By Debbie le Quesne

Posts Tagged ‘West Midlands Care Association

The haves and have-nots: Bizarre economics of care

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The UK care home sector is losing managers and failing to replace them, that was what LaingBuisson was telling the media more than 12 months ago. And guess what, it’s not changed today.

The shrinking pool of talent for the top jobs with providers of elderly care is driving manager salaries to new heights.

In the latest data I have to hand it says new-build homes are offering in excess of £60,000 a year for managers.

That means with the additional costs of National Insurance employer contributions, pension payments and other sweeteners, the source cost for providers is rapidly approaching £100,000, and a bonus scheme can easily tip this even higher.

Of course, we wouldn’t expect to see these figures being paid amongst many of our members and it’s not because they are mean employers. It’s a simple case of economics: There’s just not enough money in the pot as the region is too poor.

It’s a fact that many of the lager corporates operate in much more affluent areas than the West Midlands and unlike many here, their main trench of income is from private payers. Most of my members survive on council-funded placements and it’s their primary source of income.

Austerity measures is seeing the industry becoming increasingly polarised – the haves and have-nots.

In May last year, according to LaingBuisson Recruitment co-founder James Rumfitt, the residential care sector as a whole was struggling to find managers of competence.

I am not surprised.

According to the healthcare consultant’s Care Home Pay Survey – second edition, the average care home manager salaries at the beginning of 2015 were up 4.2 per cent above the previous year.

This was incredible 49 per cent higher than salaries seen a decade ago. Compared to an increase of just 24 per cent in median full-time employee earnings in the UK economy as a whole, it’s an eye-watering hike.

Isn’t it odd, the general care market is in turmoil, yet the economic dynamics of a shortage of good managers, pushes up their salaries at the top end of care provision. Supply and demand are hard masters.

While there will always be those who can afford private care payments and thus fund very generous salaries for the elite operators, there will be many more people receiving care on local authority rates only. Their care providers, where pay rates remain anchored to the Living Wage, will not have the privilege of top-ups to fund such salary extravagance..

But I must say this: The care I have seen in some of our struggling homes has been exemplary. Plush surroundings, teas on the terrace, matching furnishings and expensive, oak flooring, does not necessarily equate to excellence in care.

What is it about never judging a book by its cover . . .


The axeman cometh ­– Osborne’s summer Budget looms

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If you believe the harbingers of doom, a fresh £3bn Government cuts spree will see libraries, leisure centres and . . . elderly care for the chop.

The Local Government Association fears councils will need to slash 12 per cent of costs in 2016-17 to meet the demand.

Libraries could close, bus services could be slashed and potholes could be left unfixed as town halls face £3.3billion of fresh Tory cuts, council leaders have warned.

Leisure centres, bin collections and . . . caring for the elderly in their homes could all be threatened if budgets are hit, the Local Government Association fears.

With a growing reluctance, it says authorities will need to slash 12 per cent of costs in 2016-17 because of the new measures expected in the autumn.

LGA chairman David Sparks has already said there are no efficiencies left to be made for many councils, but the proverbial axeman cometh. July 8 will see George Osborne’s Tory-only Government budget rolled out.

Mr Sparks has said: “Vital services, such as caring for the elderly, protecting children, collecting bins and filling potholes, will struggle to continue at current levels.”

The LGA’s annual Future Funding Outlook report predicts councils in England will have a £9.5billion black hole by the end of the decade.

As I recall, local authorities have already made £20billion in savings since 2010 following reductions in government funding of 40 per cent.

Many LAs have worked hard to shield the most vulnerable from this austerity, but it’s not a sustainable premise.

Is it time for chocolate, cupcake and sweet tea served in china cups? Is there any good news out there?

Rocketing Dols demand means timescales breached

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Deprivation of Liberty Safeguards (Dols) are rocketing to new highs with many still breaching legal timescales for completion.

A landmark Supreme Court ruling last March triggered a nine-fold rise in monthly referrals to councils, a Community Care online magazine investigation has found.

