Registered Care Home Managers

Here’s a story that’s close to my heart. Having been a Registered Manager for several years, managed the work of a group of Registered Managers as Responsible Individual, and having gained the qualification as a Registered Manager (RMA NVQ4) I feel my opinion comes from a well informed stand point.

I often say to clients that the Registered Manager accounts for 90-95% of the quality of a home. So it is important to-

1-Make sure the home or service has one.

2-Check on their qualifications and experience.

3-Find out how long they have worked in the home or service.

It’s good to see the issue being debated nationally, the headline story being that a proportion of services providing care do not have a manager registered with CQC.

This despite recent efforts by CQC to improve this figure.

Here is what the piece in the Telegraph of 10th October has to say-

More than 2,000 care homes looking after elderly or disabled adults have no registered manager, according to figures to be published this week.

The results mean that 12 per cent of all care homes in England lack the leadership required to ensure that vulnerable people, including frail pensioners with dementia, are cared for properly, according to a study to be presented at the Liberal Democrat conference on Tuesday.

Paul Burstow, the Lib Dem MP and former health minister who obtained the figures, said the figures showed that “a revolution” in care homes was needed.

There are a number of factors underlying these figures and I would like to unpick them here.

The main one in my experience being turnover of managers. The position has changed over the last decade or so, and the focus of the job is diluted by the various stakeholders that the registered Manager finds themselves pulled between. A clear example is the needs of owners to run a profitable business weighed against the needs for care. On the surface one would expect owners to be in care business out of altruistic motives, indeed this was more the case in the past. However more and more the ‘owners’ are venture capital companies more interested in the bottom line. Care decisions are overidden by financial constraints. This leads to the high turnover of registered Managers in the sector, the majority of whom come from a caring background as opposed to a business background.


Lack of support
for registered managers is another factor that influences the lack of candidates for the sector. The old saw ‘it’s lonely at the top’ is never more true than it is now for the Registered Manager. As well as the pressures from divergent stakeholders as outlined above, there is the lack of peer support due to the business model of care provision. How can one go to another registered Manager locally for support when they are in fact business rivals? The same is true of the sharing of good practice in care throughout the sector.

Finally where do these managers come from? The skill set required to be successful in these posts is quite unique. A mix of care professional, business manager, HR professional, diplomat, carer supporter, pharmacist, CQC inspector-I could go on! There is a case for the industry taking along hard look at where it recruits from, what skills and knowledge it’s looking for and how these are developed and accredited. Yes I know Skills for Care do a good job of this, but they do it from outside the industry with one foot in the political camp of the current government regulators. Does anyone tell Costa where to get their manager from and what qualifications they must have? No the market decides that, however in the market of care, the qualities needed to manage aren’t clear.

Here’s The Telegraph piece on the story

Listen to the You and Yours item here.

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CQC Sandwich Generation Survey

I covered this story briefly earlier in the month when it was featured on BBC Radio Four’s You and Yours.
It’s a really useful piece of work though, so I thought I would cover it in further depth.

CQC commissioned Mumsnet and Gransnet to carry out a survey of the users of their sites. They were in particular looking for those that are described as the Sandwich Generation.

These are people who described as juggling caring for children and older relatives.

Eight out of ten people surveyed identified choosing care as major source of stress. Going as far as describing it as more stressful than divorce, separation, choosing a school, getting married or buying a house!

I have always described the process of finding good quality care as minefield. This survey clearly re enforces this.

Whilst I take no satisfaction in the fact that finding good care is so hard, clearly all care should be good! It is refreshing to see the CQC tasking steps to gain views and improve the information they provide. The infographic they provide shows what people want to now about care providers. All of which are included in one of my reports.

www.scotting.org/services.html

If you need some help and advice call my freephone line 0800 0016694 always happy to help .

sandwich-generation-survey-infographic-011014

Heres a link to the report on CQC website.

http://www.cqc.org.uk/content/sandwich-generation-carers-say-choosing-care-one-lifes-most-stressful-events

 

 

 

CQC to publish guidance on using CCTV in care homes

There has been a lot of noise about this issue in the press for some time, and last week it blew up again with CQC announcing the possibility of publishing of guidelines on the use of CCTV in care homes.

