Celebratory TimesUK Health & Social Care

The day to #CelebrateSocialCare 2017 FREE tgmgroup.net FIRST EDITION

Proof there is good in care: Sean Kirkwood wonders why so many people question his decision to be a professional carer, for Sean there is no job he would rather do.

Not everything in social care is bad CAMPAIGN STARTED BY HEALTH AND SOCIAL CARE LEARNTECH COMPANY AIMS TO SUPPORT SECTOR RETENTION

THE CRISIS in social care in England and Wales has become an ever-present ‘truth’ - yet look among the ruins and you will see the strong green shoots of new life in this much-maligned sector.

In the months since the British electorate voted for Brexit and since the BBC’s stinging Panorama programme ‘Nursing Homes Undercover’, the health and social care sectors have never been far from the news.

Sector funding was conspicuously absent in the Autumn Statement, and recruitment and retention seems to be spiraling out of control. Should we conclude that ‘care’ is disappearing from the social care sector in the UK?

Many of us with relatives in the care system wonder if our loved ones are safe, secure and have their needs met with dignity and care. We are anxious. Many of us frustrated and scared about our future.

“I feel powerless,” said ‘P’, a Registered Manager I spoke to from Hampshire. “I’m watching things unravel and I feel powerless to prevent it.”The pressures

Alex Knapp, Chief Engagement Officeron social care truly are immense. Bad stories sell and funding, continues to be tight.

So if the care sector is facing an unbelievable shortage of competent people, numerous provisions having no Registered Manager and daily struggles with staff recruitment and retention, where on earth are these green shoots of new life?

They are there if you choose to see them. As Winston Churchill said “The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty.”

If you’ve ever driven a car a night you’ll know how easy it is to ‘drift’ towards the lights of oncoming vehicles. It’s natural - we gravitate towards that which we focus on. We can choose to focus on the crisis in social care, or we can choose to see the growing-pains of a sector that is responding to the challenges of 21st Century life.

For each sad or depressing social care news article there are a hundred or more good news stories. There is fantastic good practice out there, if you get out and find it. Continued on Page 3

IN A SECTOR RELIANT ON PAPER, COULD YOU USE LESS AND STILL GET THE JOB DONE?Kieran Smith investigates on Page 4

#CelebrateSocialCare

WIN an iPad mini 2with The Grey Matter Group

What can the UK learn from America when it comes to recruitment and retention?

Find out on page 3Page 5

Smart Local Authorities support Health and Social Care in the shadow of financial challenges The Interview, page 6

OpinionProfessor Martin Green OBE gives his on page 7

THE DAY TO #CelebrateSocialCare 2017 Celebratory Times2Like us on Facebook facebook.com/CareCert Follow us on Twitter @tgmgroup Follow us on LinkedInNEWS

I have been working in learning, development and training in the health and social care sector since 2000. Like many people, I have noticed that the pace of change seems to be accelerating while the scope grows larger all the time. Indeed, the last three years may count as the most impactful and dynamic periods in the history of the sector.

2015 saw the introduction of the Care Certificate, the Care Act, and the CQC new Fundamental Standards. The Government introduced these changes against a context of political and demographic upheaval. There were the highs and lows of Brexit and the uncertainty this holds for the non-UK workforce, the living wage, a complete re-write of the Apprenticeship Standards, changes to the Assessment Strategy, the way the funding for the Government’s Skills Strategy and finally the Levy! Like many sector colleagues, I am positive about change. We want to improve. Yet, we recognise that managing it and trying to decide what to do next can be a challenge.

I am interested in issues affecting team performance. For those familiar with the DiSC model of behaviour profiling I am deep in the ‘I Quadrant’ - people fascinate me. Chartered Psychologist Professor Derek Mowbray produces thought provoking articles on personal resilience, which he defines as follows:

“Resilience is the capacity to face up to challenges that may threaten us, in a manner that enables us to deal with the challenge without it having a detrimental impact on us.”

It is vital for an adult care worker to develop high levels of personal resilience so that they can balance giving the best possible support with the many other demands on their time.

Managers also have a big role to play in developing a resilient, nurturing working environment. In fact, the situations that occur because of a manager’s activities have a disproportionate impact on the experience of the adult care worker and ultimately on the person being supported.

