Caring Times, July/August 2024

08/2024

July/August Edition

Starmer

steals

the show

Care sector reacts

to Labour’s

runaway victory

Leader’s spotlight:

Barchester’s Pete Calveley on 10

years as chief executive

Politics & policy:

Baroness Andrews stops by to

discuss all things election

Legal & regulatory:

Sector view on Ian Trenholm’s

departure from the CQC’s top job

caring-times.co.uk

business

14 LEADER’S SPOTLIGHT

Barchester’s chief executive Pete

Calveley on 10 years at the helm

18 POLITICS & POLICY

Labour peer Baroness Andrews exposes

Conservative’s failings in care

20 OPINION

Robert Kilgour on whether Labour will fulfil

its social care promises

22 HOME CARE

Birdie on repairing a broken system;

Homecare Association’s demands from the

new government

business | welcome

Chief executive officer

Alex Dampier

Chief operating officer

Sarah Hyman

Chief marketing officer

Julia Payne

Editor-in-chief

Sam Lewis

Features editor

Charlotte Goddard

Subeditor

Charles Wheeldon

Advertising & event sales director

Caroline Bowern

0797 4643292

caroline.bowern@nexusgroup.co.uk

Business development director

Mike Griffin

Business development executive

Kirsty Parks

Event manager

Conor Diggin

Marketing content manager

Sophie Davies

Publisher

Harry Hyman

Investor Publishing Ltd, 3rd Floor,

10 Rose and Crown Yard, King Street,

London, SW1Y 6RE

Tel: 020 7104 2000

Website: caring-times.co.uk

Caring Times is published 10 times a year by

Investor Publishing Ltd. ISSN 0953-4873

© Investor Publishing Limited 2023

The views expressed in Caring Times are not necessarily

those of the editor or publishers.

Caring Times and the CT® logo are registered trademarks

of Nexus Media Group

And now for something

completely different...?

We’ve had a while now to process the

idea of a Labour government with the

polls being overwhelmingly in the

party’s favour since the very beginning

of the campaign. Nevertheless, it’s hard

to know yet what to make of our new

government, at least when it comes to

social care, because there are still so

many question marks surrounding what

exactly it intends to do.

The party was cagey from as far back

as last year, refusing to reveal budgets

around social welfare, ostensibly in

order to avoid giving the Conservatives

ammunition to use in the lead-up to the

election.

Then the Labour manifesto was

released. It was received with tentative

approval by many in the sector, with

Labour seen to have gone further than

it could have done, especially in regard

to the pledge to create a National Care

Service.

What caused scepticism, however, was

a certain vagueness around timelines

and how the party’s plans would be

implemented, as well as costings.

Anyone who thinks this is indicative of

a promise that will go unfulfilled – you

might be right. This is politics, at the

end of the day.

As I have said before, all we can do at

this point is hope for the best, plan for

the worst, and keep campaigning for

reform through the first 100 days and

beyond.

Meanwhile, this election special

edition of the magazine is packed full of

advice, opinions and insights from some

of the biggest names in care – including

Labour peer Baroness Andrews,

Barchester chief executive Pete Calveley,

Care England chief executive Martin

Green, Homecare Association chief

executive Jane Townson, Renaissance

Care founder and chair Robert Kilgour,

The Care Workers’ Charity chief

executive officer Karolina Gerlich and

many more – all of whom thankfully

dive deeper into what the new political

landscape means for the sector than I

ever could. I hope you enjoy reading this

issue.

Sam Lewis,

Editor-in-chief

Caring Times

@Caring_Times

linkedin.com/company/caring-times

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business | news

News in brief

POLICY & POLITICS

Research from the Institute for Fiscal

Studies (IFS) raised concerns around

the proposed funding for state-funded

services under the next government.

The IFS stated that despite some

promising pledges around areas like

social care, the plans for the funding

of social services and other publicly

funded services have not been thought

through sufficiently. The organisation

also said that between the Labour

and Conservative parties there is a

“conspiracy of silence” around “public

service spending plans”.

New research has shown that the UK

health and social care sector has the

lowest redundancy rate of any sector.

Data from Money.co.uk shows that

there were only 12,000 redundancies in

health and care in 2023, a rate of 2.7%

– joint lowest with the professional,

technical and technical activities

sectors. Other industries in the list

included wholesale, retail, hospitality,

financial, construction and transport.

Hypothesising as to the reasons for

the low number in health and care, the

research document said: “The critical

nature of health and social services

could be why redundancy rates for

these jobs are so low. This is especially

true in crises, such as the cost-of-living

crisis and the Covid-19 pandemic,

when more people need support from

this sector.”

PROVIDER NEWS

Yew Tree Grange in Redcar, North

Yorkshire, opened to residents

Yew Tree Grange

Parklands mental health training, Heather Reid (left) and Lynda Mackenzie

following a multimillion-pound

investment from the site’s locally

owned developer, Prestige Group. The

luxury care home is the firm’s flagship

development and boasts suite rooms

that are “50% larger than standard”,

the company claimed, with en suite

bathrooms, large beds, furniture

packages, in-room fridges, flat-screen

TVs and garden patios.

Aurem Care has been awarded Bronze

certification by the Armed Forces

Covenant, recognising its commitment

to supporting the Armed Forces

community. The certification is part

of the Employer Recognition Scheme,

which recognises employers that provide

exceptional support to defence personnel

and their families. Aurem Care employs

a number of former services personnel

and aims to widen its reach to spouses

and other relatives, including those

looking to return to work, perhaps after

a deployment overseas.

Scottish care operator Parklands

Care Homes has launched a mental

health training initiative for employees.

Staff at Parklands, which has 12

homes in the Highlands, Moray and

Aberdeenshire, are being given the

opportunity to take part in a twoday

mental health first aid training

programme. The company hopes

equipping employees with the skills

to address mental health challenges

will help them to support people

experiencing mental health challenges.

The training programme will cover

topics including recognising signs of

distress, offering appropriate support,

learning basic suicide intervention

techniques, and understanding how to

protect mental wellbeing.

Former England and Manchester

United footballer Gary Neville

attended the opening of a new

dementia wing at a Lancashire care


news | business

home. Ribble Valley Care Home,

near Clitheroe, Lancashire, invested £2

million in the extension, as reported

by the Lancashire Telegraph. The Sky

Sports pundit also spoke about the

convincing link between a professional

football career and the onset of

dementia in later life, with research

showing players are three and a half

times more likely to suffer from the

condition. This is believed to be due

to frequent heading of the ball, which

over time causes damage to the brain.

HOME CARE

Home care provider Right at Home

UK launched a campaign to challenge

misconceptions surrounding the social

care sector and highlight the vital role

of community care workers. The More

than Care campaign features real care

professionals reflecting on their lifechanging

and rewarding experiences

of caring for people in the community.

The campaign aims to showcase the

wide range of responsibilities involved

in caring for people at home and

highlight career opportunities available

in the sector.

Great British Cycle Relay

LEGAL & REGULATORY

Greenways, a care home in Crawley,

West Sussex, has been rated Inadequate

by the Care Quality Commission

following an assessment carried out in

February and March. Greenways, run

by Adelaide Care, is a residential care

home providing personal care to up to

six people who have complex learning

disabilities and care needs including

autism and epilepsy. As well as its

Inadequate rating, it has been placed in

special measures to protect the people

living there.

Architectural practice Holmes Miller

has received planning approval for

three new care homes in Scotland.

The homes are located at Anniesland

in Glasgow, Linlithgow in West

Lothian, and South Queensferry near

Edinburgh. Holmes Miller secured

planning approval for the homes

on behalf of Morrison Community

Care Holdco – a joint venture of

Morrison Community Care Group and

construction firm CCG (Scotland).

FUNDRAISING/EVENTS

Boutique Care Homes founder and

Ameet Kotecha, Boutique Care Homes

managing director Ameet Kotecha

raised £5,776 to support unpaid carers

in Surrey, as part of a fundraising

challenge. ‘I’m a Director, Get Me

Out of Here!’, organised by Crossroads

Care Surrey, saw local directors tackle

Bushtucker trials to raise funds to

support unpaid carers in the county.

Kotecha said: “Family carers are the

unsung heroes of the care community,

tirelessly dedicating themselves to the

wellbeing of their loved ones, often

without recognition. Boutique Care

Homes stands proudly as an advocate

for their invaluable support.”

The second Great British Care

Cycle Relay took place across the

country, in tandem with Care Home

Open Week. The relay started at Sale

in Greater Manchester on Monday 24

June and over the course of five days,

riders covered more than 300 miles,

ending in West London on Friday 28

June. Care Home Open Week and the

Great British Care Cycle Relay are

initiatives run by Championing Social

Care. The aim is to shine a positive

light on the work of the care sector.

CARING-TIMES.CO.UK JULY/AUGUST 2024 | 7

business | real estate & development

Property news

& Co managed the sale, which was for an undisclosed sum.

Hallmark Luxury Care Homes provides residential, nursing and

dementia care to 1,500 residents across 23 locations in England

and Wales.

PGIM Real Estate is acquiring the real estate and operations of

Signature Senior Lifestyle, an owner, developer and operator of

senior housing in the UK. The transaction is expected to close by

the end of the year. The Signature portfolio consists of 13 senior

living communities, comprising 10 operating properties and three

consented development projects in and around Greater London.