The ruling’s extension of human rights protections has been welcomed by social workers, but they warn more resources are urgently needed to help frontline teams cope with demand.

Under the Dols, local authorities must assess whether people who lack capacity to consent to their care arrangements are being deprived of their liberty in care homes or hospitals and, if so, whether this is in their best interests and necessary to protect them from harm.

The legal landmark was set with cases involving Chester west and Chester Council and Surrey County Council. The outcome was a revised test that has lowered the threshold for deprivation of liberty in care.

Six months on from the ‘Cheshire West’ judgment, a Community Care investigation, based on data obtained under the Freedom of Information Act from 103 local authorities in England and 19 councils and health boards in Wales, showed a massive impact it has had on the adult social care system.

Community Care notes: “In 2013-14 councils received 8,455 requests for Dols assessments; since April this year they’ve already had 32,988 referrals. The figures mean average monthly referrals have risen from 713 in 2013-14 to 6,643 in 2014-15. The effect of the dramatic rise in cases is clear. Last year 2.2% of cases breached timescales; so far this year 50% of cases were not completed in time.”

The investigation also found “that the shortage of trained staff in councils means local authorities have already spent £1.4m on independent BIAs (business impact analysis) in 2014-15. That’s almost three times the £550,000 spent across 12 months in 2013-14.”

Predictably, the chorus of complaint is one of more resources required. I know that the teams have had to divert much of their safeguarding resource to getting as many fulfilled in the times scales as they can. In some areas that means they are having to priotise.

However the Department of Health has not passed this message onto CQC who feel that it is there duty to punish Care Homes very severely if they have not put everyone through for a DoLS that they can. We talked to the DOH when we saw them in January and asked them to help CQC understand the problem.

It seems it is understandable for local authorities to fall behind with their timescales but not care homes!

Record turnaround for fist WMCA DBS online

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It’s been a long time coming but it’s worth noting that the first electronic DBS check  completed by West Midlands Care Association was done so in record time.

Within just four hours the documentation was completed for Birmingham’s Albion Court which is part of Restful Care Homes.

The association won approval by the Home Office to deliver an online disclosure and barring service in November.

The move followed months of negotiating to secure a competitive deal with an accredited online operator. The contract finally went to uCheck.

A raft of security measures has been introduced at the WMCA headquarters to comply with HO regulations.

With strong support of its membership, WMCA has pushed hard to improve the current delays in processing disclosures.

This should now see the end to the horrendous delays we have experienced. One case took a staggering 141 days to process, with past averages working out at 33 days.

By committing to work alongside uCheck in this fast-track initiative we are underpinning our commitment to improve the DBS experience and we know it is something our members desperately need.

The new system helps eliminate common errors found in form filling exercises which often don’t come to light until the application is in the process system.

Don’t miss out on our audit tool for the new CQC inspections

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The new Care Quality Commission inspection model has been rolled out and we’re all eagerly waiting for the new ratings to be announced.

At the time of writing this, nothing has been announced among our members so we don’t really know how high the bar has been set against the previous criteria.

We are, however, confident that delivering a practical guide which can easily be personalised to any care business, will be an invaluable asset for members in this time of transition.

Simply, we want to make sure everyone is well prepared for the inspection revisions, so West Midlands Care Association has produced a simple, walk-through guide that addresses the five critical pillars of the new regulations.

It’s aim is to provide an easy-access knowledge base of how to safely justify answers CQC is looking for and ensure nothing is missed.

Those using the tool and unable to resolve queries will be able to access support with a phone call.

Under the CQC initiative, inspectors will use professional judgment, objective measures and evidence to assess services against five key questions: Are they safe; are they effective; are they caring; are they responsive to people’s needs; and are they well led.

A standard set of key lines of enquiry (KLOEs) will be used to extract the information to ensure a level playing field on all inspections, a move that has been welcomed by the industry.

