slip off the
headphones, who don’t get to return the gloves and glasses. I was thinking of
the people who can’t switch off dementia.
Afterwards, during a hugely informative debrief, we’re told the virtual dementia
we were subjected to was ‘mid-level’ . . . cue more pause for thought from
everyone in the room.
This tour gave an invaluable insight into the world that people living with
dementia experience every day. I’m glad I did it. If more people were able to
understand how lonely and frightening an existence it is, perhaps we could all do
something to make life easier for someone living with dementia.� See also ‘Learning by experience’ - Page 28
DEMENTIA SIMULATION GIVES INSIGHTBy GOOLISTAN COOPER, communications officer for
The Royal Star & Garter Homes.
An evaluation of the Care Quality
Commission’s approach to inspection
and ratings has found that, while it
is a significant improvement on the
system it replaced, it could be made
more effective.
The research, carried out by The
King’s Fund and Alliance Manchester
Business School between 2015 and
2018, examined how regulation was
working in four sectors - acute hospitals,
mental health, general practice and social
care – in six areas of England.
The report highlights a number of
areas for improvement in CQC’s
approach to regulation. It cautions that
the focus on inspection and rating may
have crowded out other activity which
might have more impact. It
recommends that CQC focus less on
large, intensive but infrequent
inspections and more on regular, less
formal contact with providers, helping
to drive improvement before, during
and after inspections.
“We found that CQC’s approach
works in different ways in different parts
of the health and care system,” said
Ruth Robertson, report author and
Senior Fellow at The King’s Fund.
“When CQC identifies a problem in a
large hospital there is a team of people
who can help the organisation respond,
but for a small GP surgery or care home
the situation is very different. We
recommend that CQC develops its
approach in different ways in different
parts of the health system with a focus
on how it can have the biggest impact
on quality.”
� A copy of the report and report
summary is available to download at:
https://www.kingsfund.org.uk/
publications/impact-cqc
provider-performance
The Association of Consulting Actuaries
(ACA) has found little consensus
amongst employers on the long-term
funding of social care.
The ACA says extra public funds
already ear-marked by Government for
social care are widely supported and
might help address a one-off immediate
need, even if they increase taxes.
However, the expected rise in costs
year-in, year-out due to an ageing
population suggest other changes that
encourage costs being met from private
pensions, insurance solutions and
alternative funding solutions are also
going to be needed in any longer-term
package.
“Our survey findings suggest that
employers are as uncertain as the
politicians as to how rising social care
costs can be funded,” said ACA chair,
Jenny Condron.
“Whilst tax rises have some traction
in meeting the immediate problem,
a constantly rising tax rate to
meet this and other funding priorities
seems likely to prove increasingly
unpopular, particularly if it falls on the
working population.
“It will be interesting to see whether
the Government’s upcoming and long-
delayed Green Paper will be wide-
ranging as we hope, looking at longer-
term pre-funding solutions.”
� The report is available at:
https://aca.org.uk/placard-examines-
social-care-crisis-and-solutions/
A Clapham nursing home has been
named Care Home of the Year by the
National Gold Standards Framework
Centre for End of Life Care (GSF).
Nightingale House was one of nine
homes on the shortlist which also
demonstrated long term, sustained
quality care, being accredited by GSF
for the fourth time.
The judges, who included national
independent experts from the care
homes sector, found high standards of
care embedded in all of these front-
running homes.
The Care Quality Commission (CQC)
has recognised the standards of care at
a number of these homes, including,
Nightingale House and rated them
‘Outstanding’. Simon Pedzisi, director
of care and services at Nightingale
House said the two accolades were
inextricably linked.
“Without a shadow of a doubt, GSF
helped us achieve the Outstanding
rating from CQC,” he said.
“For us to demonstrate high
standards of care means we are
demonstrating high standards of end of
life care because of the age profile of
our residents. GSF is the foundation of
our care which means it is the
foundation of our CQC rating.”
Estimates by Age UK have found that
an increasing number of older people
are being admitted to hospital for
conditions which should have been
dealt with at home due to failures in the
care for people in the community.
The estimates show that older
people have seen the largest increases
in admission rates with percentage
changes of over 100% for each of
the different age brackets aged 65
and older in the 14 years since
records started.
Sally Copley, director of policy,
campaigns and partnerships at
Alzheimer’s Society, said that for most
people receiving adult homecare and in
care homes living with dementia, there
was no question that the social care
crisis is a dementia crisis.
“It’s beyond heartbreaking that
people with dementia are ending up in
hospital as a result of poor care in the
community,” said Ms Copley.
“In fact, there were more than
50,000 avoidable emergency
admissions for people with dementia
last year.
“This needless care gap in the
system is leading to the human cost of
people with dementia being pulled from
pillar to post in search of adequate
care, disrupting their home life and
forcing them to struggle in crowded
hospital wards.”
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news DIGESTNovember 2018
www.careinfo.org
‘GREEDY DEVELOPER’JIBE PROMPTS CALLFOR COUNCILLOR’SRESIGNATION
CALL FOR RETHINK ONLIBERTY PROTECTION
SOCIAL CARE MISSES OUT ON WINTER FUNDING
HEWSON FLIES FLAG FOR AVERY HEALTHCARETelevision actress and media
personality Sherrie Hewson has
been appointed as Ambassador for
Avery Healthcare care home group.
After her own mother’s
experience of being in care, Ms
Hewson says she is passionately
concerned about the senior
adult social sector.
She will be visiting all 54 of the
Avery care homes around the
country in the next year. Sherrie Hewson
Provider representative body Care
England has expressed concern that
the social care sector has once again
been left out of new funding for NHS
for winter.
In early September the Department
of Health and Social Care announced
that hospitals would receive £145m to
prepare for winter demand. The money
will be spent on upgrading wards,
redeveloping A&Es and extra beds at
NHS trusts across England.
Care England chief executive
Professor Martin Green said boosting
the NHS’ resilience to cope with the
inevitable pressures this forthcoming
winter would be futile if the social care
sector was overlooked.
“Every winter we see the NHS
receive new funding whilst social care
does not,” said Prof. Green.
“We hope however that the NHS will
ensure that it works with the
independent care sector to use existing
spare capacity in care homes. The
Department of Health and Social Care
needs to demonstrate its understanding
of the system or revert to type and be
called the Department of Health and
dispense with the social care.”
Care providers are concerned about
the Mental Capacity (Amendment) Bill
which will introduce the Liberty
Protection Safeguards (LPS), replacing
the existing Deprivation of Liberty
Safeguards (DoLS). The Bill had its initial
Committee Stage in the House of Lords
in early September.
The Voluntary Organisations
Disability Group (VODG) says the
legislation requires a radical rethink,
pointing out that the Department of
Health and Social Care (DHSC) has
failed to fully engage and consult with
social care providers on the reforms.
VODG warns of the potential conflict
of interest created by placing LPS
assessment responsibilities on care
managers, rather than resting with local
authorities, making the person
responsible for maximising the use of
the service also responsible for
deciding if someone objects to being
there. Providers may face allegations
they are depriving someone of their
liberty to fill a vacancy.
VODG chief executive Dr Rhidian
Hughes said the charity also had
concerns about the financial and
practical impact of fulfilling this new
responsibility when care providers were
already under enormous strain.
The boss of a Cheshire-based care
home company is calling for the
resignation of a Warrington councillor
after comments he considered as
inaccurate, inappropriate and
misleading were made about a planning
application submitted by his business
for new care facilities in Lymm.
Liberal Democrat Councillor for
Lymm North and Thelwall, Ian Marks,
made the comments about the
proposed application for a multimillion
pound care facility on the site of the
Macdonald Hotel on Whitbarrow
Road, accusing the company of
“gross overdevelopment” and of being
a “greedy developer completely
ignoring the community in which the
site is located.”
Director of McGoff Group Chris
McGoff, has hit back, accusing the
Councillor of hypocrisy and saying there
were many flaws in his argument that
could ultimately mislead the local
community and adversely affect future
levels of quality care that could be
delivered for some of the most elderly
and vulnerable people in the borough.
“I entirely object to the defamatory
comments made by Councillor Marks,
and the highly prejudicial statements
made about me, the business and this
planning application,” said McGoff.
“Some people, including Councillor
Marks, may not be aware that the site
already has extant planning
permission for a significant hotel
expansion,”he said. “Our proposed
building is circa 40% smaller in terms of
floor space and circa 20% smaller in
terms of built footprint with more green
space and, as such, has a much lower
impact on the local environment. If our
proposed scheme is smaller than the
one that already has approved extant
planning permission then how can it be
gross overdevelopment?
“I also entirely object to the accusation
of greedy developer,” said McGoff.
“These are purpose-built care facilities
that we build, retain and operate from,
with a very lengthy return on investment
and we are in this for the long haul.”
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legal landscape November 2018www.careinfo.org
10
A man in Somerset has contacted Caring Times,
saying he is unhappy about the administration fee
charged by a care home operator following the
admission of his mother-in-law.
“My mother-in-law was hit with a fee of £980 for
"administration",” the man said.
“This represents one week’s care fees; if her weekly
fees were £1200 the administration charge would
have been £1200.
“Not only is this unjustified, it's appalling and very
upsetting for both residents and families. My mother
and gran spend time in various care homes and we
have never encountered such charges before.”
The man added that he understood the practice
was currently under investigation by various
organisations including Competition and Markets
Authority (CMA), Age UK, Which Magazine and care
services minister Caroline Dinenage.
“I appreciate the fact that this charge is stated in the
Care home admin fees come under fireterms and conditions that my in-laws were given when
they made their initial visit. However, they were led to
believe that this was industry practice so had no cause
to argue. My mother and grandmother both spent time
in various care/nursing homes during their lives and we
have never come across this practice until now.”
Admission costs
Independent care consultant Anne Smith said the
adminstration charge might be justified.
“I work with several homes that deal in a high
number of respites; the work to admit these residents
is recognised as very high,” said Ms Smith.
“Care documentation alone can take five hours or
so. Then there is the admin time to ensure all the
paperwork is signed. In terms of the other services,
more time is taken on admission than anything else.
“Deep cleans, fresh linen and fabrics, new
mattresses possibly, painting, new carpets, chef time
to identify likes, dislikes and diets, and more
individual staff time than normal helping the new
resident to settle in.
“Although it should arguably be covered by the
weekly fee, I am not sure the weekly fee in this
example is high enough to cover all the costs;
strictly “admin costs” though they might not be.”
CMA’s final guidance
The CMA final guidance on care contracts and
consumer law obligations is expected to be
published in mid-October.
The guidance will, says law firm Royds Withy
King, have wide-reaching implications for
care homes and care providers, requiring them
to review the way they operate in terms of
admissions procedures, marketing, and how they
contract with service users.
Care providers who do not comply with consumer
legislation will need to make significant and substantial
changes to their service user contracts or risk fines
and enforcement action from the CMA, Trading
Standards, CQC, and directly from service users.
