Care News WINTER 2021
Welcome Welcome to our Winter Care Newsletter. In October, Skills for Care released its annual Workforce Report which suggested that there are now more unfilled care jobs than before the pandemic. The percentage of unfilled roles increased from 8% to 8.2% in August 2021, equating to over 100,000 roles. In this climate, we are dedicating this edition of the Care Newsletter to the workforce: how to attract staff, and how to retain them. To help address the issue from several angles we are delighted to share the thoughts of legal colleagues at Clarke Willmott and Bevan Brittan, as well as the experiences of a provider who has just opened a new home. We have also revisited a piece by Senior Tax Manager Elaine Grose about low-cost staff incentives, and share the new ideas we obtained at the Care Show in October. Christie and Co have offered their final Market Review of the year, and we also have some thoughts on the implications of the Care Quality Commission’s new strategy for providers. Enjoy the newsletter.
Michelle Ferris Head of Charities and Care, Albert Goodman
Commissioning a care home:
Building a staff team from zero to opening day With the shortage of nursing and care staff in the UK quoted frequently in the media, many care providers are experiencing difficulties recruiting for vacant positions. But what if you had to build a whole new team at one go? That was the challenge facing Carla Bowman, the Manager of Elliscombe House, earlier this year. Here, she tells us how she successfully recruited a multi-disciplinary team that were ready to welcome residents on the opening day of the home. How many staff do you have at Elliscombe House? Currently, we have successfully recruited our immediate team to open the home with safe staffing numbers. Our recruitment will continue as we admit residents and our service evolves. Staffing numbers at Elliscombe House are based on our residents’ dependency, promoting safe care throughout. Our staff team practice a person-centred approach to our residents, which is fundamental to quality care and support. Both of these practices affect staffing numbers; at full occupancy we expect to have a minimum of 40 staff in total. How many of your staff are registered nurses? Both the Deputy Manager and I are experienced practising Nurses, whilst our wider care staff team is a mixture of Registered Nurses and Health Care Assistants, with a Registered Nurse on duty 24 hours a day. How did you find your new team? As with so many things, it has taken a variety of methods to find our team! We used a care specialist recruitment agency with whom I already had a relationship to find many of the staff, whilst others have contacted us directly after learning about Elliscombe House through the media or their friends and family. I have also kept in touch with some former colleagues of mine, and I’m delighted that several of these have chosen to apply for roles with us. How easy has it been to recruit your staff? Finding a whole new team was equally exciting and terrifying. I was acutely aware of the importance of finding the right team, to enable us to deliver the quality of service and high standard of care we provide at Elliscombe House. I also needed to ensure that the candidates I chose not only had the appropriate skills sets and experience, but that they embodied our values and would contribute towards creating our vision. Using a care recruitment agency has been invaluable in this process. Our account manager, Louise from Osa, is someone
I have built a relationship with over a number of years. She therefore understands my expectations and standards, and the values which I think are essential in my staff team. Despite the challenges currently facing the Health and Social Care sector, Louise was able to find high-quality candidates who matched our requirements. By understanding our vision she has been able to attract candidates who want to work at Elliscombe House, and it has been exciting seeing the team building and developing. Together we have focused on identifying individual strengths, to ensure we have built a high-quality, diverse team. How about your non-care staff? We took the same approach recruiting non-care staff as we did recruiting care staff. At Elliscombe House our residents are our highest priority, so even staff who will not be directly delivering care will play a big part in the experience offered to our residents. Louise and I worked together to ensure that the candidates had the required skill sets for each role, whether it was housekeeper or gardener, along with the qualities and values we were looking for. What are your plans for the future? Our plans for the future are exciting! We have a unique opportunity to build a wonderful service focused on delivering high quality, person-centred care, and offering experiences to our residents you simply don’t find anywhere else. But it’s not just our residents who are important. Our staffing team can expect to be empowered, supported and encouraged to be the best versions of themselves, and whether that means developing their careers with Elliscombe House or gaining experience with us before pursuing ambitions and dreams elsewhere, we will celebrate with them. I naturally hope that everyone who joins our team is as excited about this journey as I am, and we look forward to working together. My ambition is that as Elliscombe House’s reputation grows as a provider of excellent nursing care and as a caring employer, it will mean we are recommended, and staff will want to come and work for us in the future should we experience vacancies.