I have met with more than 400 care workers in the last year. I am amazed by the way these fantastic care professionals understate the importance of the work they do. How many times have you heard: “I am only a Care Assistant,”? The way that they manage the emotionally and physically demanding working environment is also humbling. I regularly hear “if it wasn’t for the residents I would leave. I could earn more money stacking shelves.” Sadly many do leave, and what a loss that is.

For some, the implementation of a new set of standards accompanied by a different inspection regime is a step too far and the pushback from time-poor, over-worked staff can be challenging to managers.

Not every care setting is like this, but my experience suggests that the majority of care services have staff managing levels of pressure that would be unacceptable in other sectors. Anecdotally, staff turnover and attrition figures support this.

Pressure is a good thing, isn’t it? It provides the impetus to do things. It is engaging, even exciting! To some degree, yes. But when pressure doesn’t go away it eventually becomes tension.

Tension is okay, it is still engaging, we can self-medicate - strong coffee, etc, in order to cope, but this declining continuum of pressure - tension - strain and eventually, stress is not good.

At the point where tension becomes strain, we become less concerned on the tasks we are doing or on how we are performing and become more focused on the impact that this is having on our wellbeing. If the strain continues, we enter into a state that Psychologist Professor Derek Mowbray describes as ‘Psychopresenteism’ - being present in body at work but not in mind.

Stress costs the country millions of pounds and the impact of this catastrophic situation on the individual’s health and wellbeing is extremely serious.

The CIPD 2016 Absence Management Survey states:“Stress has once again topped the list of the most common causes of long-term absence, and is the second most common cause of short-term absence after a minor illness.”

Any good or bad situation will change. We must recognise this and approach things differently. We can use techniques like mindfulness to help manage anxiety. We can support staff to increase their personal resilience. We can help managers to understand the impact that their role has on organisational culture; we can coach, reflect, listen actively and take psychological responsibility for the wellbeing of each other. These are all ways that we can reduce the negative impact that change has on us.

So, let’s make 2017 the year in which we make the workplace a resilient, nurturing place to be. Let’s care better for our care workers and make it easier to #CelebrateSocialCare.

Resilience is a Recipe for SuccessPaul Shepherd from Gritstone shares his thoughts

The Apprenticeship OutlookSponsored by HRUK

The health and social care sector is in the eye of the perfect storm.

Strong downward pressure will be felt on the front line through the funding cuts made by local authorities, increases in the minimum wage and the introduction of charges for staff training.

Severe flooding with negatively charged messages will be experienced across the sector resulting from the absence of high-quality preventative barriers in a minority of very low, lying and isolated settings.

Since storm clouds are gathering right across

England and Wales, let’s return to the introduction of mandatory fees for training.

There are three categories of service providers based on our respective payroll bills:

Levy clients If our payroll bill exceeds £3m, a 0.5% tax will be applied through the PAYE system.

Non Levy Clients Providers with more than 50 staff but with a payroll bill of less than £3m will attract a 10% fee contribution.

SME Providers with less than 50 staff - no mandatory training fees apply

Gauging the temperature of the sector

A recent survey carried out by City and Guilds suggested that 33% of Levy clients were unsure of what the new measures and fees meant to them and how they would be applied in practice.

With such a variable outlook we understand the confusion! Our own research has raised as many questions as answers.

We have been fortunate enough to work alongside some of the best and the brightest within the field of learning and training and between us

all have come up with a thorough understanding of the fee system that is to be introduced. We understand how, with careful planning, we can upskill our workforce in a financially viable way for all – no matter which way the wind is blowing.

It is more important than ever that your learning and training providers work in partnership with you to make sure you get best possible return for your investments because it is precisely that: an investment in your staff to support your business to grow and bask in the sun.

For more information about how the new apprenticeships will affect your business and how The Grey Matter Group partnership with HRUK can support your organisation, contact The Grey Matter Group now by email: support@tgmgroup.net or telephone: 0345 873 3873

Skills for Care, CQC and NICE guidance all points to COMPETENCE, something that has to be evidenced, not taught and certificated. Need help with that? Go to www.tgmgroup.net

Celebratory Times THE DAY TO #CelebrateSocialCare 2017 3NEWS

Neil Eastwood from Sticky People, one of The Grey Matter Group’s partner companies, gives his perspective on how efforts to reduce staff turnover in American care settings can help managers wrestling with the same problem here.