“Up-front fees and security or reservation deposits
will be more closely scrutinised,” says Hazel Phillips,
head of the social care team at Royds Withy King.
“Care providers should start reviewing their
practices and contracts now in advance of the CMA’s
final guidance.”
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inspection & regulation November 2018www.careinfo.org
Mythology and inspired fictionconstantly repeat tales of thosewho create a monster which will
have the physical power to achieve itsmaster’s desires. Dr Frankenstein, DrFaustus, or even the Minoan Minotaur cometo mind. Perhaps the most striking andterrifying was Dr Frankenstein who built andequipped a mechanical robot, overlookingthat a measure of reflection was required tolimit the excess of brute strength withoutother credible control.
Regulators are important, indeednecessary, but they may grow beyond thecontrol of those who have conceived andcreated them. The current role of the adult
Will anyone control the monster?
Ridouts Professional Services
managing director
PAUL RIDOUT says the
Care Quality Commission is
perceived as working to
assume control of the
sector which it was
established to serve.
www.ridout-law.com
social care regulator is to hold those whomthey regulate to account. Their rationaleshould be simply to ensure that the regulatedoperate within acceptable levels of controland deliver the outcomes of their services,ensuring that those services are conducted inaccordance with transparently visible norms.The regulator should be the servant and notthe master of the sector.
Inevitably, regulation will involve theexercise of power against some who arefound wanting. The spirit of regulation willalways attract those for whom there is afrisson of energy in imposing rules on others.It is all too easy for that necessary process ofmonitoring and enforcing to become one ofstigmatisation and bullying.
Traditionally regulation was operatedlocally with the regulator being accountableto local stakeholders. In health and socialcare there was a change to a national body in2002 and that was followed by a period whenthe regulator was seen to be increasinglyweak and not fit for purpose.
A new regulator, the Care QualityCommission, was established in 2009,becoming operational in 2010. The CQC hasembraced its task with strength of mind andsome zeal. This regulator has increasinglyseen itself as the leader rather than theservant of the sector. It has no respect forrules set to contain its activities but prefers tomake up its own rules which are not easilyquantifiable or subject to the challenge whichthis regulator so dislikes.
What is lacking is a controlling oversight ofthe operation of this regulator so as to keep itin check and balance its natural enthusiasmfor intervention against a need to ensure thatthe sector is not strangled out of existence.
Tactical avoidance of control
In 2009 Parliament reset the rules. Frominception the CQC has sought by tacticaloperation to change the rules and avoid andeschew the control which should come fromthe law. The law can only work effectively ifit has foundations upon which to move itslevers of enforcement and reasonable time inwhich to work. We will catalogue theemasculation the legal structure:
1. Making the foundation of operations formultiple operators a condition and not aregistration – the location condition.
2. Eschewing the test of compliance andreplacing this with a consumer-basedconcept of individual ratings, skilfully anddeliberately languaged to mislead onnegativity. What is wrong with compliancehidden in the mantra “only good is goodenough”, the rating “requires improvement”means almost good or not consistently good.To the public “requires improvement” meansunacceptable. The use of these ratings isbeing taken as a measure, with no effectivechallenge available, whereby externalstakeholders will judge and degrade.
3. Producing inspection reports withsensational language which tend to judgesubjectively and without hard evidence.
Access to contemporary notes is refused.Challenge is virtually impossible. Thejudgement of inspectors or worse, unseenmanagers, is not subject to any effectivesystem of challenge and is published far andwide even when known to be subject toserious disagreement.
4. Removal of the licence to trade is nowincreasingly both threatened andimplemented by removal of condition ofregistration (the location conditions)instantly and without any serious andeffective prospect of challenge. This placesoperations, staff, and, service users in aninvidious position without warning orbalance. No matter how quick the appealprocess it is valueless if the subject hasalready been destroyed.
5. Now, most worrying of all, the regulatoris starting to dictate not just the quality ofservice but also the structure and content ofservice so that the regulator seeks to shapethe scope of what it regulates, viz:
� The size of care centres for those withlearning difficulties;
� The development of online medicaladvice and now, we have;
� The size and content of care homes
Slowly and incrementally the regulatorhas expanded its power and influenceand continues so to do. It may well be seenas a monster which is working to assumecontrol of the sector which it wasestablished to serve.
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November 2018
www.careinfo.org
An Oxfordshire woman has contacted
Caring Times and told of her difficulty in
finding employment as a care worker.
The 45-year-old woman has children at
primary school (with an older one at
university) and her husband works
remotely and is only at home on
weekends.
“I have been thinking about working
in a care home as a new career and I
wanted to go in at the lower level as a
care assistant,” the woman told Caring
Times.
“I thought it would be reasonably
easy as I understand that the care
sector is crying out for staff. I applied to
several care homes because I wanted
to be part of a team – working alone
and driving around to provide homecare
doesn’t appeal to me.
“I have had a number of one-to-one
interviews and have gone back to
several places for second-line
discussions on flexibility and what I
could do and how much I can offer, but
I don’t seem to be getting anywhere.”
The woman explained that her
working hours were restricted to
schooltime but the school was
arranging ‘wrap around care’ after
Christmas which would extend the
hours she could work.
“But I am being offered 12-hour
shifts,” she said. “I offered to do a 12-
hour night shift but a 12-shift during the
day is just not possible; I cannot get the
child care. I was offered half-days – 8am
’til 2pm or 2pm ’til 8pm – but it had
to be a mix of the two; I couldn’t
do mornings only, which of course is
very difficult for me.”
She had been able to commit to
working alternate weekends, which she
could do because her husband was at
home on weekends, but the
requirement to work weekday
afternoons could not be surmounted.
“I believe I am a willing, capable,
enthusiastic and positive person but I
can’t find anyone to employ me for the
hours that I am available to work,” she
said.
“It was the same everywhere I
went. I have worked as a massage
therapist for 15 years and as a
beauty therapist for 10 years. I
have run my own business, I have done
a lot of voluntary work; in care homes
and with meals on wheels, but it seems
care work isn’t an option for anyone
who has children to look after.
“There are a lot of us; we have a lot to
give because of our life experiences and
our understanding about caring for
other people but the care industry
seems to be unable to tap into that.
“Our productivity once we are
working is usually very high; we show
up for work, we want to do a good job.
We don’t waste time; we have an awful
lot to give but the hours are not flexible
enough.
“I think there is a little bit of short-
sightedness by providers, and a lack of
flexibility. Care providers are missing out
on a potentially huge resource and of
course I’m very disappointed. I could be
involved in a sector where I might be
able to grow and give more back, but I
just can’t get my foot in the door.”
Care homes need to be more flexiblewith working time, says jobless mother
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inspection & regulation November 2018www.careinfo.org
14
It is a rarity these days to find a CQC inspection report whichdoes not make some reference to person centred care planning.One of CQC’s fundamental standards requires care to be
planned and delivered taking into account the specific andindividual needs, circumstances and views of the individualresident concerned. But what about provider-centred inspections?
We frequently represent care providers in challenging draftinspection reports, both through the factual accuracy process andratings reviews. It is a common complaint that providers feeldraft inspection reports do not provide an accurate reflection oftheir service, have failed to take into account aspects of how theservice operates or to consider information which the provideror manager wanted to show the inspector about the service.
Provider-centred inspections?
Lester Aldridge Solicitors
partner LAURA GUNTRIP
thinks factual accuracy might
be improved if inspectors
listened closely to what
providers tell them.
01202 786161
Providers sometimes say an inspection reportreads as though it is describing a differenthome. In extreme cases, providers have told usthey think that inspectors have got confusedand that parts of the report are actuallydescribing a completely different home.
It was only recently that the Health Service
Journal reported that the Care QualityCommission had been forced to apologise toan NHS Trust after it accepted thatinspectors had used data about anotherprovider as part of its inspection report.
The regulator had included data aboutanother Trust in its data pack for inspectorsinspecting the Robert Jones and Agnus HuntOrthopaedic Hospital Foundation Trust inJanuary 2018, which was then used as part ofthe Trust’s routine check of the hospitalservice. That same evidence was thenattached as an appendix document, whichunderpins the inspection and is publishedalongside each report for the NHS Trusts.
On receipt of a draft report, the Trust
noticed this mistake and immediatelynotified CQC who accepted that a mistakehad been made and decided to undertake afresh inspection by a new inspection team inthe near future.
Whilst this is the first time this is reportedto have happened, there are many providerswho suspect they have been the victim ofsimilar mistakes for some time. On oneoccasion we were able to successfullychallenge factual inaccuracies in a draftreport, resulting in a rating changing fromInadequate in the draft report to Good in thefinal report, highlighting the stark differencebetween the draft and final report.
CQC did not come back and inspect butthe final report read like a completelydifferent care home to the draft report, withmany of the statements in the final reportbeing polar opposites to those which hadbeen included in the draft. On that occasion,CQC did not accept that data about anotherservice had been used, saying the inspector
had been unwell on the day of the inspectionand had therefore not been as thorough asthey would usually have been.
CQC’s inspection reports are the onlyofficial publicly available document advisingthe public about how a care home operatesand its compliance with the regulations. Thewhole focus of the inspection report is thecare home to which it relates. Given thereliance the public places on such reports,and the potential ramifications on providersof a damning report or poor rating, it iscrucial that CQC’s inspection reportsprovide a genuine and accurate reflection ofthe care home in question.
Perhaps this would be best achieved byCQC adopting a provider centred inspectionapproach, listening to and understandinghow the individual care home operates andtaking into account the informationprovided by a provider to the inspector - aswell, of course, as the experience of peoplewho use the service.
Helping Health/Social Care staff understand, empathise with and care for people living withthe long-term cognitive and behavioural legacies of traumatic brain injury/CVA
Contact John McCrea on:01908 375 838 • 07882 438 632
www.inbs.co.uk
Brain Injury Awareness Training
10-17CT1118gh.qxp_Layout 1 08/10/2018 12:23 Page 14
new look • new content • new ideas
Subscribe to Caring Times and Journal of Dementia CareBook conferences and awardsExplore our new recruitment portal
10-17CT1118gh.qxp_Layout 1 08/10/2018 12:23 Page 15
interview November 2018www.careinfo.org
16
Target Healthcare REIT (Real EstateInvestment Trust) launched inMarch 2013 with an initial capitalraise of about £45m. Its market
capitalisation today is around £390m with 52operational assets and a further sevenforward-funded assets that are now beingbuilt on a pre-let basis.
Twenty-one tenants operate care homesowned by Target, including Care Concern,Priory, Caring Homes and Ideal Care Homes.
“There are about half-a-dozen operatorsthat account for around eight per cent of ourportfolio and then there are about 13 or 14that are less than 5 per cent of the whole,”Kenneth told me.
“So it’s a very diversified income streamfrom the point of view of our investors.When we launched, we took a philosophicaldecision to invest in “best in class” carehomes in the local market.