Signature’s management team will continue to operate the

homes. The acquisition was made in partnership with investment

manager Elevation Advisors to source, structure and execute the

transaction and asset manage the portfolio.

Oakland Care officially opened its latest care home, Osbern

Manor, at a VIP launch event on 14 June. The 72-bedroom

care home located in the village of Wigmore in Kent, is the

tenth to open in the business’s portfolio of care homes across

the Southeast and London. The £13 million home will offer

amenities such as a café bistro, hair salon, activity room, library,

quiet lounges, courtyard and landscaped gardens. It is certified

‘Excellent’ by BREEAM.

Four Seasons Health Care announced it will sell the business,

including all 46 remaining freehold care homes which trade

under either the Four Seasons Health Care or Brighterkind

brands. The group has appointed CBRE, an advisory firm in the

health and social care sector, to act as advisor to conduct the sales

process.

Hallmark Luxury Care Homes has acquired Penylan House,

a 75-bed residential and nursing home in Cardiff, from Linc

Cymru Housing Association. Business property advisor Christie

Care group Anavo has acquired the 75-bed Lindridge Care

Home in Hove, East Sussex, from Sussex Partnership NHS

Foundation Trust (SPFT). Brokerage for the transaction

was undertaken by Lambert Smith Hampton for SPFT, and

Colliers on behalf of Anavo. Anavo runs 11 homes across the

UK and has a new build home in Lancing, West Sussex due to

open in the third quarter of the year, plus another development

in Whitchurch, Shropshire opening soon.

Exemplar Health Care, a nursing care provider for adults

with complex and high-acuity needs, opened a new property,

Hillside Court in Leeds. The home has 41 large bedrooms,

each with en suite facilities, across four units. The home has

communal dining and living spaces, sensory bathrooms, an

activities hub, therapy room, consultation room, visitors’ suite

and a large accessible garden. Construction for Hillside Court

began in August 2022, led by Walter Thompson Contractors.


real estate & development | business

purpose-built by LNT Developments and contains 66 en suite

rooms available for one inclusive fee, with 24-hour care and a

personalised activity programme, restaurant quality food, on-site

cinema, salon, café and library. Each room has an en suite wet

room, a flat screen TV, a mini fridge and underfloor heating. 80%

of the available roof space has been lined with solar panels, with

the homes making their own electricity, and selling what they

don’t need back to the grid. The buildings also operate without

gas and are A-rated for energy, with an underground system

running miles below the home to heat the hot water, provide

underfloor heating and air cooling.

Dovehaven Care Homes has acquired the 120-bed Callands

Care Home in Warrington, Cheshire, from HC-One. The home

offers residential, nursing and dementia care, as well as catering to

more complex conditions. A statement on Dovehaven’s website

said: “While the home currently has a history of an ‘inadequate’

rating from the Care Quality Commission, we’re not worried.

We have a fantastic track record of taking wonderful care of our

residents, and we’re fully committed to bringing Callands up to

the same high standards we have in all our homes.”

Not-for-profit company Somerset Care Group has acquired

Green Tree Court nursing home in Exeter. The 68-bedroom luxury

dementia and nursing care home will complement Somerset Care

Group’s existing home care services in Exeter and East Devon. The

organisation also runs 21 care homes in Somerset.

Oyster Care Homes has opened Copperfield Court, a luxury

home in in Broadstairs, Kent offering 24-hour residential,

dementia and respite care. The home was developed by LNT

Developments and its facilities include a bistro, cinema, hair

salon and café. The entire facility is powered by solar photovoltaic

panels. Television presenter and newsreader Jan Leeming led the

ribbon-cutting ceremony at an opening event attended by the

mayor and mayoress of Broadstairs, along with members of the

local community.

Danforth Care opened Coronation House in Thetford, Norfolk,

which provides 24-hour residential and dementia care. It was

A £12.4 million loan has been provided by development finance

lender Atelier to construct a purpose-built, 76-bed care home

in Worcester. The care home will replace a derelict former

restaurant. This marks Atelier’s second loan with this care home

developer and operator.


business | personnel

People moves

in association with

The Care Quality Commission’s chief executive Ian Trenholm

has stepped down from his role and as a board member of the

CQC. Kate Terroni, the CQC’s deputy chief executive is acting

as interim chief executive and a permanent appointment will

be made in due course. Trenholm said: “During my six years

leading CQC, we have made important changes to the way we

work in order to help improve care and keep people safe. We are

now in the final stages of delivering an ambitious transformation

programme; this month saw the delivery of the last big milestone

in a complex and challenging programme of work.”

Melony Fairchild

Ian Trenholm

Pat Cullen stepped down from her role at the Royal College

of Nursing in order to stand as the Sinn Féin candidate for

the Fermanagh and South Tyrone constituency in the general

election. Cullen has worked at the RCN for eight years, the last

three of which have been spent as general secretary and chief

executive. Nicola Ranger, the RCN’s chief nursing officer and

deputy general secretary and chief executive, has become the

acting RCN general secretary and chief executive in the interim.

Meanwhile, the RCN is seeking applicants for a permanent

general secretary and chief executive.

UK where she was managing director for the organisation’s home

care business. Before this she was group care services director at

Trinity Homecare, having spent more than 20 years in the care

sector after beginning her career as a care assistant.

Bidcorp UK has appointed Andy Farnworth as the new

managing director of its fresh food division Bidfresh, replacing

Brian Hall, who after nearly 20 years at the company is retiring.

Farnworth previously spent 16 years at Fresh Direct, most

recently as managing director for all of the UK’s fresh operations,

and before that as sales and marketing director.

Not-for-profit dementia care specialist Belong has appointed

Cheryl Davies as general manager for its Macclesfield village.

Davies, whose career spans more than three decades, returns

to Macclesfield following three years as general manager at

sister village Belong Crewe. Until 2021, Davies was Belong

Macclesfield’s registered manager, responsible for its 24-hour

care and nursing provision for 72 residents. Prior to this, she

established the group’s home care service, Belong at Home.

In addition, Caroline Ray has been appointed as the general

manager of Belong’s newest village in Chester.

Pat Cullen

Home care group Bluebird Care has appointed Melony Fairchild

as operations director, overseeing five offices across Southeast

England and London. Fairchild joins the group from Nurseplus

Cheryl Davies and Caroline Ray Belong

Nourish Care has appointed Matthew Stewart as the new chief

product officer of its digital care management software. Stewart

was previously chief product officer of Orgvue, the design and


personnel | business

a hospice and as a specialist nurse in the community. Williams is

also a qualified chemotherapy nurse.

Healthcare Homes Group also appointed Ben Rogers as home

manager of Saxlingham Hall Care Home in Norwich, a 34-bed

facility providing residential, nursing, respite and palliative care.

Rogers has worked in the care sector since the age of 16 and has

experience of various care settings, with a particular emphasis

on caring for the elderly. Over the past 15 years, he has gained

management experience, primarily as a troubleshooting manager,

effectively leading and improving care homes to achieve better

standards of care.

workforce planning software-as-a-service platform. Before that,

he worked for Experian Decision Analytics.

Healthcare Homes Group has appointed Karen Williams as

home manager of Bedhampton Court Care Home in Havant,

Hampshire, which provides residential, nursing, respite, palliative

care, and care for younger adults with disabilities. Williams has

experience of the NHS and the private sector. She qualified as a

nurse in 1984 and has worked both as a nurse and a manager and

spent significant time in end-of-life care, working as a manager of

Ben Rogers

Karen Williams

Mavern House in Wiltshire has appointed trained nurse Rosie

Hardie as care home manager. Mavern House provides nursing,

dementia, residential and respite care for up to 54 residents.

Hardie worked as a community district nurse for eight years, then

moved to the NHS’s crisis intervention team in North Wales,

eventually managing a group of more than 20 people. In the

private sector she helped to establish a new dementia village in

Chester and acted as regional manager across six care homes in

North Wales and Chester.

Malvern House


business | opinion

The root of the problem

Caring Times editor Sam Lewis discusses the recent news that a “comfortable”

retirement reportedly costs Brits more than £1 million, and reflects on what this

says about the country’s struggling social care system

Reading about the scarily large

amount of money needed for

a “comfortable” retirement, I

found myself pondering the real, often

unspoken problem facing the UK social

care system.

For those of us working in the sector

day in, day out, it’s easy to find oneself

in the weeds, blinkered, focusing on

the minutiae and not seeing the bigger

picture.

When I attend conferences and

events in the sector, the discussions

cover all manner of challenges faced

by care services: from the major –

lack of funding, the need for reform,

recruitment and retention, the

government’s apparent lack of concern,

issues with the regulator and local

authorities – to the, if not minor, then

more specific – marketing, training,

nutrition, fostering a good work culture,

tech implementation… I could go on.

The conversation always seems to

come back to “We need more funding

and reform”, but I’ve always found this a

frustrating topic. Not because I disagree

with the sentiment, but because, even

in my short two years writing about

the sector, it feels more and more like a

fruitless endeavour.

I don’t know how many years or

decades the sector has been going

round in circles, asking for these things

from various governments, but, while

I believe we should keep campaigning,

I don’t think we should count on the

support we want any time soon. ‘Hope

for the best; plan for the worst’ seems an

appropriate position to take, especially

at a time when the new government’s

intentions for social care are still

something of a question mark.