STAFF REWARDS DON’T HAVE TO COST THE EARTH A year ago Elaine Grose, Albert Goodman’s Senior Tax Manager, shared her thoughts on how providers can thank their keyworkers without breaking the bank. We’ve revisited it and added some examples of care organisations which are doing just that. With increased outgoings on PPE, covering the costs of staff who are self-isolating, and inflated insurance premiums, most care home businesses were lucky to see a profit in 2020; 2021 is not looking much better. So how can you reward your dedicated workers, who have supported the most vulnerable in our society, without doing too much to harm your bottom line? There are of course the basics: Clear communication of expectations, as one disengaged staff member adds to the team’s overall burden Regular breaks with in/outdoor spaces to relax in away from the residents Flexibility with working hours Investment in equipment to reduce the physical burden Well run and supported systems, to ensure minimal disruption to your staff’s administrative burden Creating a constructive and open feedback system. Then there are financial rewards: Discretionary bonuses Increased holiday entitlement Generous employer pension contributions Benefits which attract little or no tax liability Employee share schemes, to create an additional return when finances permit. Since Elaine first wrote this piece we’ve learned of two homes which have implemented some of her points: Indoor space for regular breaks - Elliscombe House Carla Bowman, Manager of the newly-opened Elliscombe House, has written an article elsewhere in this newsletter about building an entire staff team. One of the things the owners of Elliscombe House paid particular attention to was their staff room, which is located on the top floor of the home. This means that staff can enjoy their breaks undisturbed, and the owners have provided comfortable furniture, a nice view, and tea and coffee facilities. These small things show staff that they are valued, and give them somewhere to relax before resuming their shift. Employee incentive scheme – KRG Healthcare Late in 2020 KRG Healthcare set up a Reward, Recognition and Wellbeing programme for their staff called ‘Applause for KRG Stars’. The programme includes discounts at 900 shops, employee of the month rewards, exercise/fitness/wellness videos, advice on money matters, and healthy eating recipes/articles. Let’s face it, most individuals working in the care sector are not in it for the money, but when it comes to those that go above and beyond, their financial value should not be overlooked! If you’d like to discuss the options available to you as an employer, please do get in touch at elaine.grose@albertgoodman.co.uk or by telephone 01823 286096.
Mandatory Covid-19 vaccination: Meeting the challenges and harnessing the opportunities Jodie Sinclair, Senior Partner at Bevan Brittan and Head of the Employment, Immigration and Pensions team, outlines the current position on mandatory Covid-19 vaccinations and the practical steps employers should take. Where we are now With the legal requirement for staff working in or visiting CQC registered care homes to be fully vaccinated against Covid-19 now in force, employers will need to continue to adapt and innovate in the delivery of their service to meet ongoing demands and to attract a new cohort of workers to this hugely important sector. Despite wide-ranging efforts by care home providers to encourage all staff in scope to have the full vaccination against Covid-19 ahead of the 11 November 2021 deadline for mandatory vaccination, we continue to hear concerning reports of a staff exodus in an already stretched sector – with an estimated staff shortfall as high as 170,000 by the end of the year. Attracting and retaining staff has never been such a business critical consideration, but with this “burning platform”, comes with it huge potential around the art of the possible. Some staff, with the support of unions, have brought legal challenges for both disability and religious discrimination as well as over the fairness of the earlier Government consultation and human rights implications. At the time of writing, no court hearing date has been listed, but should the challenge succeed, a court could order that the mandatory Covid-19 regulations are amended or even quashed. Until then, however, the sector cannot simply pause and wait for an outcome of the judicial challenge.
For the wider health and social care sector, the Government consultation on mandatory vaccination for frontline health and care staff closed on 22 October 2021. At the time of writing, recent reports indicate that Sajid Javid, Health and Social Care Secretary, has confirmed he is “leaning towards” introducing legislation that would make jabs a condition of employment in the NHS, it may still be several weeks until the outcome of the consultation is published. With ongoing calls for parity between social care and the wider health and social care system, including the NHS, any decision not to extend the requirement to those working in GP practices, people’s homes, the NHS or the independent sector, could be a further blow for social care.