“I’m leaving.” Not easy to be told in any situation, but if you are an employer in the care sector, you have been hearing it more frequently in the past year.

Of course, workforce departures can seem like a series of isolated disappointments, each with ‘unique’ circumstances. As a busy manager, there is rarely the time to explore underlying causes before moving on to dealing with the consequences – the potential impact on clients, recruiting to replace them and adjusting rotas. No wonder it’s easiest to simply accept it and move on. But, in this article, I want to bring you some fresh retention perspectives based on studies of what American providers are doing.

What can we learn?

The starting point for much of my work was to study the recruitment process in America. My findings included:

• Best practice recruitment is a fundamental driver of retention. Selecting mainly suitable and reliable staff is, in my view, the single biggest contributor to longevity in the role.

• The first 90 days of employment is critically important. Norms are set and impressions are made particularly in the first few weeks of the job. Exemplary American care providers ensure that during this period their management is regularly visible to new starters, that their opinion is actively sought, and each new member of staff is assigned a mentor.

• Caring attracts them, a lack of respect pushes them away. The best carers are relationship-centric people. Pay is not their biggest motivator. In the pressure of a busy care setting, it is too easy for supervisors to communicate poorly or show a lack of humility or empathy towards staff. This would be damaging to any workplace relationship, but for those who care for a living, it is toxic.

• Age is a predictor of employment tenure. The American experience seems to suggest that older workers are more likely to stay longer, particularly if there is uncertainty over a consistent income. Younger staff may be more reliant on a minimum earnings level while those without dependent children, and perhaps other sources of income, can be more flexible. This is particularly noticeable in home care settings. There was also evidence of younger carers seeking career progression to a much greater extent than those later in life.

Please don’t go! Frontline care staff retention and what we can learn from AmericaSome practical interventions based on American learning

I have suggested below a few interventions that readers can consider, from the relatively simple to implement, to the more ambitious:

Quick Fixes1. Ensure you stay in touch with ‘good leavers’ with regular texts. In tests three

out of ten American leavers returned to their employer because there was ongoing communication.

2. Be sure to send a personal note of appreciation home to all ‘good’ staff at least once a year. This will not only be motivating to them but will also be seen by a spouse or partner who can often be the one encouraging them to leave.

3. Involve frontline staff in a task force or some aspect of your operation outside of their core duties. A great one is to get them to meet prospective new staff and answer questions about the work. This will make them feel valued and empowered and differentiate your company to applicants.

Medium Term Actions1. Put your supervisory staff and schedulers on a communication and active

listening course. This will help reduce disputes, conflict and lower turnover of both frontline carers and supervisors.

2. Review your incentives and motivation schemes. Get staff feedback on whether an Employee of the Month award is doing what you intended. Consider introducing more personal appreciation mechanisms.

3. Upgrade your recruitment process. To improve retention, it is important that you minimise the addition of unsuitable staff through poor attraction and selection. In many cases weak attraction leads to a limited choice of candidates and pressure to offer a job to the only applicant.

Longer Term StrategiesIt may be necessary to consider a fundamental culture change towards one of mutual respect and empowerment. This would include reviewing leadership, workplace practices and communication methods. Whilst this is a big commitment, it may be the right approach for some organisations.

Neil Eastwood is Founder of Sticky People Ltd, providers of the PeopleClues candidate screening tool for values based recruitment to UK care employers.

Email: neil@stickypeople.co.uk • Twitter: @StickyNeil

…continued from front page

A consequence of The Grey Matter Group’s work with so many social care partners is that we get to hear those good news stories. We share your experiences when care is outstanding. We speak with the quiet ranks of ordinary staff providing extraordinary care.

Over the past months, many of our partners have achieved ‘Outstanding’ Care Quality Commission ratings. In my opinion, ‘Outstanding’ providers are those that have a fundamental belief in their caring mission and use this to innovate, to challenge and to develop.