However, what we often neglect

to discuss when talking around this

subject is the true cause, the root of the

problem: population.

Or, more specifically, the UK’s ageing

population.

I know I’m not breaking news to

anyone here. It’s obvious; when one

generation is more populous than

the next, the burden on the younger

generation when the elder reaches

retirement age is greater.

Now add onto that inflation, as well

as the dramatically increased length of

most people’s retirements compared to

several decades ago, and you have an

unsustainable elderly population. This

is the cost of our improved healthcare,

of our growing longevity, and our trend

towards having fewer children. All of

this is good stuff, but it comes with a

nasty side effect.

This is the true cause of the social

care sector’s woes. I don’t want to

Sam Lewis

come across as though I am blaming

anyone here, and I’m also very aware

that there are plenty of other issues to

tackle, from the ground level right up

to central government, but the biggest

issue of them all is the age demographic

breakdown of our population.

The country is quite literally out

of balance, as a result of growing life

expectancies and increasing wealth

disparity, and the financial burden has

become almost unsustainable. We now

“However, what we

often neglect to

discuss when talking

around this subject

is the true cause, the

root of the problem:

population.”


“In the meantime,

however, we need

to work out a means

of looking after

our elderly without

sacrificing their

quality of life, along

with our economy,

because that’s exactly

what is happening

right now.”

can, apparently, no longer afford to

support all of our older and vulnerable

citizens – at least not in a dignified way

that affords them maximum quality of

life in their later years.

So, what can be done about this?

Unfortunately, I don’t have the answer.

As far as I know, there’s no silver bullet.

Nor do I have a magic wand to wave. I

wish I did.

Ironically, attracting as many

international workers as possible is one

solution that comes to mind. Bringing

in younger workers will go some way

to redressing the imbalance in our

population. Sadly, our last government

did everything in its power to deter

migrants, only worsening the situation

for the care sector. We’re yet to find out

if the new government will do anything

to rectify the issue, but the Labour

manifesto would have you believe

the party will take a similar tack to its

opponent, the Conservative Party.

Indeed, Labour was criticised preelection

(and even prior to the launch

of its manifesto) for pledging to reduce

immigration without having a proper

workforce plan for adult social care.

Martin Green, chief executive of Care

England, said: “Care England has long

said that in order to reduce the sector’s

reliance on overseas staff, reform must be

delivered that makes the sector a more

attractive destination for the domestic

workforce. This means boosted pay,

terms and conditions, the chance for

career progression and parity of esteem

with colleagues in the NHS. Labour

must deliver on these priorities and

engage in meaningful consultation

with the adult social care sector in the

production of its workforce and training

plan. The judgement whether a sector

has taken ‘sufficient steps’ to boost

training and skills being at the discretion

of the minister is a cause for concern.”

One provider I spoke to last month

told me that he believes the number of

care sector vacancies will have risen to

more than 200,000 by the time Skills

for Care’s annual sector workforce data

is released this month. This would mark

an increase of a third over the already

horrifying, record 152,000 vacancies in

2022/23.

Of course, when we get down to topics

like immigration, this can be an incredibly

difficult conversation to have, and it can

become political and argumentative very

quickly, which is not my intention.

Sometimes, though, it’s the difficult

conversations that are the most

important. If other countries are to

follow the population trajectory seen

in places like the UK and Japan, it is

actually a good thing; in the long-term

it will bring down the global population

and curtail some of the issues caused by

overpopulation. In that sense, ageing

populations can be seen as a necessary

evil, one which will help us secure a

better future for the next generations.

In the meantime, however, we need to

work out a means of looking after our

elderly without sacrificing their quality

of life, along with our economy, because

that’s exactly what is happening right

now.


business | leader’s spotlight

A decade of care leadership

Barchester Healthcare chief executive Pete Calveley talks to Caring Times to mark the

10th anniversary of his joining the company and talks about the election, the future of the

Care Quality Commission, and why the provider is in the best place it has ever been

How’s how is business going at the

moment?

Really good. Quality-wise, we’ve hit

our highest ever CQC ratings with

Good and Outstanding at 86.5% and

no Inadequate homes. The rest are rated

Requires improvement, and lots of those

haven’t been inspected for years, so we’re

very ready for inspection – it’s a bit

frustrating.

We always put quality first. Ever since

I’ve been here, we have always believed

that if you put quality first in each of

your homes and hospitals, you’ll get the

best reputation locally. You’ll become

the provider of choice, and you’ll get

commercial success, but only in that

order.

Commercially speaking, things are

great. We’ve now got 260 care homes

and private hospitals, with over 13,000

residents and patients.

You mentioned struggling to get

the CQC to reinspect some of your

homes, and that’s just the tip of

the iceberg when it comes to the

sector’s complaints. Do you think the

regulator’s days are numbered?

You may or may not be aware, we

actually put a judicial review in

against the CQC, because of their

implementation of the single assessment

framework, which we thought was

chaotic. There was no commitment

that they’d actually look at the homes

which have gone the longest without

inspection. Some of our homes haven’t

been inspected in nearly seven years,

and there was no promise that they were

going to prioritise those homes or even

give us a timetable.

One of the most frustrating things

about this is that these ratings are

actually misleading. We have to publish

on our website the fact that a home is

rated Requires improvement or whatever

it may be. After seven years, we may

have had two different managers come

and go, neither of whom were actually

responsible for the last inspection. All

our staff feel a bit demoralised, and

managers think, “Why would I go to a

home that is Requires improvement with

no guarantee that it will be inspected in

my time there?”

The staff have all worked so hard

to put that Requires improvement

rating in the rear-view mirror, and now

with our internal audit system I don’t

doubt these homes would be Good or

Outstanding, because that very much

mirrors the CQC inspections. It’s quite

demoralising.

Thankfully, since we had a meeting

with them, they’ve actually committed

to showing a timetable and prioritising

homes that have gone the longest since

their last inspection, particularly those

that are either Inadequate or Requires

improvement.

Another big problem with the single

assessment framework was that, even

Pete Calveley

though the CQC inspects based on

around 30 quality statements, they were

only initially committing to look at

five or six of those quality statements

in an inspection, and after seven years

that’s simply not good enough. Such

lacklustre inspections undermine public

confidence in the regulator and in care

homes.

People have even made jokes about

doing your own whistleblowing

anonymously to try and get the

“We actually put a

judicial review in

against the CQC.”


“There’s a huge

amount more that the

care sector can do if

we work in partnership

with the NHS.”

inspectors in. I’m not sure if it’s ever

happened, but there’s a sort of urban

myth that it might.

Fortunately, they are making some

compromises and I’m hoping that

they will implement them as they’ve

suggested.

Profits were up for Barchester in the

2022/23 financial year. What do you

put that down to?

An element of that is that we’re growing.

We build 10 new care homes a year, so

that helps in some senses, but also, when

you open a new care home, you usually

make a loss in the first year. If you’re

opening 10, it drags your profitability

back a bit. The flipside of that is that the

historic ones we opened three or four

years ago are now trading well.

When it comes to the commercial

side of the business, we operate on a

home-by-home basis, just as we do on

the quality side. Then we break down

the commercial elements – whether

it’s occupancy or whether it’s agency

use, staffing, procurement costs – and

we focus on every single aspect of it.

For example, recruitment was quite

difficult a couple of years ago across the

sector and agency use was very high.

Now though, we are very well recruited

thanks to our fantastic recruitment team,

and only about 0.5% of our working

hours are filled by agency staff, which is

a tiny amount compared to the sector

average. This was really important to us

because obviously agency staffing is very

expensive as labour costs go, but also

it’s inconsistent for residents – they’re

getting staff who don’t know them and

haven’t been trained in the ‘Barchester

way’.

Elsewhere, things like procurement,

occupancy and fee negotiations – all of

those elements are coming together and

are always underpinned by our focus on

quality driving our reputation in local

markets, which is why profits have been

so strong.

The most important thing is a

relentless focus on every detail of every

home and every hospital. This means we

can help and support the teams on the

ground, but we can also fix problems as

we see they’re arising.

What do you think of Labour winning

the general election? Will it be a good

thing for social care?

That’s a tough one. There’s a lot of talk

about “You can’t fix the NHS without

fixing social care” because they are

interdependent and mutually supportive,

and yet, historically, people have treated

them as different silos.

The idea of having a whole care

community that works well with

admission, treatment and discharge

to the right setting from hospital is,

of course, appealing – whether that’s

back at home, supported sometimes by

domiciliary care, or whether it’s a care

home. There’s a huge amount more

that the care sector can do if we work

in partnership with the NHS, social

services and local authorities in terms of

getting that integrated care; that mutual

understanding of where the best place is

for a person and what skills you need in

each of those places to make sure people

get the best care and best rehabilitation

to maximise the opportunity of them

going back into the community.

That all requires great joined-up

thinking, and it requires proper funding

and an acceptance of the true cost of care

for the service that’s being provided.

There were changes to the Health

and Care Worker visa earlier this

year, namely the banning of migrants

bringing dependants with them. Has

this significantly affected Barchester

or were you not particularly reliant on

overseas staff before the change?