“We find it hard to imagine that anycredible operator or investor would invest inanything other than a future-proof product,and the future for us would include both theprivate and public space and also bedroomswith adjoining wet rooms. It is a matter of ‘dounto others as you would have them do untoyou’ and we believe that because much of thecare home resident population is incontinent,and we want these continence issues to betreated well in the residents’ own bedrooms–not sitting soiled in a wheelchair and beingtaken somewhere else.”
Of the approximately 3800 beds in theTarget portfolio, there are only about 140beds that are not yet equipped with wetrooms but there are plans to covert these overthe next year or two. Ninety per cent plus ofTarget’s beds are dementia-related – acombination of nursing and residential beds,with a very small provision of specialist care.
“So we have essentially 100% wet roomstock, which is dramatically different fromthe sector as a whole,” said Kenneth.
“We think that’s a wise area for the retailinvestor to be investing in because youwould no longer think of going to a hotel inLondon, or on your holidays, where the toiletfacilities were down the corridor, and it’sunimaginable that this sector will be like thatin 20 or 30 years’ time.
“We are an active supporter of the smallerlocal operator because we think this isessentially a local business and we want bestin class care in local communities. That is a
part of who we are; we think the largeoperators can do it well, sometimes, andthere are some exemplars of that, butgenerally we support the five, 10, 20 carehome operator.
“This is absolutely a services based, caringbusiness and if we ever think it is anythingelse, we are in the wrong place, but you canhelp the carer and I believe that responsiblecapital has that duty. Significant investorsinvested in us a number of years ago andhave continued to support us. Our role is ascustodians of pensioners’ money, forpensioners.”
Target Healthcare REIT is quoted on theLondon Stock Exchange, investors includethe Church of England, along with wealthmanagers like Brezin Dolphin, Invested,Rathmines and CAS Capital.
”It’s their money we’re investing and weare very much a conduit for UK investors,”said Kenneth. “We are absolutely a Britishbusiness and we have significant investmentfrom ethical funds – we are seen very muchas that kind of company.
“There are perhaps a little more than ahundred new care homes being built each
year, for a total of about a billion pounds, soif you consider that be have got to just under£400m in five years, and we’re buying about£18m of the product every year, so we havebetween five and 10% of that new build stockeach year. So, in the same way as we’vegrown steadily, with the right physical assets,we plan to continue to do that.”
Kenneth sees staff recruitment andretention as a major ongoing challenge foroperators.
“Staffing is a huge issue,” he said. “Staffturnover is too high and the sector needs toprofessionalise in terms of more stability inthe leadership and we are seeing that acrosssome of our homes.
“I think one of the advantages of having abest in class home with wet room facilities –and we know this from talking to the carersin our homes – is that the carers believe theycan give more holistic care and have betterworking conditions than in the old fashionedstock, but retaining care workers is a keyproblem for many operators.”
I asked Kenneth about Target’s plans forfuture growth and whether REITS wouldhave an increasing presence in the care homesector.
“We think there’ll be a mixture,” he said.“We are very happy for our profitableoperators to have a mixture of freeholds andleases, and we are happy to be in that mixand contributing to the raising of thestandards. The sector hasn’t had the best ofnames and we want to try and do a little tohelp raise the bar.”
A focus on‘best in class’
Caring Times editor Geoff Hodgson talks to
Target Healthcare REIT founder and chief
executive of KENNETH MacKENZIE
about his company’s policy of investing
only in the highest quality care homes.
We are an active supporter of
the smaller local operator
because we think this is
essentially a local business.
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promotion November 2018www.careinfo.org
A fantastic online presence is key to appealing to
prospective residents and is an essential part of a care
home’s overall marketing strategy.
Research shows that health related information is the
single most searched internet topic. When families need
help with caring for a loved one they go online to
research, not only looking at their care options but also
for information that can help the family to decide on the
best way forward and answer their questions.
Shaun Louis is the founder of the Social Care Hub, a
leading marketing agency working with care and nursing
homes across the country. He says: “As a care home,
being ahead of the curve in terms of your online presence
allows you to be found earlier in consumer’s online
journey, and if done correctly will keep your brand top of
mind when they start looking at their care options.”
Now this is all well and good, but how do you go about
getting started?
Blog
A blog is a great place to start, not only for improving your
search engine rankings but building relevant and
informative content that you can post across all of your
care home’s social media accounts to drive more traffic
to your website.
Louis’ advice is to begin is by mapping out all of the
questions you get asked by people first enquiring into
your home and think about what information prospective
residents and their families would find useful. He adds,
“For example, you may get lots of questions initially about
funding a care home place. Using this information, you
could create a post around paying for care home fees,
break down the options available for different groups and
end the post with a clear call to action such as getting in
touch with your care manager who can arrange a time to
view the home.”
Search Engine Optimisation
Optimising your website for search engines to get on that
first page is key to increasing traffic and enquiries on your
website. There are many factors affecting your search
engine ranking and these are always changing, however
Louis outlines a few things that you can do to keep on
top.
Research the competition: Find out what keywords
your competitors come up for in search results, and who
is linking to their website e.g. ‘Care Homes in
Cambridge’. You can then use these findings to inform
your own strategy.
Mobile first design: Make sure your website is
mobile friendly & easy to navigate. “Over 52% of web
pages globally are served to mobile devices, meaning it
is integral to have a mobile optimised website. This
avoids users leaving your site due to the fact it can’t be
navigated on the device they are using,” he says.
Work on gaining new backlinks: backlinks remain
the biggest factor affecting your websites ranking in
search engines. Louis says “in essence this means
another website with a link directly to yours”. You can
start by asking suppliers and partner companies to link
you on their websites and ensure that any external web
content created about your company includes a link back
to your care home’s site.
Keywords: Keywords are incredibly important when
optimising your website for search engines. Louis
believes the best way to get started is by planning out a
list of keywords or search terms you want your website
to appear in search engines for, and use this to inform all
of the content created for your website either in your
pages or blog posts. However, he mentioned that it is key
with this to also write fluidly and integrate keywords into
your pages’ content, rather than placing a list of them in
one area of your site.
Paid Search Ads
Another highly effective way to gain new enquiries is to
run paid search ads, these are search engine like listings
served at the top and bottom of the search engines’
results pages.
Similar to search engine optimisation, you would need
to start by drafting up different search terms that your
prospective residents would look for online e.g. ‘Care
Home in Reading’ or ‘Dementia Care in Reading’. You
can then run ads on a pay per click basis against these
search terms, that are targeted to people in your
geographical area.
Using a platform like Google AdWords or Bing Ads is
by no means a plug and play solution, and there are lots
of complexities to get right. Louis adds, “Despite this and
with ongoing monitoring and tweaking, paid search ads
are a fantastic way to gain traffic and generate good
quality and targeted enquiries.”
Social Media
The rise of social media has given care homes the unique
opportunity to reach prospective residents and keep the
conversation going with people who visit your website
but have not yet made an enquiry.
Louis goes on to say, “Most of success on social
media comes down to stories and emotion, and with so
much great stuff going on in care homes it makes
regularly posting out content onto these platforms a no-
brainer.”
Relevant content could include your blog posts,
residents’ stories, updates, events and documenting day
to day activities in your home and will help in building
brand awareness.
Working on your social media presence will not only
set you apart from the competition, but make prospective
residents and families feel more confident about the
quality of your home and the care provided there when
researching online.
www.socialcarehub.co.uk
Building your care home’sonline presence
18
This feature aims to give you
a range of useful and
actionable tips to help you
get ahead of the curve and
make an impact online.
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focus on dementia
20
November 2018www.careinfo.org
Abbotswood Court in Romsey, operated by Cinnamon Care
Collection, has recently introduced a new NAMASTE care
programme which they say has helped to enable meaningful
interactions with loved ones.
Enhancing life –the NAMASTE approach
Home to a dedicated dementiacare team, the 60-bedAbbotswood Court currentlyhas 21 residents living with
dementia. To aid this growing dementiacommunity, the home recently introduced aNAMASTE care programme which providesstimulating and meaningful experiences.
Dementia manager Sarah Delveshighlighted an instance of positivebehaviour encouraged by her through the
use of the programme.“Dementia can be incredibly challenging
for family members and we have a femaleresident with advanced dementia whosehusband often feels like he has lost his wifeto the illness,” said Sarah.
“Prior to one of his visits, on the day of the
Royal Wedding, we gave the lady a sensoryhand massage using oils in our NAMASTEarea. As her husband came down from thelift I said, ‘here comes your husband!’ He satnext to her, she stroked his face and said,’ Ilove you.‘ Gifting the pair a tender momentrepresents our team's ability to help ease theseverity of some dementia symptomsthrough the new programme.''
Developed in the United States,NAMASTE combines compassionate carewith music, therapeutic touch, colour, foodtreats and scents. This is said to give peoplewith dementia the best possible quality of lifeand encourage positive behaviour.Abbotswood Court adopted the programmefollowing a study of five UK care homes
which found it enhanced the quality of life ofresidents with advanced dementia and age-related neurological conditions.
“Aside from our NAMASTE careprogramme, every member of the dementiacare team is specially trained, experiencedand cares deeply about enhancing the lives ofour dementia residents,” said Sarah.
“Our work can include small things suchas spending time chatting with and listeningto individuals with dementia.
“We will also do activities which aremeaningful to people living with dementia,for example watering plants, playing music,knitting, going for a walk or looking at the
An Abbotswood Court resident receives a hand
massage as part of the home’s NAMASTE care
programme.
wildlife. Furthermore, we will encourageresidents to do purposeful tasks, such aswashing up, sweeping and laying tables.”
By encouraging someone with dementiato do something creative, some gentleexercise, or take part in a stimulatingactivity, Abbotswood Court helps residentswith dementia to realise their potential,improve their happiness and share qualitytime with loved ones. They also host aregular ‘Forget-Me-Not Café' which givesresidents’ family members and carers in thecommunity the opportunity to meet overcoffee, speak to like-minded individuals andcombat loneliness.
The Royal Star & Garter Homes care home
in Solihull has retained its Level 1
Accreditation by Dementia Care Matters,
following a recent, unannounced audit.
Level 1 is the highest accolade
achievable through Dementia Care Matters’
National ‘Butterfly Household Model of Care
Accreditation Award’, indicating that a home
is demonstrating ‘exceptional person-
centred dementia care of the highest quality
of life level’. Dementia Care Matters (DCM)
carries out more than 700 audits a year and
only 1% of care homes in the UK achieve a Level
1 distinction.
The Royal Star & Garter Homes are ‘Butterfly
Service’ Homes and follow the Dementia Care
Matters’ internationally recognised standard of
care. The care team work as a close, coherent
family which is feelings-based and emotional; they
treat residents as they would wish to be treated
themselves, with compassion and love.