Here’s the headline from The Daily Mail 6th October:

Families given official green light to spy on care home staff if they fear their elderly relatives are being abused

I think the CQC position is more nuanced than that, but in effect will sanction families and employers using cameras to spot abuse.

I have made my thoughts on this clear several times since it was first mooted. In a nutshell they are-

1-CCTV will not prevent abuse.
2- CCTV is useful in gaining convictions where abuse is suspected.
3-Better recruitment, retention, training and pay will reduce abuse.

My views are echoed elsewhere, The Guardian on the 8th October ran a piece with the title

CCTV in care homes: secret cameras are not the way to improve care

Rather than allow covert filming, the Care Quality Commission should focus on driving up standards

The main thrust of the article is about the underlying causes of bad care, and I would agree, these need to be addressed as opposed to using CCTV to spot the symptoms.

The full article can be found here-

http://www.theguardian.com/social-care-network/2014/oct/08/cctv-care-homes-secret-cameras-improve-care

The CQC statement can be found at-

http://www.cqc.org.uk/content/statement-about-use-cameras-monitor-care

Local Government Ombudsman finds council top up fee policy to be illegal

The subject of third party top up fees is one I’m often asked about.
More often than not the people involved in working out who owes what to who, do not have enough information and experience to work it out correctly.
This story shows how one council got it wrong, by effectively requiring a lady to top up her own fees, which is against the law. (National Assistance Act 1948)
Underpinning the argument here is the basis of funding for health and social care. Health care-Free at the point of delivery. Social care-Means tested. This political hot potato is one that the political parties have been juggling at their conferences in recent months.

http://www.communitycare.co.uk/2014/10/03/ombudsman-criticises-council-forcing-resident-pay-unlawful-care-home-top/ For the full story

http://www.scotting.org for more on paying for care

You and Yours 7th October 2014

You and Yours have been producing some good coverage of the care sector for some time now. I particularly liked todays episode as it repeats one of my key messages to people. Always get good advice when looking for care. Odd to see CQC taking this position, but also refreshing to see them taking a real world view of the whole picture.

How easy did you find it to get good quality care for your elderly parents or relatives? The Care Quality Commission says it is one of the most stressful things we’ll face in life.

We’ll ask why is it so difficult and what can be done to make it better.

Guests will include the Care Quality Commission and Carers UK.

Web users click here for full story

For those reading in print the programme can be found at- http://www.bbc.co.uk/programmes/b04kbjhx

And don’t forget advice, help and information is available on my website-www.scotting.org

Elderly woman died after suffering burns in nursing home bath

This is a very sad story, and my heart goes out to this ladie’s family.

However I can’t help feeling it further shows up the defficiencies in care and nursing home regulation.

The story has been reported by the Health and Safety Executive, after a now dissolved company was found to be negligent.

http://press.hse.gov.uk/2014/elderly-woman-died-after-suffering-burns-in-nursing-home-bath/?ebul=hsegen&cr=15/29-sep-14

The worrying element is that highlighted by the magistrate. The directors of the company have walked away from this with a £5,000 fine. Which may or may not be paid by the company, as its now dissolved.

So what is to stop these clearly unsuitable people starting up a new home, if they haven’t already done so?

NOTHING!

My Care Service Report and Select-a-Home service will always look into the Directors of care companies and their past. www.scotting.org

 

 

 

Union Supports Poor Care Provision!!!!???

Whilst one has sympathy with the people affected, it’s odd to say the least to see a union taking this stance. In effect asking CQC not to close a home providing poor quality care.

Surely they should be supporting their people, who have been part of the failed service, to find other employment?

 

Is it me?

 

http://www.bbc.co.uk/news/uk-england-kent-28874174