We have 19,000 employees and each

year our international recruitment team

works really well with the homes we are

prioritising because they are struggling

to recruit in their particular locality. This

means we bring over about 300 nurses or

carers a year from different parts of the

world.

In the first few months since it was

implemented, we’ve not seen a reduction

in applications or a slowing of people

moving through the application process.

But, as you can see, 300 out of 19,000

staff isn’t a major proportion of our

workforce, so it’s not a major worry for us.

You’ve just hit a big milestone: 10

years at the helm at Barchester.

Congratulations – how does that feel?

It’s so, so great. I know it sounds like a

cliche, but it’s absolutely flown by, that

10 years.

I started on 1 June 2014 and there was

a load of work to do to put that qualityfirst

agenda into place and start those

improvements. It was also a massive

job selecting the right senior team,

operational teams and support teams, >


business | leader’s spotlight

> as well as general managers and their

teams in the homes.

It’s been such a full-on experience,

but I think we’ve got to a really great

place now. We’ve got fantastic teams and

support across the board, and I think

we’ve achieved a huge amount.

We started that new-build programme

– 10 new-builds a year. We also started

refurbishing the whole estate to make

sure that the lived environment is ideal

for the lived experience of the residents

and their families, but also a great work

environment for our staff.

Every year we upgrade a number of

homes to improve that experience for

both residents and staff. That number

will be around 27 this year, and we’re

actually investing around £24 million.

It’s the right thing to do, especially when

the homes are more profitable, because

it means we can deliver an increasingly

fantastic quality of service. Their success

means we can reinvest back into those

homes, back into staff.

We try and support our staff in

every way we can, with their wellbeing

and their work environment, but also

their career pathway. Barchester has a

personal development plan for literally

every member of staff. That provides an

opportunity for every member of staff

to sit down and say “OK, if I want to

get to there, what support or training or

courses do I need in order to achieve my

aspiration?” It’s things like this that have

got staff turnover and staff satisfaction

well above the healthcare average.

So many of our team members have

developed and progressed through the

business. Some of them have started

as carers or senior carers and ended

up being general managers or regional

directors in our business. Deputy

managers have gone on to become

general managers because we have our

‘Barchester way’ – it’s our blueprint of

what we’ve learnt over the last 10 years

or more and how we want things to be

done across every aspect of running a

care home or hospital.

Unsurprisingly, there’s a certain way

people have to be trained. When our

staff train through the ‘Barchester way’

and communicate and pursue their own

personal aspirations, we end up with

great retention, career development and

staff satisfaction.

That’s one of our most satisfying

achievements over the last 10 years –

the fact that we actually invest in the

buildings, invest in staff development

and look after their wellbeing. There was

a time when we weren’t a living wage

employer, and now we pay a minimum

of 40p above the living wage. Often the

average is more than £1 over the living

wage.

“Every year we

upgrade a number of

homes to improve that

experience for both

residents and staff.”


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business | politics & policy

A carers-first approach

William Walter, managing director of Bridgehead Communications, sits

down with Labour peer Baroness Andrews, former chair of the Adult Social

Care Committee, to discuss the social care policies announced during the

election campaign and what the new government should do for carers

The Conservative manifesto

promised to enact fully the

delayed reforms to social care,

including the cap on lifetime costs. Do

you believe this policy alone would

have been sufficient to deal with the

challenges for people seeking to access

care for themselves or their loved ones?

No. Not at all. It’s a partial and very

much delayed response to only part

of the challenges of providing social

care on an equal and just basis. First,

this commitment has been delayed for

so long that the cap itself needs to be

revisited.

A policy for social care has to respond

to the pattern of needs and resources

across the whole sector; the workforce is,

as we know, absolutely critical, and that

includes pay and professional standards

and how care is provided at home.

That also involves bringing together

health and housing policy, building and

adapting homes for people who need

support at home, and ensuring that

health and social care are working more

closely now that the integrated care

boards are in place.

The Liberal Democrats and Greens

have both pledged to implement

Scottish-style free personal care in

England and Wales in their platforms. Is

Scotland’s approach and model one that

“It’s not at all

clear the price that

other parts of the

health and social

care services in

Scotland have paid

for free personal

social care.”

can effectively meet England’s care needs

in the long term? I think this is a counsel

of perfection. You cannot make easy or

credible promises based on comparisons

between the small population and the

different priorities of Scotland with

the vast and complex communities of

England and Wales.

Moreover, it’s not at all clear the price

that other parts of the health and social

care services in Scotland have paid for

free personal social care. Clearly, there

must be trade-offs because we have to

deal with the realities of financing the

complex range of needs that have to be

met.

The priority should be that those most

vulnerable and with the fewest resources

should not be penalised because a more

generous policy leaves them at particular

risk. All these factors and choices have to

be weighed against what is essential, just

and affordable.

The government has implemented

a ban on care workers bringing

dependants with them to the UK which

has already led to an 83% drop in visas

in March this year compared to the

previous year. Given that the sector faces

around 150,000 vacancies [via 2023 data

from Skills for Care], can this situation

be sustained without exacerbating

workforce shortages?

Policy for the social care workforce has

swung wildly around recently, and now

there’s even more instability created in

the system. We cannot build a workforce

policy that relies on immigration

which, predictably, has brought its own

complications and unfairness.

We are fortunate that we can draw

on skilled and compassionate overseas

workers, but it has to be properly

thought through in the context of a

proper pay and career structure for UK

workers. In the short and long term, we

need a guaranteed offer for social care

workers based on decent pay and dignity

and a progressive career structure, which

Baroness Andrews

will mean they can commit to it in the

long term.

Labour has retained its commitment

to a fair payment agreement in the

sector. Is such a policy a suitable means

of improving the incentives for people

to pursue a career in social care, or could

it force impossible costs onto local

authorities already near bankruptcy?

I think that this is the first and

absolutely critical step in building a

resilient and sustainable care workforce

for the future. However, it will have to

be appropriately grounded in realistic

expectations about the costs and

evidence of what will work best and

fairly.

The experience of local authorities

and their knowledge of how to retain

and recruit care workers will be essential

to getting it right. The financial

requirements and impacts have to be

transparently worked through, and

local authorities and care workers'

organisations are critical to this.

However, the point is that, in

the long term, it can save costs as a

professional care workforce will enable

better planning of services without the

need for agency work and constant

improvisation. It will be a game-changer

in the way care workers are seen as


politics & policy | business

skilled professionals, and it will be the

first step in creating a profession people

are proud to work for and can afford to

work in.

Finally, the recent scandal of unpaid

carers being forced to pay fines for

breaches in the Carer’s Allowance has

shocked the nation. How should the

new government go about incentivising

and supporting the millions of unpaid

carers upon which the sector is

dependent? This is indeed a scandal

because we know that while the system

was alert to where unpaid carers had

gone beyond the legal limits, it did not

alert the people involved and allowed

them to build up outstanding debts to

be repaid.

This should never have happened,

and we need reassurance that it will no

longer occur, along with acknowledging

that such debts should rightly be written

off. Unpaid carers need an advocate and

a champion – a commissioner who will

give them additional profile and support,

more provision to identify them when

they come into contact with the health

service and social services, and a more

straightforward pathway for support.

Moreover, the Carer’s Allowance

needs to be revisited, and working hours

should be made more flexible. In short,

they need more support, not more

pressure, given what they give back not

just to their families or friends for whom

they care, but to society as a whole.


business | opinion

Cinderella service

Robert D Kilgour, founder and chairman of The Social Care Foundation, asks

whether now is finally the time for meaningful social care reform – or whether

the carriages and footmen are about to turn back into pumpkins and mice at

the stroke of midnight now the election is over

Everyone agrees that social

care is not working well at the

moment and that it’s in urgent

need of major reform and that such

reform will not be a quick fix. It will,

in my opinion, ideally need cross-party

agreement to improve its chances of

success, largely due to the likely lengthy

timescale involved in the reform

journey.

Most people also recognise that

we need better and more integration

between the NHS and social care.

Currently, separate budgets too often

lead to lengthy discharge delays, against

clinical advice, incurring the waste of

taxpayers’ money. Working smarter

would lead to much more efficient use

of scarce resources.

It is a simple statement of fact that

you cannot fix the NHS’s problems

without fixing social care. Social care

is much larger than the NHS, and if

social care collapses, then expect the

NHS to follow, leading to worse bedblocking,

more cancelled operations

and longer NHS waiting lists. The

social care sector needs to come to an

agreement with the government on fair

and realistic long-term funding and

workforce plans, with the government

and local authorities finally accepting

that they need to pay care home and

home care fees closer to the true cost of

care.

Some low-hanging-fruit changes and

improvements that would greatly help

“It is a simple

statement of fact

that you cannot

fix the NHS’s

problems without

fixing social care.”

social care include: local authorities and

the NHS being encouraged to pay bills

promptly; better ring-fencing of social

care funds received by local authorities

so that they don’t get diverted and used

for other purposes; better and more

direct access for social care to existing

available technology funds so they don’t

have to go through local authorities;

better promotion of careers in social

care, such as a targeted PR campaign;

and the appointment of an elderly care

commissioner who could take a broad

view of, and advocate for, elderly care

across all sectors.