Such has been the dedication of the dementia
care teams that the charity now provides the
DCM dementia care training in-house, working in
Solihull home keeps premier ‘butterfly’ grading
conjunction with the expertise and experience of
its highly motivated staff.
Rachel Christophers is a well-loved friend of
the Solihull home, where her husband, Theo, an
Army veteran, lived with dementia until his death
earlier this year.
“Theo received amazing care at the home,”
said Rachel. “I don't know another place like this!
The care team are exceptional: they bring life-
giving and positive energy all the time, enabling
residents to play their own part in this wonderful
and vibrant community.”
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focus on dementia
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November 2018www.careinfo.org
When discussing any form ofdementia, much of theemphasis is placed on theaspect of care, notably in
residential care homes. While it can’t bedenied this is of the utmost importance, arewe overlooking the precursor activity thatcan take place while people with dementiaare in the preclinical, mild cognitiveimpairment and early stage?
I’m not referring to medical interventionhere, but the positive impact of communityand social interaction.
Many older people desire to live in theirown home with as much independence aspossible. However, there is always thedanger that loneliness and isolation set in,while home maintenance can becomeincreasingly challenging and everyday taskssuch as eating and drinking enough canbecome major concerns. A 2014 survey foundonly half of people surveyed felt they were‘living well’ in their own homes withdementia.
The National Housing Federation hasrecommended that new care developmentsto allow people with dementia to liveindependently in their own property in thegrounds of a care home with somecommunal facilities. In addition, it has alsorecommended purpose-built retirementvillages, such as those we develop, areincluded in this mix.
The retirement village model variesconsiderably from provider to provider.Within our own portfolio we have a growingnumber of villages that include on-site carehomes alongside independent living
properties with communal facilities such asresidents’ exclusive restaurant, coffee lounge,library and leisure amenities. Where there isno care home, we have a registereddomiciliary care service working in mostlocations.
It is the strong community feel and thesocial interaction that this encourages thatturn our developments into thriving, close-knit villages. This, in turn, helps to nurture asense of wellbeing. People who hadpreviously lived in a big family home, wherethey rarely spoke to neighbours in the samestreet, now find themselves in a communityof people who are very much like themselves– they have the same outlook on life, oftenshare the same mind set which means theyenjoy similar interests and hobbies, all ofwhich can happen in the village.
We find that before long, they have forgedstrong friendships and find themselves busy,spending time doing the things they love,and in many cases, rekindling interests orhobbies they had long forgotten about orignored. All of this in a familiar and securevillage community environment.
Social interaction and a strong socialnetwork are known to preserve cognitivefunction, alleviate the feelings of loneliness,depression and agitation experienced bypeople living with dementia and generallyimprove the overall quality of life.
Villages across our entire portfolio, not justthose with care homes on site, have in depthsocial calendars. The real beauty here is thatthese are largely led by residents themselves– they have a particular interest and soorganise a group.
As a result, we have an incredible cross-section of activities from allotment, walkingand holiday groups, sports clubs andcompetitions, theatre and shopping trips tothe more sedate indoor favourites – bookclubs, art and craft, poetry and IT classes,bridge and canasta clubs, the list goes on.
At a time when isolation and frailty canstart to become a growing cause for concern,this more community-based existence canprovide real opportunity for social relations,and the potential for an enhanced ‘wellness’lifestyle while still enabling individuals toretain independence and freedom.
Less than two years ago, new researchcarried out in the United States found therewas a correlation between loneliness and thelevel of amyloid – a protein associated withdementia – in the brain. In addition, a trialfunded by the National Institute of HealthResearch in 2018 concluded that socialinteraction is pivotal to improving the qualityof life for people living with dementia.
We see the social and community elementsof our model as an aid to enhanced andlengthened wellbeing; these settings have thepotential to stimulate and support peopleand hopefully play a part in helping to delaythe progression of dementia or otherassociated illnesses.
The independent nature of village livingmeans that people with dementia who are fitand well and want to continue to live in theirown property must have care support or aspouse living with them when they move in.
But the village model really comes into itsown when dementia reaches the point wherea care home is the only answer. Rather thanhaving to move many miles away to anunknown facility, an individual can moveacross the village and into our care home. Fora couple this can ease what is a highlytraumatic situation; it also means they cancontinue to be ‘together’.
While it may be impossible to eradicate thestrong feelings of worry and helplessnessthat come with the diagnosis of dementia, wedo know that with thriving communitiescomes strong support networks for allinvolved, and this can only ever serve apositive purpose.
Village model can work fordementiaSARAH BURGESS, group sales and
marketing director at Retirement Villages
Group, says that with dementia, we need
to consider the impact of community
and surroundings as well as care.
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focus on dementia November 2018www.careinfo.org
are told has been vegetarianfor more than 50 years,suddenly asks to eat meat?
It stimulated a lot of discussion, with somesaying a person’s life history must berespected so they should only be givenvegetarian options to choose from, whilstothers said the path of least resistanceshould be chosen and allow them theirchoice to eat meat.
The debate ran on for around a fortnightand finally concluded with 38% saying theywould allow that person to eat meat, and62% advising that the person should be ableto live the rest of the life as they had before:as a vegetarian.
Atechnique that helps people livingwith dementia to see satisfyingprogress in achieving everyday
goals is now being trialled by SunriseSenior Living UK.
The University of Exeter is leading aprogramme to train carers in goal-orientatedcognitive rehabilitation. It entailspractitioners working with people livingwith dementia and their carers to establishgoals that are most important to helpingpeople maintain their lifestyle. These differdepending on the individual, ranging fromcooking food, to remembering the names ofloved ones. The practitioner works with theperson and the carer to put in place strategiesto help them achieve these goals.
The technique has been found to besuccessful. A large-scalestudy involving 475 peoplewas conducted across eightsites in the UK. Half ofthem received tencognitive rehabilitationsessions over three months,and the other half did not.The group receiving thetherapy then took part infour ‘top-up’ sessions oversix months.
Sunrise to trial goal-baseddementia therapy
As a result, the Alzheimer’s Society hasfunded the researchers to implement thetechnique by offering training to staff in NHSTrusts and social care organisationsproviding care to people with dementia, andSunrise Senior Living UK communities areamongst the organisations that are signed upto a 12-month trial: Sunrise of Tettenhall,Sunrise of Eastbourne, Sunrise ofChorleywood and Sunrise of Edgbaston.
The goals participants choose vary, asdementia affects people in a wide range ofways. Some participants want to find ways ofstaying independent, for example, by
learning or re-learning how to usehousehold appliances or mobilephones. Some want to manage daily
tasks better, perhaps by developingreminders to remember their keys and pursewhen they go shopping. Others want to staysocially connected, and focused onimproving their ability to engage inconversation. Sometimes staying safe isimportant, so strategies focus on practicalchallenges like withdrawing money safelyfrom a cashpoint.
Jackie Pool, director of memory care atSunrise Senior Living UK and GracewellHealthcare, said the technique would enableresidents at Sunrise homes, who have a formof dementia, to live better, more enriched lives.
“There are so many proven benefits tooffering cognitive rehabilitation and therapyin dementia care and we look forward totesting out these methods and reporting theresults,” said Jackie.
“This 12-month trial is just one of the manyinitiatives that we as an organisation areimplementing, as part of our ongoingenriched memory care programme that willallow residents living with dementia tofurther improve quality of life and live wellfor longer.”
JACKIE POOL:
There are so many proven
benefits to offering cognitive
rehabilitation and therapy
in dementia care.
There are thought to be as many as 6,500vegetarians living in care in the UKand statistically, around 70% of those
will have dementia. As their mental capacityweakens and the dementia advances, itreaches a point where some forget that theyare vegetarian, and start choosing to eat meatat mealtimes. This is a moral dilemma fromthe carer’s point of view – do you considertheir previous dietary history or their currentpersonal choices?
To research this further, I asked a questionon Facebook: Given that free choice is usuallyprioritised in care and nursing homes, whatwould you do if someone, who is in yourcare, who is living with dementia, who you
A dietary dilemmaShould vegetarian care home residents
with dementia be given meat if they ask
for it? asks JERRY SHORT, content
writer for the Evolve Care Group.
The British charity, Vegetarian for Life hasa major goal to improve the standard ofvegan and vegetarian catering in existingBritish care homes.
For the Bristol-based Evolve Care Group,which runs 12 care homes spread across theSouth West of the country, the health of thosein their care, and how that could be affectedby diet, is of particular interest.
Evolve joined VfL and is working with themto ensure the diets of those they care for will bechosen not just for taste, but for the vegetables’health-giving properties, too.
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focus on dementia November 2018www.careinfo.org
Here are a few suggestions to bear inmind when developing a dementia-friendly garden:
1. Encourage wildlife: The benefits of nature,natural light and wildlife have a markedeffect on the improvement of wellbeing,happiness and a sense of purpose.� Bird box and feeds: Watching birds is bothrelaxing and therapeutic, often the samebirds will return over long periods of time –encouraging recollection skills.� Ivy and climbing plants: Evergreen plantsand climbers are a great garden addition toensure a protective habitat for wildlifethroughout the year.� Long grass: Longer grass encourageswildlife, particularly butterflies and willallow for wild flowers to flourish – keepgrass cutting to a minimum over thesummer months.� Flowers: Plant an array of bulbs andperennials every couple of months to create asensory experience throughout the year –
Creating a dementia-friendly gardenActive Minds offers some tips
on the key considerations
when establishing a
dementia-friendly garden.
flowers attract a variety of insects includingbees and butterflies.2. Sensory experience: Paying closeattention to sensory elements in a dementia-friendly garden is particularly important tohelp evoke positive memories and improvemood.� Familiar smells that trigger memories orencourage positive moods are an importantelement to any sensory garden. Aromaticflowers and herbs such as lavender androsemary are soothing and may conjure oldmemories of home.� Sounds: The addition of wind chimes willcreate an ambient background sound.� Touch: Textured surfaces such as bark-
edged furniture, soft shrubs and crinklycushions on outdoor furniture will all aid thesensory experience.� Taste is a very important sense to rouse as itoften stimulates memory – if a garden hasthe capacity for a fruit tree or bush then thiswould be a great addition.� Colours: Incorporate a mix of colourfulplants and soft furnishings within the gardendesign – colour and contrast are vital forelderly people as their eye-sight fades.3. Comfort: The final consideration for anydementia-friendly garden is comfort. Visitorsto the garden may not be able to spend verylong perusing the plants and wildlife so acomfortable spot to sit and observe is vital.� Seating: Comfortable, sturdy and all-weather outdoor furniture is key.� Shelter: For the colder, wetter months, anundercover area would be ideal.� Soft furnishings: For safety and comfort,soft furnishings such as cushions, andblankets should be available.