We all know the new approach is all about CQC asking the questions that matter to the people who are using the services, but there is a raft of critical procedures and policies that care providers need to be getting right.

Just having the knowledge where to look for supporting information required by CQC and how to present it will make a huge difference to inspection outcomes.

The inspection process aims to provide good information for the Commission for ratings and give the provider a snapshot of how they can improve.

Our CQC Audit Tool looks at ways of avoiding the pitfalls and ensuring nothing is missed in the way CQC expects the management of care to be delivered. It’s simple to use and everything is made as clear as possible

For non-members, the digital document available through email, is £70 and for member £35. Those who have previously purchased audit inspection tools

Dementia headlines: So what about all of the good work?

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Headlines claiming that there is a national care betrayal of those suffering with dementia have invaded our living rooms once again.

A Care Quality Commission review found widespread neglect, lack of care, poor training and failings in communications. And that may well be the case.

Most of the 4,000 elderly in UK care homes suffer with degrees of dementia and the CQC found that despite the scale of the problem, professionals’ responses were not adequate. These facts too, though disappointing, don’t get my blood boiling.

But the fact the findings were presented by the media as a national scandal tarred every region with the same brush.

How could you possibly say, for instance, my home town of Dudley with its Dementia Gateway initiative is failing? Then there’s Sandwell, where a care quality drive is hugely focused on the memory-loss condition . . . or Birmingham where home-owners are being given financial incentives to build with dementia in mind?

I’ll concede that nationally there are both good and bad examples of dementia care, but the way findings have been delivered are terribly one-sided.

We cannot deny we have a lot of work still to do and my association has a huge commitment to improving this specialised kind of care.

We are constantly working closely on training models with Professor Dawn Brooker of Worcester University, who established the Association for Dementia Studies (ADS) in 200; we are wholly committed to the Dudley Dementia Gateway project and support Sandwell in its endeavours too.

There is a huge amount of exemplary work in the Midlands which appears to have been overlooked.

Across the country there are huge disparities in funding allocations for dementia that could explain the flawed delivery of care.

In the affluent south there are reports of dementia care attracting local authority funding of £1,000-plus per week, while in the Midlands the average figure is £420.

Sadly there is no common national figure. Dudley pays an extra £14 a month for dementia care on top of its normal allocation for residential care; Sandwell gets £20 and Wolverhampton £29. As monthly figures they don’t even begin to scratch the surface of the additional costs dementia care demands.

Perhaps the real scandal here is with the Government that still has not grasped the nettle on how we are supposed to finance the care of these very needy people.

Birmingham’s sticky questions over online procurement glitches

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It was standing room only when West Midlands Care Association hosted a questions and answer meeting over Birmingham members’ problems with the online portal and procurement system they now have to use. Birmingham care services commisioner Jules Gregory and Elizabeth Ross, the city’s Assistant Director for Commissioning, attended the regional association meeting on Thursday (July 9) to address a raft of problems encountered by service providers as they have attempted to place tenders.

The Sproc.net site, that is designed to deliver the end-to-end process of commissioning services, including stimulating supply through to payment, is under fire from association members. The system has been used to mini tender for home care for several years and was “working quite well” the meeting heard, but problems with the more recently introduced Care Home section have emerged.

Members reported there concerned by the number of cancelled tenders being flagged up without any understanding of why, they also reported placements not going through the system which Jules and Elizabeth said would cause problems with payment later in the process. Both Jules and Elizabeth were puzzled by the scale of criticism, but said a new manager had been appointed to ensure that in the future more detail on how to secure contracts will be uploaded onto the site.

They also added that it was still the job of social workers to find the right place for their service user and a working together approach was needed to ensure right procedures were followed so that payments for services could be made quickly.

Developer Matrix SCM has created a new help desk number 0871 474 0332 that providers can use if they need to reset their password to use Sproc-Net, or they have any technical issues using the system. Providers can continue to use the Commissioning Enquiry Desk number 0121 303 3893 if they have any other queries in relation to the Sproc-Net system.