Some other practical suggestions

worth serious consideration by the

new government include: reform of

the Better Care Fund in order to make

it more productive and efficient; the

introduction of a local authorities VAT

scheme which would significantly help

the sector’s finances; the introduction

of a national care home contract like

the one that has operated successfully

in Scotland since 2006/07; double

the Nurse Bursary to over £10,000 per

annum (similar to its current level in

Scotland) to encourage more mature

students and others to train as nurses;

introduce a higher living wage for

carers, akin to the one that has operated

successfully in Scotland since 2016;

improve the current visa situation;

and use of the British Infrastructure

Bank to deliver long-term, low-interest

mortgages to care home operators, thus

encouraging and enabling an increase in

local authority care provision.

Faced with a new government, with

many pressing financial pressures and

priorities on its plate, desperately

needed major reform is unlikely to

happen very soon. The social care sector

will therefore need to continue to battle

on with its current long-established

practice of ‘self-help’ and doing the

best that it can, but that is no longer

enough to ensure the long-term survival

Robert D Kilgour

“Faced with a new

government, with

many pressing

financial pressures

and priorities on its

plate, desperately

needed major reform

is unlikely to happen

very soon.”

of vital front line services. It would also

be a great help to discussions going

forward if the sector could establish a

clearer and simpler single voice vehicle

to better engage with the government

on all issues during the likely very

challenging and lengthy reform journey.

My personal and passionate plea to

politicians of all parties is please to get

together post-election and finally sort

out social care. All the amazing front

line social care staff, the vulnerable

people they care for, and their families,

deserve nothing less.


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business | home care

Efficiency saves and improves lives

Judy Boniface-Chang, chief customer officer at home care platform

provider Birdie, says care businesses can enhance their quality of

care with minimal financial support

The home care sector is facing an

efficiency crisis. With a rapidly

ageing population, the demand

on the UK care sector is becoming more

overwhelmed by the day.

This year, a Local Government

Association report found that one in

every three local councils is no longer

confident it can meet its basic legal

duties towards elderly residents, mainly

due to capacity and efficiency challenges.

Something needs to be done and the

‘broken’ system must be strengthened

and rectified.

Unfortunately, this problem won’t

disappear overnight, no matter Labour’s

promises. Consequently, the current

inefficiency in the sector runs the risk of

continuing, leaving home care businesses

having to figure it out themselves.

So, how can care businesses enhance

their quality of care with minimal

financial support?

Save time by digitalising

records

For home care providers, the first

step should be to optimise operations

to reduce time spent on lengthy

administrative processes. Over half of

social care professionals still work with

paper records, which increases the chance

of delay, error, and heightened frustration.

New digital technologies can offer

countless opportunities for home care

providers to improve their operational

efficiency. For example, by digitalising

“The home care sector

is facing an efficiency

crisis. With a rapidly

ageing population, the

demand on the UK care

sector is becoming more

overwhelmed by the day.”

all record-taking, information becomes

easier to manage and share between staff.

Utilising smart technology in your home

care business can also facilitate a more

personalised, proactive approach since

insights about clients’ requirements are

easier to extract and prepare for.

However, technology cannot be

simply applied as a blanket solution

across the sector. Every care business

knows that administration is the

backbone of their work; it pays to

spend time ensuring that data is tracked

efficiently and wisely. Care businesses

should assess what they need from their

technology and the time they have to

put a system in place, before spending

time and money on solutions that might

not work for their practice.

Effective scheduling and

communication

Home care is known for having plenty

of moving parts and quickly changing

priorities. While all care businesses

are sure to have a scheduling and

communications process in place,

outdated practices can create more issues

than they solve, such as overbooking,

missed appointments and lengthy travel

times.

An electronic scheduling system can

streamline processes, allowing carers

to view changing schedules on the go.

Many scheduling systems now include

automated algorithms to optimise

rosters based on the location of workers

and the skills available.

Scheduling systems and digital

records can aid communication between

staff to ensure that care is continuous.

Both care coordinators and carers can

feel confident that technology has

helped plan the visit appropriately and

tracked the key medication and tasks

for each client to share it with relevant

individuals. For carers, spending less

time on travelling and communicating

with office staff provides more time to

focus on care delivery. For office staff,

“For care businesses

that have already

updated their technology

solutions, implementing a

standardised visit protocol

can be a game-changer.”

having real-time visibility on clients’

needs and concerns, as well as knowing

that the client’s family members

have access to the same information,

simplifies communication between all

parties.

Standardise care protocols to

enhance routine care

For care businesses that have already

updated their technology solutions,

implementing a standardised visit

protocol can be a game-changer. Having

a set of critical components for each

care visit not only ensures that carers

consistently perform essential tasks that

lead to better care outcomes, but also

allows the carers to build familiarity and

confidence around care routines so they

can focus more on the client.

In summary, in order to run a robust

care business, enhancing efficiencies is

key. While there are lots of constraints,

there are still many opportunities to do

things better without compromising

the quality of care. Although changing

the habit and status quo of doing things

might be daunting, it can also bring

many potential upsides. Ultimately, by

dismantling barriers to efficiency in the

sector, care businesses have the power

to enable carers to prioritise what truly

matters – delivering enhanced quality

care and benefiting the community.


Homecare Association’s

seven demands

With this month’s magazine being an election special, the team at

Caring Times knew it needed to hear from all corners of the sector, and

who better to explain home care’s demands for Sir Keir Starmer than

Homecare Association chief executive Jane Townson

home care | business

The UK faces growing demand

for care services because of an

ageing population and chronic

ill-health. To meet this challenge, we

must transform how we fund, provide

and ensure access to care. Our manifesto

for home care highlights seven areas of

focus for the new government.

1. Home at the heart

Older and disabled people prefer to

receive support and care at home. We

need increased public awareness of

the value of home care and for ‘home

first’ to become the default option. The

government, NHS and councils must

give people clear information so they can

make informed choices. When assessing

needs, it’s important to prioritise

supporting individuals at home. This

includes assessing their homes and

providing adaptations or technology to

assist.

2. Power in partnership

Collaboration across social care, health,

housing and voluntary sectors is crucial

for addressing people's complex needs

efficiently. Home care providers must

have a voice in integrated care system

discussions and decision-making at all

levels. To empower people needing and

giving care, we must engage them in

shaping services.

“The UK faces

growing demand

for care services

because of an ageing

population and

chronic ill-health.”

3. Innovate to improve

With the use of data and predictive

analytics, we can identify those at higher

risk and take action early to maintain

health. We need models of home care

that prioritise prevention and address

social factors to extend healthy lifespans.

By combining technology, data analysis

and in-person care, we can enhance the

quality and efficiency of home care.

4. Care as a career

To meet rising demand for care, the

sector will need 440,000 more care

workers by 2035. We need a workforce

strategy to attract and retain a skilled

home care workforce within the

UK. This must address recruitment,

retention, training, working conditions,

recognition, collaboration, workforce

planning and funding. Investment is

necessary to ensure care experts at all

levels receive fair and secure pay and

terms and conditions of employment.

5. Invest in the future

We need a multi-year funding settlement

of an extra £18 billion a year for social

care to meet future demand, improve

access to care and cover costs. The

government must find new ways to

fund care. Suggestions include: a cap on

lifetime care costs; a social care insurance

scheme; private insurance; and publicprivate

partnerships.

6. Commission for value

Councils and the NHS must

commission for long-term value and

outcomes, not short-term price, which

risks substandard care. Investing in early

support and prevention helps reduce

future costs. Contracting models that

provide secure income can improve

employment conditions and foster

innovation.

Jane Townson

The government must fund councils

to pay a fair cost of care and legislate

to ensure they pay a minimum tariff

to ensure providers can comply with

regulations.

7. Regulate to protect

Effective regulation is essential for

protecting the rights and wellbeing

of those who draw on home care

services. By ensuring all providers

of personal care meet rigorous

standards and dealing swiftly with

poor performance, regulators can drive

quality improvement and ensure public

confidence in services. Regulators must

be well-led, adequately resourced, and

held to account for their performance.

All providers of personal care should

be subject to oversight. A professional

register for care experts should

recognise their skills and maintain

standards.

With smart strategies, collaboration

and investment, we can build a future

where more of us remain healthy for

longer. Supporting people at home must

be at the heart of government policy.


business | event

Champion care sector fundraising

Tariq Raja, foundation manager at the CareTech Foundation, previews

Championing Social Care’s ever-more popular Care Sector Fundraising

Ball 2024, taking place on 28 September

In a world where technology,

economies and ways of working are

ever-evolving, the need for dynamic

and innovative fundraising has never

been more important. At a time when

many are struggling to make ends meet,

it is often the organisations reliant on

the generosity of others that feel the

harshest impact, potentially halting the

incredible work they do to help those in

greatest need. It is for this reason that

the CareTech Foundation is honoured

to support the Care Sector Fundraising

Ball 2024 as the philanthropy partner.

The CareTech Foundation boasts

a rich and fruitful history with

Championing Social Care, having

played a pivotal role in its growth

and development from its inception

until earlier this year. With immense

pride, we stepped away from our direct

involvement with Championing Social

Care as it matured into an entity

capable of standing on its own. This

shared history made the decision to

join forces once again for the event

an unequivocal one. The prospect

of participating in an evening of

philanthropy and celebration, akin to

those we have cherished in the past,

held an allure that was as compelling as

ever.