Care 4 Quality Ltd
CQC Compliance ConsultantsFull Home Audits •Regular Compliance Visits • Medication Audit • Pre CQC Inspection VisitsCQC Action Planning • Manager/Provider Support • Training Packages • CQC Inspection
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diary/moving around
27
November 2018www.careinfo.org
Balhousie Care Group has appointed Pablo Vilar as
the manager of its 50-bed care home in Pitlochry,
Perthshire. Pablo, a mental health nurse,
had previously worked for another care home company
in Inverness.
With more than a decade of experience working in the
care industry, Pablo brings a wealth of experience to the
role, from trouble shooting in an operations role to his
people-facing work in bar and restaurants before going to
university. He has also worked in construction, so his
experience is vast, but one common theme links all his roles
together. Pablo explained:
“Every job I have ever done has allowed me to work closely with people which is
something I've always enjoyed. Training to become a mental health nurse and
working in the care sector is really an extension of that and enabled me to work with
people a bit more formally.
“I'm really looking forward to building on the work that has already been done
here at Balhousie Pitlochry, continuing to build the strong links we have with the local
community as well as establish new ones.”
in association withAppointments
Elaine Rankin is the new manager at Meallmore’s Mearns
House care home in Newton Mearns near Glasgow.
With more than 25 years of experience in nursing care,
Elaine will will be responsible for the day-to-day management
of and ensuring care is delivered to the very highest standard.
Elaine is well established in the industry, having begun her
career as a nurse with the NHS in 1990, before moving into
management with Care at Home in 2002. She then chose to
specialise in caring for the elderly, spending a number of years with another large
care home provider before joining Meallmore in January of this year as a project
manager in Inverness.
As manager at Mearns House she will focus on developing staff skills and
knowledge as well as continue to grow its community outreach programme by
building new relationships with local schools.
“I enjoy working for Meallmore as I feel that the company values its employees
and invests heavily in their career progression,” said Elaine. “Everyone has been so
supportive during my time here. I thrive on developing a care team which has the
residents’ wellbeing as its priority.”
Stocks Hall Nursing & Care Group has appointed
Marie Harris as the manager of Stocks Hall Andrew Smith
House, a 60-bed nursing & care home in the Nelson area of
Lancashire.
Marie brings with her more than 16 years’ experience in
the care and support industry, which includes the NHS and
various managerial roles.
“I started my career in the NHS working in acute and
community settings for Mental Health services provided to older adults living in
Lancashire,” said Marie.
“I am a Registered Mental Health Nurse and started my professional career
working in nursing homes and I have never looked back. Moving through the ranks
quite quickly I ran EMI and general nursing units in different locations and worked
regionally as clinical services manager for the same company. Promotion led my
career path into quality/compliance and home management roles.
“I am so delighted that Stocks Hall have given me the perfect opportunity to
share my experience and lead a skilled and passionate team, committed to making
life and work meaningful and enjoyable for all.”
For a free listing of your care sector focused event,
email the editor: [email protected]
NOVEMBER 2018
� Care Roadshow London
DATE: November 13
VENUE: Epsom Downs Racecourse
ORGANISER: Care Roadshows
TEL: 01425 838393
W: www.careroadshows.co.uk
� Care England 2018 Conference:
‘Logging On’
DATE: November 14
VENUE: Church House, Westminster
ORGANISER: Care England
W: www.careengland.org.uk
SEMINARS CONFERENCES AND ExHIBITIONS
� #GivingTuesday
DATE: November 27
VENUE: National event
ORGANISER: Care Workers Charity
MARCH 2019
� Future of Care Conference
DATE: March 19
VENUE: The King’s Fund, 11 Cavendish
Square, London, W1G 0AN
ORGANISER: Care Roadshows/Broadway
Events
TEL: 01425 838393
NOVEMBER
� Barclays/Knight Frank/Pinsent
Masons Roundtable
DATE: November 2
VENUE: Park Lodge, West Cowick, East
Yorkshire
� UK Dementia Congress
DATE: November 6-8
VENUE: Hilton Brighton Metropole
� National Dementia Care Awards
DATE: November 8
VENUE: Hilton Brighton Metropole
� National Care Awards
DATE: November 30
VENUE: Hilton London Metropole
DECEMBER
� Caring Times Christmas Lunch
DATE: December 13
VENUE: The Dorchester Hotel, London
FEBRUARY
� National Care Awards Winners Lunch
DATE: February 21
VENUE: Coutts, London
For further information on all these events,
or to book a conference place, telephone
the Events Team
on 020 7720 2109
Alternatively, email [email protected]
or visit www.careinfo.org/events to download a booking form.
Congratulations to the following care homes and services which have been recently
rated as ‘Outstanding’ by the Care Quality Commission:
OUTSTANDING
Rated ‘Outstanding’?let us help spread the word, email: [email protected]
� Ingleby, a 56-bed care home in
Ingleby Barwick, Stockton-on-Tees,
operated by Hill Care. Manager:
Carol Singleton.
� Amherst Court, a 71-bed care
home in Chatham, Medway,
operated by Avante Care & Support.
Manager: Julie Ayres.
� Right at Home North Cheshire
and Leigh, a homecare service in
Warrington, owned by Julie Houston.
� Right at Home Swansea, a
homecare service in South Wales, has
received an exceptional report from
Care Inspectorate Wales. Manager:
Emma Link.
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focus on dementia November 2018www.careinfo.org
In social care, so much of our learning isclassroom-based and focuses onmandatory topics delivered to a room of
people with parts of e-learning blended in.It's all very samey.
After this training, or sometimes before,staff are often expected to 'shadow' someonemore experienced and work alongside themto learn 'the right way to do things'. Thisrelies heavily on the more experienced
Learning byexperience
PHIL BENSON, service
manager at Community
Integrated Care’s EachStep
Blackburn, says staff need
to know how it feels to
have dementia.
member of staff knowing the right way todo things and doing it without any badhabits.
Lastly; there is the expectation that youwill learn as you go to establish your wayof working, finding your own feet andtrying to make sense of things on yourown. I'm not sure this gets the best out ofpeople; it misses out what we need peopleworking in social care to understandmost – how something feels.
Recently I went on a training session thatwas not only enlightening as a subject butchanged the way I think about how staffworking in social care are trained in general;how we, as managers and employers,support people to gain the knowledge inhow to support someone to live a better life.How to anticipate what a person mightwant or need. How to help someone feelfulfilled or achieve their goals. How tounderstand how a person feels.
The training that I attended was a kindof ‘Virtual Dementia Tour’; we werebriefed, given special glasses to wear thatimpaired your vision and headphones thatplayed background noise that wasdistracting. We had to put gloves on whichdampened our ability to feel and were thenput in a dark room full of noise and clutter.The facilitator then tried to speak with us,interact with us and asked us to do things.All of which I found nearly impossible todo with so many things impeding me.
The most straightforward task became
difficult; I was looking at an object andcouldn’t think what it was or how to use it –this after only five minutes of beingsubjected to the experience.
Immediately I had an almost visceralconnection to the knowledge I had learnedin previous classroom training sessions, e-learning modules and studies we had doneourselves. In all of these, I had missed a vitalcomponent; how it felt to experience it fromthe other side
It's all well and proper developing bestpractice techniques to support people living
with dementia and using this in your day-to-day practice, but if we lackunderstanding about the impact of this on aperson from their perspective, then we missthe point.
One example of this is signage – in thecare home that I manage we have a purpose-built environment that supports people tobe able to move about freely with well-placed signage to help people get from placeto place with ease. However, at times it can
be a little on the noisy side – when lunch isbeing served, or people are watching TV orlistening to music, or the phone rings foryou while someone is making a cup of tea,clinking a cup. After my experience in thesimulator, I realised how useless the signs are and how broken the environment is ifthe noise pollution within it stops peoplefrom being able to concentrate on the task at hand.
Before this training I ‘knew' that highnoise levels could affect people living withdementia in this way; I had learned it. But Ihad never felt it myself, and this made myunderstanding of it so much more threedimensional. I was 100% more conscious ofit, and this made it ever present in my mind.We now work even harder to reducebackground noise levels in the home andhave seen some improvements in the waypeople move around the household andinteract with each other as a result.
The training encompassed so much morethan this and highlighted many things thatwe are working on currently. However,imagine what would be possible if weexpanded as much of our learning aspossible to simulation or experiential typelearning, where people get to feel theimpact themselves physically beforesupporting other people. I believe that itcould transform how we do what we do insocial care for the better. We wouldn't needto imagine what it felt like to anotherperson, we would know ourselves.
We now work even harder to
reduce background noise levels
and have seen improvements in
the way people move around the
household and interact with
each other as a result.
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catering & nutrition November 2018www.careinfo.org
Eight professional care chefs fromElizabeth Finn care homes acrossEngland converged on Abingdon in
mid-September to pit their skills againsttheir colleagues’.
They came from as far as Harrogate, Exeter,Droitwich and Tunbridge Wells to meet at
Eight expressions of excellence
ELIZABETH FINN HOMES recently held its inaugural
Chef of the Year competition and Caring Times editor
Geoff Hodgson went along to evaluate (and enjoy) the
contestants’ culinary creations.
Miele’s UK headquarters which includes asuite of kitchen work-stations as part of its‘customer experience’ complex.
What impressed me at first was howcalmly, and how quickly, all the chefsaccustomed themselves to the electricinduction hobs: one had gone to the troubleof bringing his own aluminium saucepanswhich wouldn’t work on the induction hob.A shrug, a quick transfer of ingredients andhe was off again – Elizabeth Finn seems toemploy very tranquil chefs.
The eight chefs competing certainlyexhibited all the skill-sets and creative flair ofany culinary professional working in anysector. It was also clear that they had a verygood understanding of the specialconsiderations a chef had to keep in mindwhen preparing meals for care home residents.
Sarah Kelly, who chefs at the 60-bed GroveCourt in Woodbridge, Suffolk, chose to focuson ‘Enhanced Finger Food’ as her maincourse entry.
“Physical disabilities, especially dexterityissues, can make eating a meal with a knifeand fork more hassle than it’s worth,” saidSarah. “Then there’s the risk that a residentbecomes malnourished or needs assistancefrom a carer which lowers their dignityand independence,
“Care homes can do much more than ahalf-hearted effort to make a few small fingersandwiches, warm some frozen sausage rollsand serve them with some crisps.”
Sarah’s offering was much more than that,
including such morsels as a smoked haddockand quail egg scotch egg with a currydipping sauce, and Suffolk garden fritterswith a herb mousse and parmesan fritters.
“Elderly people have 50% fewer taste budsand if we do not offer exciting flavours to thepalate (and a ham sandwich does not do that)then they will not eat properly,” said Sarah,who went on to the final and becameElizabeth Finn’s Chef of the Year.
But it was a close-run competition. I havebeen involved in the judging of many of ourown chef competitions which are part of theannual National Care Awards and I know thatany one of Elizabeth Finn’s eight chefs whocompeted in the in-house award would havemade a strong showing at the national level.