Looking ahead As the law currently stands, employers should continue to work towards ensuring all of their staff are fully vaccinated and to consider the following: Review and amend employment contracts & the recruitment process: ensuring contracts for new staff (and the broader recruitment process) makes it clear that Covid-19 vaccination is now a legal requirement; Temporary medical exemptions: keep under review the temporary self-certification process for medical exemption as at the time of writing, the anticipated Covid Pass is not in effect. The Government has provided a list of possible exemptions, although it notes that this is “not exhaustive”; Right to appeal: where staff have been dismissed, it is crucial that they are given a right of appeal to mitigate against potential litigation, especially where employers may not have followed the ACAS guidance for a three-stage process aligned with the disciplinary procedure; Risk Assessments: continue to carry these out, particularly for the exempt unvaccinated staff. Whilst the CQC has indicated that they will take a proportionate approach in the case of unvaccinated staff continuing to work in care homes without any applicable exemption, it is unclear what that will mean in practice in terms of their regulatory powers for enforcement. If they have not done so already, employers should take appropriate action in respect of those staff who remain in post but unvaccinated and without any exemption. Whilst this may include long-serving and exemplary employees, continuing to employ those individuals in these circumstances will amount to a breach of a legal obligation. Other practical steps that employers should continue to take include: Assessing uptake: reviewing numbers of staff that are vaccinated / unvaccinated and acting accordingly; Considering equalities issues: to reduce litigation risk, ensuring any potentially exempt staff are managed appropriately; and Auditing: ensuring a clear audit trail. With the recent Government announcement that it will provide a £162.5 million workforce and recruitment fund to care homes and home care providers, we await to see how much relief that provides in supporting the sector through the challenges that will no doubt lie ahead.
If you would like to discuss this topic in more detail and receive further advice on any of the above, please contact Jodie Sinclair on 0370 1947890 or email jodie.sinclair@bevanbrittan.com
TOP TIPS FOR HR IN THE CARE SECTOR Paula Squire, Head of the Taunton Employment and HR Team at Clarke Willmott and a specialist solicitor with over 18 years’ experience assisting her clients in the care sector, shares with us her top tips for HR professionals and business owners within the industry.
Supported by my specialist team of solicitors and HR Consultancy, I recognise that most employers in the care industry have had a particularly tough time in the last 18 months dealing with the pandemic and health and safety requirements. Below is a checklist to ensure, as we approach the end of 2021, that you have not missed any key developments. Clarke Willmott is also extending an exclusive offer below to Albert Goodman clients, that you may find of interest.
1. Covid 19 Response - Flexible Working During the coronavirus pandemic, many employees (such as office/support staff) have worked from home, and employers are seeing a rise in flexible working requests if they seek to increase attendance at the office. Remember, any employee with over 26 weeks’ service has the right to make a statutory flexible working request. It can be more difficult to refuse a request relating to homeworking where the employee has worked from home successfully during the pandemic with no adverse impact on their quality of work or meeting demand. Employers should be mindful of claims as these can stem from the refusal of a flexible working request arising from, for example, an issue with childcare arrangements or an employee’s disability. Compensation in successful discrimination claims is uncapped. If you feel you cannot meet a request, do seek advice on the process and grounds for a refusal.
2. Contracts of Employment & Employee Handbooks In April 2020, the law made changes to the minimum content of your contracts of employment, including reference to new clauses which were not previously required. On this basis, unless you have updated your contracts in the last 18 months, they are not likely to be legally compliant. Also, remember, that you are now required to issue your contract by the first day of employment.
Your employee policies and handbooks may also need some attention. Since Brexit, many data protection policies and candidate and employee privacy notices may be out of date as these are likely to reference document sharing within the EEA and also the EU General Data Protection Regulations. We now have a UK GDPR and with the UK no longer being a part of the EEA, means amendment may be needed. Also, do consider the inclusivity of your contract and policies. For example, consider your wellbeing policies, menopause policy and also language used to ensure gender inclusivity.
3. Working Time, Rest Breaks and the National Minimum Wage We assist in the buying and selling of care homes together with our corporate team. In this process, it can often be a time when working practices are scrutinised and reviewed. We check what is ‘written down’ in policies and practices and not just covered by an expectation that staff know what the practices may be. This is also the process we take in the event of a challenge by staff. Unfortunately, we see time and time again, the same legal and compliance issues which are extremely common in the care sector. Not only do you need to ensure your practices meet legal requirement but it is also documented. This can be around arrangements for employees and how they are paid for sleep ins or live-in care, with pay differences for time awake or asleep. This can also be impacted by requirements to not leave service user accommodation (even on breaks) and whether they are required to be in the same room as the service user or can they be watching Netflix in another room only keeping a listening ear. We also see issues of pay for travel time and waiting time. We saw much confusion with the Mencap case, which was finally decided by the Supreme Court in March 2021. It concluded that, generally, employees who were asleep were not working for the purposes of the National Minimum Wage Regulations. Many care homes may have made defensive decisions ahead of the outcome and so now could be the time to look again at pay and working practices in light of the confirmation.