We are proud to support the 2024

ball as it aims to fundraise for two

remarkable organisations: Marie Curie

and The Care Workers’ Charity. We

have a history with both organisations

as they have benefited from the

foundation's ‘Match Funding Grant’

and ‘Partnership Grant’. We hope the

funds raised on the night can act as a

catalyst so they can continue to carry

out their amazing work, equipped with

the tools and resources they need to

succeed.

As well as raising funds for such great

organisations that make meaningful

contributions to society, the ball, as

always, will be an evening to celebrate

the often unsung heroes of the social

care sector and highlight the amazing

impact the sector makes. Speeches – as

well as performances such as that of the

Care Sector’s Got Talent winners from

last year's ball – are still vivid memories

of the amazing celebration had. We

hope that this year will be even bigger

and better.

It's important for the foundation to

be a part of an event like this, as the

social care sector is often overlooked

and underappreciated. The ball also

serves as a platform to showcase the

great work happening and the real

difference being made, so it's vital we

get involved and make as much noise as

we can about the brilliance within the

sector.

As we look towards the ball, we

do so with a profound sense of pride

and optimism. By rallying together

in support of Marie Curie and The

Care Workers’ Charity, we reaffirm

Tariq Raja

our belief in the power of collective

action and community support. We

have an unwavering commitment to

fostering positive change and creating

a better society for all. We hope that

through the Care Sector Fundraising

Ball, both Marie Curie and the Care

Workers’ Charity will receive the

resources and support they need to

continue their invaluable work and

the care sector will get the recognition

it deserves. Together we stand united

in support of these organisations and

the remarkable individuals they serve,

ensuring that no one is left behind in

our collective pursuit of a brighter,

more compassionate future.

"It's important for the

foundation to be a

part of an event like

this, as the social

care sector is often

overlooked and

underappreciated."


Heavy fine for registered manager

Katherine Wackett, senior associate at law firm Mills & Reeve, reports

on the case of a care home manager prosecuted for failing to protect a

vulnerable resident from sexual assault

legal and regulatory | business

In last month’s article, we noted the

rise in Care Quality Commission

prosecutions, in particular for

breach of Regulation 12 of the Health

and Social Care Act 2008 (Regulated

Activities) Regulations 2014.

While we often see prosecutions

against registered providers, usually

companies, a care home manager

in Warwickshire has recently been

successfully prosecuted by the CQC

for breach of Regulation 12 and

Regulation 13. The manager was fined

£1,600 and ordered to pay more than

£8,000 to the CQC for its costs in

bringing the prosecution.

This case concerned a female resident

of the home who had Alzheimer’s

disease. She therefore lacked capacity

to consent to sexual relations. A male

resident of the same home was found in

her bedroom leaning over and kissing

her, with his trousers down. Staff

witnessed this and told the registered

manager, suggesting that the male

resident be moved to another room.

The registered manager told the staff

action would be taken but did not give

the staff any advice or guidance on

how to manage the resident or the risk

he posed. Importantly, the registered

manager also did not take any action

– she did not follow the safeguarding

policy, nor did she make any referrals,

such as a safeguarding referral to the

local authority or a referral to the

police.

Less than two weeks after this

incident, a member of staff found

the same male resident on top of the

same female resident, engaging in

sexual activity. At this time, the police

were called and the male resident was

arrested, although no further action

was taken by the police.

The CQC investigated this incident

and found that there had been a breach

of:

• Regulation 12 – there had been

a failure to provide safe care and

treatment to the female resident. In

particular, there had been a failure

to adequately assess and mitigate the

risk the male resident posed; and

• Regulation 13 – there had been a

failure to protect the female resident

from abuse and improper treatment.

In particular, there had been a failure

to follow systems and processes that

were in place to prevent abuse.

Following the investigation, the

CQC decided to prosecute the

registered manager under Regulation

22. The manager was prosecuted for

failure to comply with Regulations

12 and 13, such failure resulting in

avoidable harm to the female resident

and the significant risk of harm to

other residents. Importantly, this

demonstrates that the offence can be

committed even where there’s no actual

harm but a significant risk of harm

(although in this case, there was both

Katherine Wackett

actual harm and significant risk of

harm).

Registered managers have legal

responsibility to ensure compliance

with the regulations. This case

demonstrates how important it is

for registered managers to follow the

policies and procedures that are in

place, and to report incidents when

they happen. Had the registered

manager followed the safeguarding

policy and reported the first incident,

the second incident is unlikely to have

happened and she may have avoided

prosecution.

“This case

demonstrates how

important it is for

registered managers

to follow the policies

and procedures”


care

32 LEGAL & REGULATORY

Sector reacts to Ian Trenholm’s

sudden CQC departure

34 LEADER’S SPOTLIGHT

Visiting Angels’ UK chief executive Dan

Archer on the election, local authorities

and fixing social care

38 OPINION

The Care Workers’ Charity chief executive

Karolina Gerlich outlines what care

workers need from the new government

40 SURVEYS & DATA

Hallmark’s diabetes training for staff and

how it benefits residents

care | activities news

Creative Caring

As always, carers have been demonstrating their creativity

through fun and innovative events for their residents

Having a ball

Residents and staff from Shockerwick

House Bupa Care Home in Bath,

Somerset, geared up for the return

of Netflix favourite, Bridgerton, by

recreating the show. Staff transformed

the 18th century mansion conversion

into an enchanting regency-era fairy tale,

hiring costumes and setting up classic

shots including afternoon tea, croquet

and reading the latest copy of Lady

Whistledown’s newsletter.

Fun with frogs

Hastings-based MHA Lauriston

received a visit from animal handling

firm Jaws N Claws, which brought

bullfrogs, lizards, cockroaches, snakes

and a bearded dragon to meet the

residents. Dionne McEwan, home

manager, said: “Phil from Jaws N Claws

bought some frogs which were from the

Dominican Republic and the residents

found them really interesting.”

Princess parade

Park View Care Home in Witham,

Essex, part of the Runwood Homes

group, welcomed the Witham Carnival

Queens and Princesses for a visit

organised by wellbeing lead Diane

Anderson. "The Carnival Queens visit

our home every year, and the residents

really enjoy their visits,” said Anderson.

“This is a really special day for the

residents, as they enjoy looking at the

lovely dresses the Carnival Court wears.”

On your bike

When retro bike group the Grumpy

Grandads came to help Colten Care’s

Poole home Bourne View celebrate its

fifth anniversary, they made sure the

occasion had the feel of a 1960s Mod-era

road trip. Resident Pam Pamphilon said:

“I used to have bikes in the past and it

was marvellous to sit on one again.” The

celebration also included a party with

music from singing duo The Land Girls.

Bake for victory

Sandstone Care Group’s Telford Hall

Care Home in Shropshire hosted a

1940s baking workshop for residents,

families and the local community, to

commemorate the 80th anniversary of

D-Day. The workshop was run by Katie's

Kids Kitchen, with festivities taking

place to a backdrop of lively wartime

music. Maria Armstrong, activities

coordinator, said: “It was brilliant to

see volunteers from Telford Hall's first

dementia care workshop in March

helping out on the day, making it extra

special.”

Plane to see

Staff at Connaught Care’s Henbrook

House, a luxury care home in St Neots,

Cambridgeshire, took resident Fred

Dawson on a trip to the Royal Air Force

Museum in Hendon, accompanied by

several enthusiastic friends. A lifelong

enthusiast of World War II aircraft, Fred

is finding it increasingly difficult to study

the subject due to visual impairment.

Staff decided to bring his books alive by

helping him to experience them directly.

Swift transformation

In partnership with care home

marketplace Lottie, residents at

Bartlett’s Care Home in Aylesbury,

Buckinghamshire, recreated their

favourite Taylor Swift covers in

anticipation of the UK Eras Tour. With

an average age of 87, residents dressed

up and posed to recreate five of Swift’s

album covers including 1989 (Taylor’s

Version).

Songs for all ages

Nine residents from Grosvenor Manor

Care Centre in Chester, part of New

Care, took part in an intergenerational


activities news | care

singalong. The youngest at the event was

10 days old, and the eldest was 100 years

old. The project was co-ordinated by

Live the Beat, a company which provides

creative music classes.

Taking the biscuit

Residents at Friends of the Elderly’s

The Old Vicarage in Wallingford,

Oxfordshire, voted for their favourite

biscuit and took part in a biscuit-themed

quiz to mark National Biscuit Day. The

top three biscuits were identified as

chocolate, Jammie Dodgers, and custard

creams. Residents concluded that

biscuits today are a lot smaller than they

used to be.

Show time

Residents from specialist dementia care

home Camelot House and Lodge had a

fun day out at the Devon County Show

near Exeter. The group had an entertaining

day inspecting the livestock, farm

machinery, stalls and eating ice cream. One

resident, Fred Grant, was able to relive

memories having grown up on a farm.

Shaken not stirred

Colten Care homes in Dorset,

Hampshire and West Sussex held

‘happy hours’, with drinks making and

tasting sessions. At Woodpeckers in

Brockenhurst, Hampshire, residents

mixed non-alcoholic ingredients to win

the prestigious crown of King or Queen

of the Mocktails. At Wellington Grange

in Chichester, residents received an

invite to a cocktail evening with a choice

of five drinks, and at Brook View the

in-home café became ‘Brookies Cocktail

Bar’ complete with a soundtrack of jazz

standards and a cocktail-themed quiz.