Elizabeth Finn chief executive RichardHawes spent the day observing the close-runcontest and the judges and representativesfrom Bidvest and e-foods, who co-sponsoredthe event, helped out with the washing-upthrough the day.
It was a great atmosphere and a great wayto recognise the contribution which carechefs make in the care home space.
ABOVE: TASTY MORSELS: Sarah Kelly’s enhanced
finger food helped her win the title.
LEFT: Neil Warren, chef at The Cotswold care home
in Burford, was one of eight contestants in Elizabeth
Finn Homes’ Chef of the Year competition.
Elizabeth Finn Homes’ Chef of the Year
SARAH KELLY: Care homes can do
much more than a half-hearted effort to
make a few small finger sandwiches, warm
some frozen sausage rolls and serve them
with some crisps.
20-41CT1118gh.qxp_Layout 1 08/10/2018 12:27 Page 30
Registered Care Home Manager for care home in Gloucestershire
Requirements for the post• Significant experience in managing care homes for the elderly• Flexibility and ability to accommodate change • Outwardly facing with proven networking skills• Strong but fair management style• Must be a registered nurse with a current pin • Excellent knowledge of CQC regulations• Good appreciation of HR issues• Competent and concise in writing reports• Understand the financial/economic issues in running a care home• Proven ability to manage both care and hotel services
Package£60K p.a. dependent on experience and qualification
plus 10% Annual Performance Related BonusContribution to relocation expenses
Apartment provided at subsidised rental for initial 3-6 months
Applications to [email protected] with cover letter & CV to include mobile number & email address
20-41CT1118gh.qxp_Layout 1 08/10/2018 13:32 Page 31
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building with care November 2018www.careinfo.org
around our ‘household’ model raises the bar
for dementia design and has been
recognised not only for providing an
excellent environment for people with
dementia to live, but also for care colleagues
to work,” said Dr Plant.
Opening in the spring of last year,
Goodson Lodge accommodates 64
residents. Split over two floors, the home has
been sensitively designed with residents’ well-being in
mind. Every resident has access to a household living
area, including a lounge, sitting room, open plan
kitchen and dining room. The centre also includes a
‘high street’ featuring cinema, hairdressing salon, café
and shop where residents can buy supplies, toiletries
and greetings cards.
Martin Quirke, DSDC architect at the University of
Stirling, said that, as research evidence had
developed over the years, best practice in design of
care home environments had changed dramatically.
“Goodson Lodge incorporates some of the latest
thinking in this area,” said Mr Quirke.
“The building and its gardens have been sensitively
designed, with an attention to detail that promotes
comfort and wellbeing, whilst unobtrusively designed
safety features help to optimise independence
A care home in Trowbridge, Wiltshire, has been
awarded the Dementia Design Gold Award by
independent experts at the Dementia Services
Development Centre (DSDC) University of Stirling.
Goodson Lodge Care Centre, operated by The
Orders of St John Care Trust, attained an assessment
score of 98% for its dementia friendly design, setting
a new benchmark as the highest scoring residential
aged care setting on record world-wide.
The Dementia Design Gold Accreditation Award,
which is only offered to environments that achieve the
highest standards of design, is administered by the
University of Stirling’s Dementia Services Development
Centre (DSDC), an international centre of knowledge
and expertise dedicated to improving the lives of
people with dementia.
The accreditation scheme independently assesses
both hospital and residential care settings through a
detailed and extensive audit process that rates the
design of the building against research-evidenced
dementia design principles.
Client development manager for The Orders of St
John Care Trust, Dr Timothy Plant, said the accreditation
was a testament to the work of the Trust in prioritising
the needs and wellbeing of people with dementia.
“We are proud that the design of the building
Goodson Lodge – a leader indementia design
amongst residents as they live a life filled with
meaningful and enjoyable activities. The Orders of St
John Care Trust are recognised for their
compassionate and committed approach to dementia
care, and the outcome at Goodson Lodge is
testament to this.”
Goodson Lodge manager Annette Ayles said the
residents were proof that this new type of home had a
massive impact on the way they lived.
“It is a privilege to work in such a special
environment,” said Annette.
“Spaces are cosy and on a domestic scale and
keep our residents independent, stimulated and
active. They are able to use the space like they would
their own homes.”
Goodson Lodge in Trowbridge; recognised
as a world leader in dementia design.
Work has begun on site at a new retirement village in
Newport near Saffron Walden, Essex.
Debden Grange is the latest addition to
Retirement Villages’ portfolio that currently
comprises 16 operational luxury retirement
developments across the UK.
Retirement village will include a 40-bed care home
Impression of Debden Grange House, a 40-bed care home to be built as part of Retirement Villages’ newest
development now being built in Newport, Essex.
The development will see the completion of Debden
Grange House, an on-site, 40-bed care home, which
will also offer the wider village residents a homecare
service for those that require extra support.
Retirement Villages has turned again to specialist
design and build partners Castleoak who will carry out
the project in two phases. The initial stage will see
seven two-bedroom properties released for sale this
Autumn and completed by late Spring 2019, with the
entire village due for completion the following year.
The design and build cost of the new development
will total £24m, with RVG investing a total of £30m
into the site.
The ground floor of each brick built cottage will
comprise a large, spacious hallway, open plan living
and dining area, a modern kitchen with high-spec
integrated appliances, and a double bedroom and a
separate shower/wc.
Upstairs, the landing leads through to a large
master bedroom with ensuite and fitted wardrobes;
each home has a 24-hour emergency call system for
peace of mind.
The second stage of construction will see the
completion of a further 74 properties, including 64
two-bedroom modern apartments.
A purpose-built central clubhouse will complete the
village, which will house an on-site restaurant,
resident’s bar and lounge, library, hairdressing salon,
shop and sun terrace.
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For further information, to book a sponsorship package or to exhibit at any event, please contact Alan Leary, General Manager at Hawker Publications
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building with care November 2018www.careinfo.org
With more than 30 years of providing care to adults
with severe learning and physical disabilities in homes
across the borders of Hampshire, Surrey and West
Sussex, specialist provider Omega Elifar has recently
opened The Firefly Club, a residential care
development in Bordon, Hampshire.
The property, opened in early September,
comprises 10 independent living suites alongside
eight full-care suites and a large activity suite, and is
designed to deliver an assisted living experience
guided solely by each resident’s needs – with an
industry-leading high staffing ratios.
Firefly Club offers scaleable careThe independent living suites are private,
contemporary studio apartments with fitted
kitchenettes, defined living/dining areas, in-room
laundry facilities, en-suites, and voice-activated
assistance technology. Residents also have full use of
the communal kitchen and dining room. The care
suites are more spacious and include en-suite wet
rooms with overhead hoist systems. Residents can
choose to independently prepare their food, or have
their meals fully catered; laundry and housekeeping
services are also provided.
The activity suite affords residents the opportunity
to discover new passions and immerse themselves in
Firefly’s range of events, including regular film nights,
afternoon teas, dances, and themed dinner evenings.
The suite includes an exercise room and a hydro-
therapy pool accessible as well as offering classes
that promote an active and energetic lifestyle.
Residents can also participate in aromatherapy, or
undertake physiotherapy sessions conducted by
licensed practitioners.
Omega Elifar managing director Vanessa Read said
The Firefly Club was a personal passion project.
“Omega Elifar has years of experience providing a
high standard of interactive care to adults with learning
difficulties, and over time, we realised that there was a
gap in the care industry for adults with a wider range
of care needs who still wished to live independently,”
said Vanessa.
“We understand that each individual is unique and
thus, have approached the creation of The Firefly Club
in a manner where everything is scalable to our
residents’ improving or declining needs. No one will
ever have to move out if their needs grow or lessen.
Ultimately, in introducing The Firefly Club we are
aiming to provide a personalised home for those that
need a little extra care and attention. I believe that we
can make a difference and The Firefly Club will help us
achieve this.”Specialist care provider Omega Elifar opened
The Firefly Club in early September.
Care sector construction firm Castleoak has reported
a strong financial performance for the year ending
31st March 2018, with turnover increasing 12% to
£78.9m and group profit growing by £980,000 to a
pre-tax profit of £1.1m. The group’s operating
performance, coupled with strong cash management,
saw cash balances of £7m retained.
“Our focus on delivering valuable, high quality
specialist development solutions, and the drive and
dedication of our team is enabling this growth,” said
chief executive Craig Currie.
“Our initiatives to embed our purpose and values
across our team are working. Behaviours matter, the
team’s in great shape.”
Castleoak is maintaining long term customer
partnerships with 96% of projects from returning
customers. Significant new customer wins in the year
included Whiteley Village Trust, Abbeyfield Southern
Oaks and the first Birchgrove development, a joint
venture with Bridges Fund Management.
The business is creating more specialist care and
retirement living developments than ever; which now
account for 30% of revenues. In the new financial year
Castleoak will hand over its most ambitious
development to date – the £21m Birchgrove
development in Sidcup combines assisted living and
Castleoak reports strong financial growth
an adjacent care home, creating the first Birchgrove
assisted living scheme of 74 high quality apartments
with care services for rent, plus an 80-bed care home
for long-term customer Care UK.
“The Sidcup project was created by Castleoak’s
development team who identified the need for
specialist housing and care, acquired the site and
secured planning, funding and leasehold agreements
prior to our construction team starting on site
optimising timber frame structures manufactured at
our factory. It’s a great example of what we call our
‘smart solution” said Craig.
Castleoak chief executive Craig Currie
Construction work has begun on a £3m care
home in Cross Green, Leeds.
Due for completion in 2019, it is the latest
new build undertaken by Yorkshire-based
Exemplar Health Care, who provide specialist
nurse-led care to adults with complex needs
including people living with early-onset
dementia, long term mental ill-health and
Huntington’s disease.
Exemplar operates 26 care homes across
Yorkshire and the Midlands.
New Exemplar home
Impression of Exemplar Health Care’s new
£3m care home now being built in Cross
Green, Leeds.
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November 2018www.careinfo.org
37
The Regard Group, the UK’s third
largest private care provider in its
sector, has strengthened its presence
in the South West with the acquisition
of the Cornwall-based Solar Care
Homes Ltd.
This latest acquisition has increased
Regard’s portfolio to 167 services,
offering 16 new beds in Redruth to
adults with learning disabilities, autism
and physical disabilities.
“One of Solar Care’s services is
rated Outstanding by the CQC, and we
were attracted to them because their
vision matches our own – to provide
excellent care and support, to
continuously improve the quality of our
service and to make people’s lives
better every day,” said Regard chief
executive Carole Edmond.
“We are confident that Solar Care’s
staff and the people they support will
feel very much at home as part of
Regard. Our regional director for the
South and South West, Kerry Libby, is
leading the team which is helping to
ensure a smooth transition for the staff
as well as continuity of care for the
people they support.
“Regard is pursuing a strong growth
strategy, both organically and through
acquisition of like-minded quality-
focused companies, and more such
deals are planned.”