There is a big difference between following the regulations and embracing them. Our experience shows us a clear correlation between the providers who challenge themselves over how they meet the regulations, who adopt sector-wide guidance and who embed best practice and the organisation who achieve the highest rating from CQC. There is also very clear evidence that these organisations struggle least with staff retention. It is a virtuous circle.

The truth is that social care in the UK is certainly not failing — yes, it is hard work, and yes, it faces new systemic challenges — however, it continues to make a difference to millions of lives every day.

The people who achieve this everyday miracle deserve our praise and admiration — not just because the job is hard, but because they connect with people, support independence and help others maintain a sense of life and enjoyment. They are dedicated to caring for and supporting others. Their mission, like ours, is to improve lives.

#CelebrateSocialCare

Recognised Provider endorsement for The Grey Matter Group announced. Assurance that doing learning differently is good for care.

Moving learning and development away from paper can reduce more pain than the thought of it causes.

Tel: 0800 888 6868 Web: www.uniqueiq.co.ukEmail: sales@uniqueiq.co.uk

FINANCIAL, STAFFING AND OPERATIONAL CHALLENGES are at an all time high in social care, but smart Local Authorities know just how to respond.

West Berkshire Council (WBC) is a unitary authority in southern England. Like all LAs, it has limited funding and resources for social care workforce training for its in-house staff and the Private, Voluntary and Independent (PVI) sector. Alex Knapp spoke to Tandra Forster, Head of Adult Social Care at WBC, about how she ensures that carers are competent and safe to practice.

“Our learning culture starts with induction,” said Tandra when we met. “We made sure that the Care Certificate knowledge assessments were written into our induction policy as a mandatory requirement.” This is a smart way to start. Gathering a benchmark of initial understanding gives WBC the confidence - and valuable objective evidence - that knowledge has been assessed from the outset.

“It also gives our teams a method of accurately identifying individual learning needs,” said Tandra. “We knew ten years ago that The Grey Matter Group’s online assessments were an effective way to identify if new staff already had sufficient knowledge or whether they needed to fill gaps in their learning.

“Take Safeguarding as an example. It’s one of our key government reporting targets, so we need to be able to provide robust evidence. The online assessments enable us to identify who does and does not need additional safeguarding training both at the council and in the PVI sector, which enables us to be effective and robust in our decision making around budget and resource allocation.” said Tandra.

And because WBC’s confidence in the assessment evidence is high they can make policy decisions based on this evidence. “At WBC our training programme is mapped to the Care Certificate, but our courses focus on learning, not on assessing competence or safety to practice, so we need to check this in the workplace. Our process for doing this uses The Grey Matter Group’s holistic observation module.” Holistic observation is another very smart move for WBC - it allows assessors to observe practice and gather evidence which can then be applied to the relevant mandatory observable outcomes required by the Care Certificate.

And the impact? Alongside significant time and cost savings, the feedback from staff was that they felt valued and supported when managers spent time discussing results and observing practice, which means WBC retains high quality, engaged staff. For example, Karen, a Re-ablement Assistant at WBC completed her Care Certificate in just nine weeks: “The online portfolio is extremely useful. I keep going back to it to check things, particularly when I start working with a new person,” she said.

“As a result of the continuous evidence of competence we gather during observation and supervision,” said Tandra. “We have so much confidence in the approach that we now check competence for all staff, not only new starters, and we demonstrate competence in all areas of work, not just for the Care Certificate.

“The Grey Matter Group have provided additional workshops specifically on evidencing competence and about practice observations as we felt we needed their support to strengthen in this area.”

And CQC? What do they think? “We have been inspected recently. We discussed with CQC our online assessments and how we demonstrate continual competence, all the time, in all areas. Our inspector was full of praise for the work we have done in this area.”

I thought that this would be a good moment to let Tandra know that The Grey Matter Group has been awarded Skills For Care ‘Recognised Provider’ status, meaning that Skills for Care have scrutinised our products and services and found they meet their rigorous quality standards.

“Well that’s no surprise,” said Tandra. “We know that all West Berkshire providers will join us in congratulating the team at The Grey Matter Group for their hard work and dedication to the health and social care sector. Well done!”