Street party

Residents of Adore Care’s The Durham

Gate Care Home were treated to a

spectacular performance by their own

front of house manager. Samantha

Holden, who has a background as a

professional singer, and took to the

stage in authentic 1940s attire during an

indoor ‘street party’ celebrating the 80th

anniversary of D-Day.

No place like home

Residential care provider Loveday

and the Royal Hospital Chelsea have

partnered to offer weekly art workshops

to members and Chelsea Pensioners,

many of whom have dementia. The

collaboration, called Home, will

culminate in an art exhibition which will

launch on World Alzheimer’s Day on

21 September. Those taking part will be

encouraged to express their emotions,

memories and perceptions of home

through their artwork.

Pottering about

Karen Halladay, a resident at

Drummonds Care Home near

Colchester, is exhibiting her handmade

pottery at The Art Place in Chelmsford

city centre. Karen, who is wheelchair

bound and has limited movement in her

hands, worked with potter Shaun Hall

to create bowls, mugs and even animals

in regular sessions.

Around the world

Rowans Care Centre in Macclesfield,

Cheshire, hosted a vibrant monthlong

celebration of global cultures,

including ‘visits’ to countries including

Nigeria, India, Zimbabwe, Romania,

the Philippines, Malaysia – and

England. Each country was represented

through food, dance, costume, and

informative talks, thanks to the diverse

backgrounds of the care support staff

who passionately shared their heritage.

Intergenerational joy

Regular visits by Northgate Primary

School pupils to Avalon Nursing Home

in Bridgewater, Somerset are “sparking

joy” all round according to teachers and

care workers. Children visited Avalon

frequently last term, enjoying a variety

of activities alongside the residents,

including baking, art, craft and pet

therapy. They are now in the process

of contributing to a sensory garden by

potting plants and painting pebbles and

butterflies.


care | manager in focus

10 questions with…

We speak to Ruth Garnham, general manager at Athena Care

Homes’ Avocet Court in Ipswich

Ruth Garnham

Why did you join the social care sector?

The home had newly opened when I

joined as a housekeeper. I thought I

might have wanted to be a nurse and

had worked for a while at Ipswich

Hospital, but loved working at Avocet

Court from day one, went on to have

my family and my career path changed.

I have now worked at Avocet Court

for 30 years. It was never my goal to

go into management but over the

years I have taken on a number of

roles – housekeeping supervisor, admin

assistant and hospitality manager before

becoming deputy manager, home

manager and starting my current role as

general manager in 2021.

“I have seen some

great carers during

my 30 years here at

Avocet Court and I

am extremely proud

of the team I have

here now."

What do you enjoy most about your

job?

It’s very rewarding, every day is different,

it is never repetitive and certainly never

dull. There is always something new to

learn, new people to care for and families

to get to know. I have a fabulous team

here at Avocet – like one big extended

family.

Who is your social care hero

and why?

My old boss Claudette, who was the

home manager not long after I started

work. She qualified as a nurse later in life

and on her first day as a home manager

the CQC turned up to carry out an

inspection. It was Claudette who pushed

me to develop and go into management.

I interviewed successfully for the deputy

manager role with her support, at a time

when most deputies were nurses and

I wasn’t. She knew everything about

everything, and we are still in touch

today.

What is the one thing you would

change about social care?

I would definitely change the funding

– it’s just not enough. Social care seems

to get forgotten whatever government is

in power. I’m not particularly optimistic

any change of government will make a

big difference.

What, in your opinion, makes a great

care worker?

They have to care. It doesn’t matter too

much about levels of qualifications or

education; they just have to have that

genuine nurturing side. I have seen some

great carers during my 30 years here at

Avocet Court and I am extremely proud

of the team I have here now.

What do you do when life all gets a bit

too much?

I go and be Nanny for a while, and spend

some time with the grandchildren. One

is six and the babies are nine months

and eight months. Or I would take the

dog for a walk – those things keep me

grounded.

What advice would you give your

younger self ?

Be true to yourself and make sure you

follow your dreams – don’t take any bad

advice or criticism from anyone.

Which three famous people would you

have to dinner and why?

I would pick three very straight talking

and funny people – Kathy Burke and

Johnny Vegas who are both hilarious. My

third would be Miriam Margoyles – I’m

just reading her book which is laugh out

loud funny.

What three items would you bring

with you on a desert island?

I would need music so something to play

my favourites on. I like everything from

R’n’B to rock music depending on my

mood. I’d take my dog – Bijon Fris Pixie

– who is very good company. Then my

family but only if the whole immediate

family counts as one item!

What’s your secret talent?

I make a mean rabbit shaped pancake

with fruit decorations for the

grandchildren.


care for tomorrow | care

Smooth operator

Courtney Roberts, general manager of The Old Rectory and Hanford Manor,

describes the Staffordshire care home’s switch to digital

Here at HR Care Homes we

operate two friendly, familyrun

homes in Staffordshire.

Passed down through three generations,

Hanford Manor and The Old Rectory

offer a really homely atmosphere, thanks

to this strong family connection and

their relatively small size which means

our teams can really focus on the needs

and wishes of individual residents.

Until September last year both of

our homes were entirely paper-based.

We had talked a lot about going digital

and were well aware of the benefits,

but it was going to require significant

investment in relation to the size of our

homes and the number of people we

support. We were finally able to make

the leap at the end of 2023, as a result

of funding support from the Digitising

Social Care programme.

We did lots of research into Digital

Social Care Record (DSCR) providers,

including meeting several suppliers to

discuss options in more detail before

narrowing it down to two. We put

those options to the team and they

unanimously agreed on the same one.

The staff had lots of notice before

we went live with the new system,

including time to just play around with

the technology and the platform, so that

when it came to launching they were

familiar and confident with the system.

There was a strong sense of

expectation, and naturally a degree of

nervousness before we launched. We

planned to go one floor at a time, but

day one went so well that we went live

with all floors at once the next day, and

we haven’t looked back since.

We have a real breadth of ages among

our care team – which plays a big role

in our family atmosphere. We did have

a couple of team members saying: “I

can’t put the information on there – can

you do it for me?”, but once they got

the hang of it, they actually enjoyed

updating care records on the phones

we’ve set them up with.

The time-saving is huge. We now have

staff who are able to sit and spend more

time with residents. It’s also less stressful

for them – they don’t have to sit down

and handwrite notes, and they don’t

have the frustration of being told it’s

not detailed enough, because the DSCR

platform has all the prompts and fields

we need.

Care planning is a different world now.

There’s no way we could keep on top

of it all before. Now we get reminders

when care plans need updating, which

is really helpful for senior carers and

managers. They go orange and red

automatically, so it’s really easy to

keep track of them. More importantly

though, I think the care plans themselves

have got a lot better because we’re now

putting everything online. They can be

read through by colleagues, and updated

and changed in real-time, to make them

more individual and person-centred,

which has been another real positive.

Courtney Roberts

Incident forms and reporting have

got a lot better as well. You can do

immediate analysis, record complaints,

and keep them updated, so that’s a much

better and more open process.

We hope to be able to make care

plans accessible to families, and are

thinking now about the right balance

of information to ensure it’s dignified.

We’re looking too at access to, and

linking with, GP records.

The Old Rectory and Hanford Manor

are now fully digital. We’ve learned a

huge amount about our system. Every

day is a learning curve and we share best

practice across our sister homes to ensure

the best quality is achieved.

“We have a real

breadth of ages

among our care team

– which plays a big

role in our family

atmosphere.”


care | legal & regulatory

Reaction to Trenholm departure

The Care Quality Commission’s chief executive caused quite a stir with his sudden

departure announced mere days before the election. Here, the sector has its say on

the ailing regulator and whether it will be salvageable under new management

The departures of the Care

Quality Commission’s chief

executive Ian Trenholm was

announced with almost no notice – and

the former chief executive of NHS

Blood and Transplant left the CQC

around a week after the news broke

The departure came as a surprise to

many, especially because of its short time

frame, while others commented that

they had expected him to leave soon,

whether voluntarily or not.

Meanwhile, the regulator’s deputy

chief executive Kate Terroni has taken

over the role in the interim.

Below, are the reactions of some of the

biggest names in the sector.

Martin Green

The chief executive of Care England

Martin Green said: “Care England has

collaborated closely with Ian over the

past few months to effectively advocate

for our members’ concerns regarding

the CQC’s new single assessment

“The recent initiation

of a review of the CQC

inspection regime

by ministers marks

a crucial first step

towards progress."

Ian Trenholm

framework. While ours and the CQC’s

collective goal remains ensuring

that high-quality care, support and

information are provided to people

who use health and social care services,

the sentiment within the sector reflects

significant apprehension and unease

regarding the challenges posed by the

new framework.

“The recent initiation of a review

of the CQC inspection regime by

ministers marks a crucial first step

towards progress. However, for there to

be meaningful change, there needs to

be urgent decisive action from the next

chief executive.