SolarCare Homes
Regard acquires
The deal is evidence of Regard’s
continuing good health following a
change of ownership at the end of
2017 when their investment backing
was taken over by AMP Capital.
Regard was formed in 1994 and now
has a staff of over 2,600, supporting
more than 1,300 people across
England and Wales.
Over the past year the group has
opened 12 new services, with a
further 12 new openings planned for
the year ahead.
Staff in the services previously run by
Solar Care will benefit from the deal by
having access to Regard’s learning and
leadership training, an experienced
quality and best practice team and
specialist in-house services such as a
dedicated benefits team.
Regard chief executive
Carole Edmond
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business news November 2018www.careinfo.org
Middleton Hall RetirementVillage in Middleton St Georgeoutside Darlington is tobecome employee-owned.
The move is aimed at safeguarding thelong-term future of the retirement villageand will make it one of only 300 UKemployee-owned companies and the firststaff-owned retirement village or residentialcare facility in the UK.
Middleton Hall’s 190 staff learned of theproposal at a recent briefing session wherethe company’s main shareholder, managingdirector Jeremy Walford, outlined the plan tobecome an Employee Ownership Trust.
He explained the aim was to preserve theethos and values of the business he has spentthe past 20 years cultivating and ensure thatMiddleton Hall’s employees are trulyrespected as the company’s greatest assetand share fairly in its future success.
“I have worked hard to transform whatwas a struggling care home into one of theleading retirement villages in the UK andhave taken considerable personal financialrisk to turn it into a successful and profitablecompany that is financially stable,” said MrWalford.
Mr Walford said that, as the owner of amature, cash-generating company, he wasfaced with the challenge of how to bestmaintain the long term quality of thecompany after he had sold it.
“My motivation over the last 22 years hasbeen driven by the desire to build a businessthat makes a difference to our customers andstaff rather than purely for financialreward,” he said.
“I now feel a responsibility for ensuingMiddleton Hall continues with the vision ofbeing the best and maintains the values thatmake it the special place where our residentslive and staff work for the long term.”
Middleton Hall Retirement Village islocated within 45 acres of woodland andparkland and boasts extensive facilities,including a restaurant, pool, spa, gym andsports facilities, with the aim of providing acommunity where older people can live in arange of accommodation includingretirement houses and apartments to suittheir individual needs, with theopportunity to enjoy the benefits of villagelife.
It has a rarely-awarded Outstandingrating in all categories from the Care
Quality Commission and won the Skills forCare ‘Best Employer of the Year’ Accoladeaward in 2018 as well as achieving theprestigious Investors in People Platinumaccreditation, an accolade only 0.5% ofaccredited businesses have achieved.
“I have received offers to sell the businessbut I am aware that in selling a companyyou never know who you are really sellingto in the long term and I have seen goodcompanies in our sector ending up barely ashadow of the business they historicallyhad been when run by a caring owner, afterbeing bought out,” said Mr Walford.
“In a business world where capitalismand especially social care businesses oftenhave a bad name, an Employee OwnershipTrust offers a different model of how a trulycaring company can operate, so mypersonal decision was easy.
“It should sustain Middleton Hall for thelong term, ensure continued re-investment,high staff engagement and customer focus.
Retirement village transfers
Middleton Hall staff celebrate the employee ownership announcement
Jeremy Walford
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business news November 2018www.careinfo.org
That is far more important to me than thepersonal wealth from selling the companyto a third party.”
Employee Jan Hargrove, Middleton HallRetirement Village’s marketing co-ordinator, said that the employeeownership proposal was great news,although she had not known what to makeof the suggestion to sell the business to herand her colleagues when she first heardabout it.
“I learned of the plans earlier than mycolleagues as I have been part of the projectteam preparing for the announcement and Ihad to go away and research what itactually would mean for us,” said Jan.
“I found that the common thread runningthrough other employee-owned businessesis that they are all values-driven, just likeMiddleton Hall Retirement Village, in spiteof being in very different industries.
“It is a very genuine process and givesemployees a much bigger say in what
happens to us which makes it a veryexciting prospect.”
A separate briefing explaining theproposed move to employee ownershipwas also held for residents of MiddletonHall Retirement Village.
Residents Jo and Dick Marlow said theywere very pleased with the plans foremployee ownership and hoped the staffwere equally excited by the future beingproposed.
“They are lucky to have such farsighteddirectors. We are also relieved to know thatMiddleton Hall will not become part of anational company and lose the personaltouch that makes Middleton Hall thespecial place it is.”
A project team from Middleton HallRetirement Village is now working throughthe process to transition ownership with anadvisory company, Baxendale, specialists inthe field of employee ownership. Thechange in ownership is planned to take
place at the end of March 2019.Middleton Hall provides a range of care
services including high dependency andpalliative care, hotel style residential careand supported living with care.
ownership to staff
Jan Hargrove
Adult social care provider Optalis has reported a
strong set of financial results for the year ending March
31st, 2018. The Berkshire based local authority
trading company, owned by Wokingham Borough
Council and the Royal Borough of Windsor and
Maidenhead (RBWM) reported strong revenue growth
over the previous year.
The positive results came from extending service
delivery to the Royal Borough of Windsor and
Maidenhead, partnerships with the NHS, and new
contract wins in extracare housing schemes and
supported employment services, all of which
contributed to an increase in turnover of £32m.
Optalis’ chief executive Martin Farrow said that, in
addition to these results, Optalis delivered positively
on its statutory targets and reduced delayed transfers
of care to zero across Windsor and Maidenhead.
“Not only have we delivered strong growth
financially, we have also seen positive CQC ratings
across the organisation, improved recruitment and
retention rates and positive customer satisfaction
rates.” said Mr Farrow. “This is an excellent outcome
and testament to the fact that we have great teams
doing great things every day for our customers and
for the communities we serve.
“As a business model, I am sure this will resonate
Social care trading company delivers strong financial resultswith local authorities looking to operate within a
tightened cost envelope, where the council remains
strong and at the heart of current practice, but where
there are opportunities for refinement and innovation
to enhance quality and service delivery.”
Established in June 2011, Optalis was the second
local authority trading company of its kind in the
country. Today, it is one of the largest with nearly 700
staff providing care and support services across
Wokingham, Windsor, Maidenhead and Oxfordshire.
April 2017 saw the social care provider break new
ground by becoming the first team in the country
to deliver statutory social care from within a
trading company.
Specialist care provider National Care Group
(NCG has acquired Wellington Support Ltd which
provides personal care and support for 26 people
with mental health issues living in supported
accommodation at sites in Northampton and
Kettering.
With this acquisition, NCG will apply its
resources to help expand the business in
Northamptonshire, and continue the care and
support provided by Wellington in the local area.
NCG director David Rowe-Bewick said
Wellington Support had been providing excellent
NCG acquires Wellington Supportpersonal care for people with mental health issues
in Northamptonshire for a number of years.
“We believe it will fit in well as part of National
Care Group,” said Mr Rowe-Bewick.
“We will ensure that the people supported
continue to receive the highest standards of
person-centred care during this transition by
working closely with the highly dedicated and
experienced team at Wellington.
“This acquisition shows NCG’s continued
expansion across the UK; providing person-
centred care for those who need it most.”
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building with care November 2018www.careinfo.org
To request more information, [email protected] or call 08458 690777 Our unique insight, your foresight
Essential NEWanalysis for your next developmentMitigate risk,maximise opportunities with our new location-specific data
Dedicated dementia analysisStaffing analysis
Barwood Capital, a Northampton-based real
estate investment manager, has agreed a funding
partnership with care home development
specialist Duncan Ford.
Perseus Land & Developments Ltd has been
set up by Duncan Ford who has more than 20
years’ experience in the healthcare property
sector, working for Frontier Estates, Tilfen Land
and Danescroft Developments. He has overseen
the acquisition and obtained planning permission
for more than fifty developments throughout the
UK, from Exeter to Edinburgh including the
provision of more than 3,500 care home bed
spaces.
Perseus will be a developer and facilitator of
residential accommodation for older people who
have both emerging and acute care needs
including sheltered housing, extracare housing
and care homes.
The partnership will see Barwood Capital fund
Perseus to develop care homesthe acquisition of sites with Perseus as
development manager. The Barwood 2017 Fund
closed earlier this year with the capacity to invest
in £150m of regional property opportunities.
Duncan Ford, managing director of Perseus,
said Barwood Capital was an excellent fit for
Perseus due to its commitment to invest in
regional land and development opportunities
outside London.
“There is an underlying
need for specialist acc-
ommodation for older
people which is truly
nationwide,” said Mr
Ford. “Together we will
be able to unlock
opportunities across the
risk spectrum to help
deliver the ever-
increasing demand for care homes.”
Duncan Ford
National care provider, Barchester Healthcare has
marked the start of their newest care home builds at
three new sites in Solihull, Eastbourne and Sherborne,
adding to their portfolio of more than 200 care homes
and six independent hospitals.
The new Solihull home, located at the old Shirley
Aquatics site, is being built by Seddon Construction
and will accommodate 80 people. The Eastbourne
project, being built by McGoff Construction, will have
80 beds and the Sherborne home, being built by
Acheson Construction, will have 64 beds.
“We’re pleased to be working with three different
construction teams to build our new signature
Barchester homes, all designed with a high
specification,” said director of property services at
Barchester Mark Bennett.
“Each new care home will be a positive addition to
the communities we are building in.”
Barchester’s Eastbourne, Shirley and Sherborne
Care Homes are scheduled to open in October,
November and December 2019.
Work starts on three newcare homes for Barchester
Earthmovers are working at two sites in Liverpool as
part of a £30m plan to create new living spaces and
care hubs. The services will be managed by health
and social care provider Shaw healthcare in a 25-year
contract signed with the city council.
Work has begun on the site of the £7.8m Dementia
Hub in Speke and at the proposed £8.2m Venmore
Dementia Centre in Anfield. Each centre will provide
60 bed spaces, along with care facilities for people
with dementia and other long-term residential and
nursing care needs. They will also feature en-suite
bedrooms, areas for therapy and socialising, dining
facilities and gardens. A planning application has been
submitted for a third dementia hub in Stonebridge.
Work has also begun on a £5.1m new 35-bed
Shaw to manage hubs in Liverpoolstroke facility at Anfield. This centre replaces an existing
facility which is being relocated to make way for the
Venmore Centre. At the same time, building work has
now completed at Besford House in Belle Vale.
The hub, which provides accommodation for adults
with learning disabilities, has undergone an £900,000
makeover. Improvements include decorating, new
carpets and flooring, new bathroom suites, kitchens
and furniture.
“The hubs will enable us to deliver a flexible service,
tailored to the needs of the individual service-user,”
said Liverpool City Council’s cabinet member for adult
social care and health, Cllr Paul Brant.
“Our step-up, step-down approach means that the
hubs can be used to support people with a lower level
of need who would otherwise end up in hospital, as
well as providing intermediate care to help get people
out of hospital quicker.