Smart Local Authorities support Health and Social Care in the shadow of financial challengesAlex Knapp talks with Tandra Forster

THE DAY TO #CelebrateSocialCare 2017 Celebratory Times6Like us on Facebook facebook.com/CareCert Follow us on Twitter @tgmgroup Follow us on LinkedInINTERVIEW

THE GOOD CARE GROUP, rated outstanding by CQC, enable their professional Live-In Carers to form a deep understanding of the needs of the clients who they work with - enabling them to stay at home for as long as possible.

With The Good Care Group, professional carers enjoy a role where they will work with the same client, working to improve their health and wellbeing outcomes.

The training provided by The Good Care Group is second-to-none and includes specialist training such as dementia, Parkinson’s disease, stroke and palliative care. Training is supported through the use of the innovative learning and development solutions provided by The Grey Matter Group which enables us to provide holistic individualised learning for each professional carer.

At The Good Care Group, we value the compassion and dedication it takes to become an exceptional carer. We know that it is the carers who make a difference and as such, we reward expertise, passion and respect. The Good Care Group support our carers 24 hours, 7 days a week.

Some of the benefits we provide to our professional carers include:

• outstanding free training programme• paid for DBS check• accommodation and travel paid for during

induction training in London or Spain• paid for Health and Social Care Diploma• 24-hour support throughout the year• encouragement for further learning and

development• help with travel expenses to and from placements• excellent bonus scheme• market leading salary

Visit The Good Care Group online to find out more about the most awarded Live-In Care provider in the UK: www.thegoodcaregroup.com

WIN AN IPAD - TURN TO PAGE 5 TO FIND OUT HOW

How do you find the time to discover best practice asks Pam Darroch?I AM SURE MOST PEOPLE would agree that time is limited. We often find ourselves feeling that there just isn’t enough time. Nowhere is this truer than in Adult Social Care - I know - Registered Managers tell me this so often.

There’s another given in Adult Social Care - ‘Best Practice’ - a label to which we all aspire for our work, and something that we should actively seek. So how can we do this when there is so little time?

A great source of inspiration for best practice is the CQC reports where providers have been rated outstanding - but you know what’s coming next: though it is well worth doing, reading and keeping track of reports takes precious time!

So, every month, I aim to send out a summary of notes from several CQC inspection reports from across the country. I focus on the Outstanding and the Requires Improvement because it is important to see where standards need to be lifted as much as where they are excelling.

If you would like a copy of the summary, delivered to your inbox, please sign up to The Grey Matter Group mailing list at www.tgmgroup.net

The Grey Matter Group also share best practice at regular workshops. According to the attendees these are always worth going to, even if you have been before.

Drop me a line if you would like to talk to me about the summary or how I can help you with quality and compliance. It will be great to hear from you!

Here’s to ever-improving standards Pam Darroch

pam.darroch@tgmgroup.net

Celebratory Times THE DAY TO #CelebrateSocialCare 2017 7 NEWS & OPINION

ESSENTIAL SAFEGUARDING has one aim, to ensure all children and young people have the skills and knowledge to keep safe from abuse. Through working with children and parents in early years settings, primary and secondary schools and more recently young people at university, Essential Safeguarding focus on reducing the number of children and young people experiencing domestic abuse within the home or their first intimate relationship.

Current evidence-based research informs us that almost three women are murdered every week by their partner or ex-partner, and ten men are killed every year. The financial cost of domestic abuse to the UK economy is currently £23 Billion per year, the social costs to children and adults are immeasurable.

Through years of experience, Essential Safeguarding knows that this work needs to start as early as possible when children are very young. Professionals working in education settings need the knowledge, understanding and support to identify children living with domestic abuse at home or who are themselves, young victims or perpetrators.

The Coffey Report 2014 states, “the high rates of sexual coercion and peer on peer abuse discovered within secondary schools need to be addressed through education and awareness raising that challenges attitudes and helps change behaviour.”

The partnership between Essential Safeguarding and The Grey Matter Group is contributing to reaching whole school audiences who in the past had limited access to high-quality training materials, and expert support and supervision. The Grey Matter Group is ensuring schools have the mechanism to evidence compliance with the DFE Keeping Children Safe in Education 2016 guidance and that teachers understand their safeguarding duties, feel confident to identify children at risk and are competent to respond.