4. Right to Work Checks Temporary measures allowing an employer to conduct right to work checks remotely (such as over video calls, sending in a photo or scanned document via email) will continue to be in place until 5 April 2022. This is an extension of the previous date announced by the Government. Provided your checks are carried out in the prescribed manner or as set out in the COVID-19 adjusted checks guidance, an employer will maintain a statutory defence against the offence of employing a person who does not have the right to work in the UK and associated fine. From 6 April 2022, employers will need to revert to face-to-face and physical original document checks to inspect that they are valid.
Further Support Clarke Willmott have kindly offered all Albert Goodman clients an opportunity to book in for a free 20 minute consultation with a specialist solicitor, if you have any issues surrounding the above, or indeed any Employment or HR issues, causing you concern. Clarke Willmott also offer a free contract and handbook review to check if your documents are legally compliant.
Please do contact Paula Squire on 0345 209 1200 paula.squire@clarkewillmott.com or Ruth Le Page on 0345 209 1760 ruth.lepage@clarkewillmott.com for more information.
CQC’s new strategy
– what it means for providers In late May the Care Quality Commission launched its new 5-year strategy. The strategy had four key themes: People and Communities; Smarter Regulation; Safety through regulation; and Accelerating Improvement. Since then, providers and consultants have been thinking about what the new strategy means for their care businesses, and how they can ensure continued compliance. Here, we have provided a round-up of the main advice offered by Social Care Consultants Ltd in their webinar on the subject.
People and Communities Key aims: regulation driven by people’s needs and experiences rather than how providers want to deliver them; focus on what matters to people; work with people to help build care around the person. The implications for providers: embed feedback into Quality Assurance systems at every level and every opportunity – sometimes you’re given feedback without realising it. Enable people to provide feedback – you may have to made adjustments to the way you request, it to make sure you meet the Accessible Information Standard (e.g. it is no good doing an e-survey if people don’t have access to the internet) and consider advocacy; develop means of collecting, collating and analysing feedback. Ensure people know why you need feedback – show that you have listened and acted upon it. You may need to train staff to recognise feedback in all forms, respond and reflect on it. Focus on how you can evidence equality, diversity, inclusion (if you don’t find ways to communicate with all groups you are excluding them), corporate social responsibility (paying proper wages), environmental responsibility, and community wellbeing.
The implications for providers: Forget about scheduled inspections, focus on compliance and continuous improvement, think about your data and the message it sends (e.g. staff turnover rate), prepare for a CQC inspection at any time, and for more documents to be inspected off-site. Use your governance systems to assess your own ratings, take action to ensure you are at least GOOD in all areas, review admission and discharge procedures, and include non-compliance as a risk to your service. Train staff at all levels on what CQC inspect and how they can contribute, develop a culture of continuous improvement, and provide support for managers. Invest time in improving staff morale.
Safety through Regulation Key aims: improve the safety culture, focus on learning from events and improving expertise, act on feedback, and take action when a service is not safe. Implications for providers: understand what SAFE means for you, recognise your responsibilities to reduce avoidable harm, neglect, abuse, and breaches of human rights. Develop a safety culture. Focus on training and developing staff, embed learning into practice, focus on human rights in care planning and service delivery, show how you manage rights and risks, and use governance systems. Use CQC learning from safety incidents.
Accelerating improvement Key aims: drive improvements, spotlight priority areas, empower services to help themselves.
Smarter Regulation
Implications for providers: focus on continuous improvement (assess your level of compliance and devise improvements, re-assess continually).
Key aims: to keep pace with changes in how care is provided, to provide accurate and up to date ratings, more dynamic regulation, more use of data, and focus on risk.
If you are assessed as non-compliant – work with CQC. Get a consultant now rather than a lawyer later. Look at other providers’ inspection reports, use your data, and embed technology if staff know how to use it.
CARE HOME MARKET REVIEW – WINTER Jordan Rundle, Director of Healthcare, Development & Investment at Christie & Co, gives his assessment of the market as the year draws to a close.