“They will help reduce the number of people
unnecessarily delayed in hospital following
NHS treatment by getting and improving their
experience of health and social care services by
driving up quality standards.”
Shaw healthcare will develop skills and training
programmes in conjunction with local colleges, work
with Job Centre Plus to offer local employment
opportunities, create work placements and
apprenticeships across all facilities and deliver on a
commitment to the procurement of goods and
services through local companies.
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November 2018www.careinfo.org
MARKET ANALYSIS
With SAM WRIGHT,
director with the healthcare
team at CBRE.
The other day a banker who was asking my opinion about acare home he wanted to lend to described it to me as ‘bogstandard’. On one level I got what he meant, but it also mademe realise how increasingly redundant such a phrase is.
Twenty years ago, he was right; most care homes were pretty‘bog standard’. Of course, they varied depending uponwhether they were residential, nursing or specialist butbroadly speaking, within these groups they provided a fairlysimilar level of care and service and were agnostic as to howpeople were funded.
Today however, the range of care facilities and the types ofcare and servicer they provide is much more diverse andincludes luxury homes, local authority homes, rehabilitationhomes, high acuity dementia homes, homes for specialistethnic groups and palliative care homes to name but a few.And that is before you start to consider the expansion ofdomiciliary care over this period and the explosion ofretirement living. Driven in part by the pathway andpersonalisation agendas, but also by the increasedcommercialisation, our market is today more mature andsophisticated that it has ever been; with the greater diversity ofcare, service and facilities its greatest symbol.
For investors, financiers and advisors however, this greaterdiversity doesn’t make life easy. It means that the old ‘one sizefits all’ approach is no longer so applicable, and to reallyunderstand a care home’s risks today you need to understandits key drivers – the type of care; the expected level of service;the catchment area; the funding source, and who is going tostaff it are all elements which need to be considered. Withoutunderstanding these you can’t assess the viability of thebusiness or calculate its risk profile.
As such, while this greater diversity may be ending the eraof more ‘bog standard’ care homes and making the lives ofpeople like myself a bit more difficult; if it delivers better,more personalised care for the thousands of people who needit this can only be a good thing and a step in the rightdirection for our sector.
Diversity of provision - apositive burden
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care businesses sold
44
November 2018www.careinfo.org
PROPERTIES AND BUSINESSES RECENTLY SOLD IN THE CARE SECTOR
� Information appearing in “Care Homes Sold” is
published in good faith that the information is
accurate and cleared for publication. The onus for
accuracy is on the property agent.
Caring Times will not publish, in a subsequent issue,
corrections or alterations to information supplied.
Agents, please note that items cannot be withdrawn
once the copy deadline has passed.
We advise readers to confirm any details with the
property agent concerned.
The Bungalow
Location Bolton, Lancashire
Registration 19 elderly
Buyer: Mr and Mrs Lowe
Seller: Mr Michael Greer
Agent DC Care
Tel 01937 849 268
Queens Park Lodge
Location Caterham, Surrey
Registration 10 supported living (vacant possession)
Buyer: Heathcotes Group
Seller: Active Prospects
Agent DC Care
Tel 01937 849 268
Penmeneth House
Location Hayle, Cornwall
Registration 14 elderly, dementia
Buyer: MPS Care
Seller: Mr & Mrs Richards
Agent DC Care
Tel 01937 849 268
The business has been leased to local operator
MPS Care, on behalf of Mr and Mrs Richards, who
first established the business in 1987.
Woodlands Nursing Home
Location Macclesfield, Cheshire
Registration 30 elderly
Buyer: Dr Judith Stockton
Seller: Canterbury Care
Asking price: £800,000
Agent Christie & Co
Tel 0161 833 3311
Fern House
Location Burnley, Lancashire
Registration 6 learning difficulties
Buyer: Faisal Lalani
Seller: Shaun & Amanda Brelsford
Asking price: £400,000
Agent Christie & Co
Tel 0161 833 3311
Heyhead House
Location Brierfield, Lancashire
Registration 8 learning difficulties
Buyer: Faisal Lalani
Seller: Shaun & Amanda Brelsford
Asking price: £600,000
Agent Christie & Co
Tel 0161 833 3311
The Gable
Location Burnley, Lancashire
Registration 6 learning difficulties
Buyer: Faisal Lalani
Seller: Shaun & Amanda Brelsford
Asking price: £400,000
Agent Christie & Co
Tel 0161 833 3311
Thistle Court Nursing Home
Location Cwmbran, South Wales
Registration 36 dementia/mental infirmity
Agent Aldridge Care Homes
Tel 0330 1232066
The accommodation provides predominately sin-
gle en-suite bedrooms over 2 levels. Acquired by
an established operator.
Seven supported living homes
Location Deal, Hythe, New Romney & Lydd, all in Kent
Registration 28 residents in all.
Supported Living Homes, not CQC registered
Buyer: A national care group
Seller: Mr & Mrs Dennison
Agent Capital Care
Tel 01795 521025
Former care home for redevelopment
Location Harrogate, North Yorkshire
Buyer: Amberstone Developments
Agent HPC
Tel 01904 529110
After extensive marketing, it became apparent that
the site was unsuitable for construction of a new
care home. Acting in conjunction with S&SA Archi-
tects, together with WYG Planning Consultants,
HPC was instrumental in obtaining planning per-
mission for construction of 13 apartments and a
coach house on the site.
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analysis November 2018www.careinfo.org
Specialist business property adviser, Christie & Co
has published its fourth annual report on adult social
care. The report highlights the sector’s continued
funding and staffing challenges, as well as the causes
and impacts of winter 2017/18 which saw
unprecedented levels of pressure on NHS hospital
trusts, with 24 trusts reporting a ‘Code Black’ state
across the UK.
The report, ‘Adult Social Care 2018: Funding,
Staffing and the Winter Crisis’, also presents data
gathered from surveys of local authorities and more
than 200 leading operators across elderly and
specialist care in the UK, particularly looking at the
use of agency staff, costs and fees, and how the
Government’s additional funding has been used.
RecruitmentThe 2018 report outlines the continued challenges
the sector faces in both recruiting and retaining
trained staff. Whilst the removal of the cap on Tier 2
visas for overseas nurses is a positive development,
the reports’s authors point to a 13% drop in total
Christie & Co’s social care report highlightscontinued pressure on recruitment and fees
nurse registrations. Uncertainty over Brexit has had a
material impact on EU nurse registrations which fell by
87% compared with 2016/17 figures.
While favourable immigration policies and
overseas nurses are key in helping bridge
the current gap, the ability to train and retain UK
nurses remains a key issue. The report highlights
that 30% of undergraduate students do not
complete their nursing degrees.
Agency staffChristie & Co’s operator survey responses showed
that agency staff are becoming more expensive,
despite 69% of elderly care operators reporting that
they managed to hold or reduce agency staff usage
In specialist care, agency usage has gone up
marginally whilst overall agency costs have fallen,
indicating that agency staff are being used for lower
paid support staff roles in specialist care, as opposed
to more expensive, trained nursing staff.
FeesBoth operator and local authority surveys had shown
reasonable overall levels of fee increases, albeit for
elderly care, these fell below the average fee rate
increases shown in Christie & Co’s 2017 report.
The surveys show that considerable regional
variation continues, with funding remaining a critical
issue as the sector awaits the anticipated Government
green paper this autumn.
Winter pressuresThe need for sustainable funding and a joint approach
between the NHS and Adult Social Care to
commissioning was reinforced by pressures resulting
from the winter of 2017/18.
Due to the extreme weather conditions,
unprecedented levels of demand were placed on the
system with 24 NHS trusts reporting a state of ‘Code
Black’ and NHS England issuing a directive to cancel
all non urgent operations. Christie & Co’s report found
that almost half of those trusts which reported a ‘Code
Black’ were in areas with the highest levels of delayed
discharges and a high density of people aged 65
years or above.
The report highlights the importance of community
care services in reducing unnecessary hospital
admissions and the crucial role which social care can
play in reducing bed blocking to free up much needed
hospital capacity.
Michael Hodges, head of consultancy – care
at Christie & Co, said the 2018 research showed
that once again, the most critical issues revolve
around funding and workforce related themes with
further complications related to uncertainty
connected with Brexit.
“The pressures placed on the healthcare system by
the winter of 2017 and the increasing age of the UK
population illustrate the need for additional capacity,
which can only be met by a comprehensive suite of
policies associated with the key themes identified by
our research,” he said.
� The full report is available on the Christie & Co
website: www.christie.com/news-
resources/publications/adult-social-care-2018/
The role of the healthcare
workforce has never been more
important with the themes of
funding and staffing being
inexorably linked.
– Michael Hodges, head of
consultancy, healthcare
Target Healthcare REIT, a UK listed specialist
investor in modern, purpose-built care homes, has
completed the acquisition of a development site in
Wetherby, West Yorkshire and exchanged
contracts to acquire a pre-let care home in
Newtown, the largest town in Powys in mid-Wales.
The total value of the two transactions is £17.1m.
Having received planning consent, the
development in Wetherby will be funded under a
capped development contract to create a 66-
bed, residential care home. The property will
include full en-suite wetroom facilities, large
public spaces and a high-quality fit-out. The
investment is underpinned by the strong wealth
characteristics and positive underlying
demographics of the local area.
The development, due to complete in early
2019, will be undertaken by specialist elderly care
home contractor, LNT Construction Ltd. On
completion, the property will be let to LNT’s sister
company, Ideal Carehomes. Ideal is Target’s
largest tenant by income and this property will
represent the eleventh collaboration between the
two parties.
The 35-year occupational lease will include
annual, upwards-only RPI-linked increases,
subject to a cap and collar. The yield is slightly
lower than Target’s overall average for the
portfolio, reflecting in part the tenant’s presence
Target announces two more acquisitionsin the sector and underlying financial covenant.
Target has also contracted to acquire a pre-let,
purpose-built care home in Newtown, Powys.
The acquisition is expected to complete in the
second half of 2019 once the development has
been completed and the home has been fitted-
out to the group’s specifications.
The home, which marks the group’s first
transaction in Wales, will be constructed to a very
high standard and will offer 73 bedrooms over
three floors all with en-suite wetrooms. All floors
will have large lounge / dining areas and quiet
rooms, and residents will have easy access to
secure, outdoor space owing to the provision of
a large, landscaped garden at ground floor level
and resident balconies on both the first and
second floors.
On completion, the property will be leased to a
new tenant, Caresolve Operations Ltd for 35
years on a full repairing and insuring lease. The
Caresolve management team has extensive
experience of the care sector and a proven track
record of providing support, advisory and
management services to a broad range of
operators within the sector. The rent payable is
subject to annual, upwards-only, RPI-linked
uplifts, incorporating a cap and collar. The net
initial yield on the transaction is consistent with
the group’s current portfolio average.
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