Essential Safeguarding’s work has been cited as good practice in a recent joint targeted area inspection into domestic abuse in Salford and highlighted as a key strength to help children better understand healthy relationships. The highly acclaimed multi-media performance “Black eyes and Cottage Pie” used as a tool to raise awareness with young people and professionals were recently named within the PROTECT-ED code of practice as a good example to safeguard students on Campus.

There are 60,000 early years settings, 29,000 primary schools 3,000 secondary schools and 163 Higher Education Settings within England and Wales. The innovative partnership intends to ensure that children and young people in all of these settings have the skills and knowledge to keep safe from abuse.

If you want to know more about the partnership, please contact Sarah Knapp on 0345 873 3873 or email sarah.knapp@tgmgroup.net

OPINIONTraining: the Panacea for Quality or the False God of the 21st-Century

There is no doubt that good training is the cornerstone of high quality care and the current system spends enormous amounts of money on training staff. Health Education England alone, has a budget of £4.9 billion and when you add the money that is spent by individual trusts and organisations, the figure for training in the NHS, leaps to an estimated £100,000 a minute.

It is certain that training is often seen as the panacea for all ills, but I would argue that it has become a bit of a false God of the 21st-century and we need to examine what we spend on training and what we get for it.

If the quantity of training was the definer of the quality care, we would not see any poor care, or bad practice in the NHS. Every time there is a scandal or an Inquiry into poor practice, you cannot get beyond the first couple of paragraphs of the expensive enquiry report, before the author has issued the words: ”There is a need for more training.”

The question I always ask is what was deficient with the training that the staff had, and why did it fail? It is my view that we, as a society, are spending huge amounts on training our health professionals and yet there seems to be little clarity about how we assess the benefits of this training and whether it improves services to the citizens who use health and care.

There is also a major challenge, in that we have vastly disproportionate amounts of money going into the two halves of the health and social care system. The money available to train social care staff is comparatively small

and very uncoordinated. There are huge bits of our system in social care where there is no proper career pathway and no clarity about what training is required, let alone any quality assurance mechanisms, to ensure that it delivers better outcomes to the frontline service user.

There is also a challenge that in major and very important parts of the system, such as commissioning and regulation, there is also no clear and coordinated approach to training and career pathways. In recent months, Skills for Care have done some work on training for commissioners, but the challenge will be getting this training mainstreamed, and ensuring that there is proper quality assurance within this part of the care system.I believe there is another challenge within social care particularly, which is the move towards more online training. Whilst I think online training has a very important role to play and allows for flexibility in how people improve

their skills, I am also very mindful of the need to engage with others and to share experiences. Part of good training is about the interaction you have with your peers and colleagues and how you challenge each other to improve your practice. This may not be possible if you are delivering training to people who are isolated and behind computer screens, rather than connected and talking through the issues with each other.

There is a real need for root and branch reform of the

training process in health and social care. We need to see better apportionment of training monies across both sectors, so that health and social care have parity of access to the huge amounts of money that the taxpayer puts into the system.

There is a vital need for quality assured training and to constantly re-evaluate how people’s training is improving the services that citizens receive at the frontline. We need proper quality assurance programmes, that tell us what training works and what is the most efficient way to deliver this to the entire system. Every bit of health and social care needs to be clear about its training needs and that includes commissioning and regulation. I would like to see an approach that enshrines a proper career pathway for both these important parts of the system, and training and support pathways that will enable people to be at the top of their game in these areas.

Finally, I want to see far more parity of quality and access across the whole system so that health and social care are integrated from the start. If we are going to meet the enormous challenges that we face in the future, we need a workforce that is able to move seamlessly across the system, and who are trained and supported to work for the benefits of citizens regardless of what service they require at any particular point in their journey through the system.

Professor Martin Green OBEChief Executive, Care England

“There is a vital need for quality assured training and to constantly re-evaluate how people’s training is improving the services citizens receive at the front line.”

Keeping children and young people safe from abuseSarah Knapp reports

The Essential Safeguarding Team

The Grey Matter Group. Dedicated to supporting the health and social care sector since 2006.

Can we walk with you on your journey to #BeOutstanding? www.tgmgroup.net

© 2017 The Grey Matter Group, All rights reserved.

Join the most awardedLive-in care team.

See our feature on page 6