Despite the unprecedented challenges of the pandemic, many care operators have generally continued with scheduled development site acquisitions this year, as they fulfil strategic objectives to improve the quality of their asset base in the medium to long term. The pandemic has highlighted the need for greater infection control measures, and such design features are now being integrated in new schemes which are being shaped by evolving operational requirements. These are much easier to incorporate into new build developments than retrofit existing converted assets. Both the rapidly ageing population and the closures of older converted homes are exacerbating the overall bed demand and supply equation in many regions across the UK. Investor appetite is undoubtingly increasing, with the arrival of large European investors and a broadening array of institutional investors attracted by the long-term fundamentals the sector offers, in comparison to the more traditional property sectors such as retail and offices. The increased demand and lack of alternative opportunity for investors is resulting in yield compression across the spectrum of covenants, and is also creating additional liquidity in the sector, allowing operators to undertake strategic growth plans. Some areas of the South East have seen high levels of new build activity, and specialist developers are now branching out further into pockets of the North and South West of England. These regions have seen much less development activity in recent years, but continue to have strong demand drivers and undersupply of market standard bed capacity. Land availability in locations with compelling underlying demographics remains scarce, and securing planning permission continues to be a highly protracted, costly and uncertain process. Because of these factors, land values for sites with planning permission have continued to increase at a steady rate and we anticipate demand to remain robust for the foreseeable future. We are also witnessing greater recognition of the value of specialist developers in the sector using their expertise to derisk the speculative nature of development, so that operators can concentrate their efforts on navigating the challenges the pandemic has created. There are good opportunities available for existing operators of any size to partner with specialist developers, to assist in facilitating their strategic growth plans.
Due to exceptional understanding of the sector and trusted network of healthcare specialist developers, Christie & Co are in a unique position to assist operators in facilitating strategic acquisitions and would be delighted to meet with any operators or developers wanting to know more.
THE CARE SHOW
13TH-14TH OCTOBER Albert Goodman attended the Care Show as a visitor. Exhibitors we spoke to were pleased with the attendance, and agreed that it was good to be meeting face-to-face once again. We were particularly interested to learn about new initiatives and ideas for the care workforce, and amongst the companies we spoke to was ‘Sona.’, a new employee app. The app enables staff to manage their work lives more efficiently, with modules allowing them to see real-time shift availability, manage their holiday and absence, see messages from their Managers, and provide feedback. A key advantage of this for the care sector is that the Manager or Administrator won’t have to make endless telephone calls to fill shifts, as staff can see what it available at any time. ‘Sona.’ Are offering a free pilot of their app, which is available via their website www.sona.is We also attended a seminar on ‘Why Social Media is Crucial for Recruitment and Customer Acquisition’ by Healthcare 92. They recommended using Facebook and Instagram for care staff, and Linkedin to attract nursing staff. They stated that 8 out of 10 people who are applying for a job look at the organisation’s social channels first, so it is vital that these are regularly updated with new content.
CARE HOME MANAGEMENT MAGAZINE: FINANCE PODCAST We were delighted to take part in a Finance Podcast for social care businesses, hosted by Care Home Management Magazine, in October. Michelle Ferris (Head of Charities and Care) and Andrew Hopper, Workplace Pensions Consultant spoke about the funding of care (and how to speak to residents about it) and unpaid debts, two very difficult subjects which are more important than ever after the challenges which the sector has and continues to face. The overriding theme was how it is so vital to get professional advice. The podcast is available at The Care Home Management Podcast - Care Home Management | Care Home Agency Advice (chmonline.co.uk)
End note As we reach the end of 2021, I think we can all agree that the year has presented as many (if not more!) challenges for care providers as its predecessor. Nevertheless, we hope that the articles in this newsletter help you to manage any workforce difficulties you may be facing. As ever we value your feedback, and would welcome your thoughts on our new ‘themed’ approach – what topics would you like us to cover in future editions? Until next time, I wish you all a well-earned peaceful festive season, and a prosperous 2022.
Michelle Ferris Head of Charities and Care, Albert Goodman
DID YOU KNOW...? Albert Goodman can provide your care business with: Accounts and Audit compliance Consultancy for business development/growth Acquisition and sales advice Property Capital Allowance reviews (to release ‘hidden’ tax reliefs) Corporate and personal tax services for owners (compliance, advisory, restructure, succession and exit planning) Later Life Care funding solutions Corporate Finance including valuations and due diligence for acquisitions and sales Workplace pensions Payroll Bookkeeping Outsourcing App Advisory
CONTRIBUTING TO YOUR SUCCESS If you would like to discuss any matters in this newsletter please get in touch with your usual Albert Goodman contact or Michelle Ferris direct.
michelle.ferris@albertgoodman.co.uk
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01823 286096
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