“We look forward to engaging

productively with the incoming chief

executive at the CQC, continuing these

dialogues to accurately represent the

experiences and perspectives of care

providers across the country. Their first

priority should be to promptly review

the Single Assessment Framework and

collaborate with the sector to develop

an improved system that has balanced

reliance on current and relevant data,

transparency in regulatory approach,

and consistency and uniformity in

assessments. We strongly reiterate our

dedication to this goal and will support

the new chief executive in delivering on

this right from the outset.”

Sarah Duffy

Social care consultant Sarah Duffy said

on LinkedIn: “Ian is leaving swiftly…

but after a very turbulent time for the

regulator, his departure has felt like a

long time coming. It’s telling that Ian’s

resignation statement doesn’t contain

any apology, either for the wider [adult

social care] sector or to CQC staff,

despite the well-publicised issues under

his leadership.

“Kate will be a ‘safe pair of hands’

for the interim. I would personally

choose Joyce Frederick as the next

CEO. A long-standing employee with

a track record of speaking truth to

power (which they certainly need) and

doing the right thing, even when that

“Let’s hope the CQC

board get their next

appointment right.”


is difficult. Lots of the CQC senior

leadership are great at talking the talk;

Joyce is one of the few remaining that

can actually walk the walk. She has

integrity and is reasonable and fair.

Isn’t that someone we all need for the

regulator at the moment?

“Let’s hope the CQC board get their

next appointment right.”

Jayne Connery

Care Campaign for the Vulnerable’s

(CCFTV) founder Jayne Connery said:

"This transition marks a pivotal moment

for the CQC to reassess and reinforce its

commitment to safeguarding the rights

and wellbeing of vulnerable individuals

in care homes.

“CCFTV strongly believes that the

CQC must adopt a more proactive

stance in ensuring the safety and quality

of care provided to residents. The

numerous reports of inadequate care and

maltreatment highlight the urgent need

for the CQC to enhance its vigilance

and responsiveness.

“First, the CQC should increase the

frequency and depth of unannounced

inspections. Regular, rigorous

assessments are essential to identify and

address issues before they escalate into

serious problems. These inspections

should focus not only on compliance

“CCFTV strongly

believes that the CQC

must adopt a more

proactive stance in

ensuring the safety and

quality of care provided

to residents."

with minimum standards but also

on evaluating the quality of life and

emotional wellbeing of residents.

“Second, the CQC must implement

robust mechanisms for early detection

of potential abuses and neglect. This

includes leveraging technology, such as

supporting providers that adopt overt

safety monitoring which can provide

critical oversight and transparency

in care delivery. The integration

of such tools can act as a deterrent

against maltreatment and ensure that

care providers adhere to the highest

standards of care.

“Furthermore, the CQC must

engage more effectively with families

and care staff. By promoting open

communication channels, the CQC can

gain valuable insights from those directly

involved in the daily lives of residents.

This collaborative approach can lead

to quicker identification of issues and

the development of practical solutions

tailored to the specific needs of each care

home.

“The CQC’s proactive engagement is

imperative to safeguarding vulnerable

individuals in care homes. With new

leadership on the horizon, this is an

opportune time for the CQC to adopt

comprehensive oversight strategies,

promote transparency, and support

continuous improvement. By doing

so, the CQC can play a pivotal role

in enhancing the quality of care and

protecting the dignity and rights of

those who are most vulnerable.”

Jeremy Huband

Finally, Jeremy Huband, non-executive

director for Phoenix Specialist Risk

Solutions, commented via LinkedIn:

“Ian Trenholm leaves [the] CQC in

a worse state than he found it. I’ve

asked on calls to their oversight team

if a care home inspected as Requires

improvement three years ago should

be considered Good as they haven’t

bothered to go back to check, to be told

yes. Perhaps [the] CQC should pay the

increased insurance costs that home will

suffer.

“Perhaps the new government should

consider scrapping this workshy body

and work more collaboratively with

Scotland. Ask the Care Inspectorate to

step in. They ‘look at the quality of care

in to ensure it meets high standards.

When improvement is needed, [they]

support services to make positive

changes’. The difference is they support

services and don’t look for reasons to

close them.”

“When improvement

is needed, [they]

support services

to make positive

changes’. The

difference is they

support services and

don’t look for reasons

to close them.”


care | leader’s spotlight

A conspiracy of silence

Caring Times editor Sam Lewis catches up with Dan Archer, UK chief executive of

Visiting Angels, who reveals his path to working in home care, why local authorities

are not to blame for low sector wages, and his keys to fixing social care

How's business at the moment?

We have 71 locations now in the UK,

just over 1,400 carers, and growing every

month. I've always said recruitment

and retention is the biggest problem

that everybody's got, and while it’s not

easy for us, we've given ourselves an

advantage in that respect.

With the changes to the health and

care visa back in March, has that

made a noticeable difference for you in

terms of recruitment?

I don’t think we fix 160,000 vacancies

in adult social care by finding 160,000

people from somewhere else in the

world. They don't realise how hard the

job is, so bringing them to the UK –

they figure it out pretty quickly, right?

In my view, it was always doomed to

fail. It was never the solution that we

needed, and the numbers support the

decision the government has taken.

100,000 people into the UK on shortterm

care worker visas, and the net job

creation benefit of 8,000 – that doesn't

work.

The problem with the steps that the

government has taken is that they’ve

shut the door on people coming in, but

they've not fixed the underlying problem

in social care, which means that the

vacancy rate is going to increase.

If 100,000 people came into the UK

for a net job creation benefit of 8,000,

that means some people went home.

I can only presume they got here,

realised it wasn't what they thought it

was, and went back home; or they were

overqualified, which meant they got

“The same carer

comes every week,

which is ultimately

all the client ever

wants.”

hoovered up into nursing support; or

else they displaced UK workers, and

those UK workers will still be leaving the

sector at the rate they were previously.

We now don't have many foreign

workers coming in to replace them, so if

you're a betting man, I think the vacancy

rate in adult social care is going to be

over 200,000 [in the next Skills for Care

report].

How did you get involved in Visiting

Angels to begin with?

I've always said people don't know about

what we do unless they work in the

sector or they or a family member has

received care, and that's exactly what my

starting point was – the care we received

for my nan was at best substandard.

There were dangers, lots of different

personnel, irregularity around the time

of visit. My nan always used to say she

only knew she was getting care when the

blue tabard showed up – she didn't know

the people.

Over about nine months, with that

service not improving in any way despite

our complaints, I saw the very worst

of the sector. In the end, a carer not

attending a visit led to my nan falling,

and after a period of time in hospital she

passed away. That was my first exposure

to social care.

A few months later, I was speaking at

a conference in Telford to a room full of

franchise industry people about Twitter.

This was 2011. One of the people that

saw me speak was Trevor Brocklebank,

the founder and chief executive of Home

Instead. We spoke about his business

and my nan’s experience, and I came

away from that conversation with the

overriding feeling that if we’d had Home

Instead looking after her, she probably

still would have been with us.

I could absolutely tell what his

business did was markedly different to

the experience that we'd had. A couple of

weeks after that, I was approached by a

headhunter who said that Home Instead

was looking for somebody to be head

Dan Archer

of marketing for the UK. In the space

of a year, I went from knowing nothing

about the sector, to first-hand experience

of a bad service, to then working for one

of the best providers in the world.

After I cut my teeth learning with

Home Instead, and directly prior to

starting Visiting Angels, I was UK MD

of a business called ProMedica24, which

is Europe's largest live-in care franchise.

I was at another conference in June

2016 and awoke to the news that we had

voted for Brexit. The business model for

ProMedica was that we had recruitment

teams in European countries finding care

workers and bringing them to the UK.

I realised things were going to need to

change.

In February 2017 I resigned and was

placed onto gardening leave, so that's

what I did: some decorating, some

gardening, and generally getting under

my wife's feet, which led her to tell me:

“Just get out the house and go and be

gainfully employed again.”

That’s when I started the research on

what became Visiting Angels UK.

Had you heard of the company before?

Visiting Angels is in five countries,

has 800 locations around the world,

and has been in the US since 1998,


so I somewhat knew the brand but

not the people. I took a bit of time to

get to know the people – I wanted to

understand who it was I was going to

be dealing with on a day-to-day basis.

Then I started doing the research for

the launch of the business and looked at

nearly 50 care providers in the process:

franchised domiciliary care, nonfranchised,

corporate and independent,

extra care, residential – I did a proper

sweep of the market to see what was

happening in the sector as a whole.

What shocked me was that none of

them had a people-focused mission

statement. If they had mission

statements at all, they were focused on

clients and care delivery. They wanted

to be an outstanding care provider, to

provide care the way a family member

would expect, but nobody was talking

about their staff.

I thought that was bizarre, because

that's the biggest problem in the sector.

I know your ethos at Visiting Angels

is something like ‘happy staff equals

happy clients’. Can you give me an

example of how this plays out?

There are practical operational examples.

The most tangible customer benefit

is that consistency in the workforce

means the same carer comes every week,

which is ultimately all the client ever

wants. You can't replace that consistency

and continuity. Even for a more basic

companionship case, you can’t just give

someone a different face in a uniform

every week. Putting staff first means a

happier, more stable workforce, which

means I can afford my clients the choice

of who delivers their care.

Something called ‘choose your

caregiver’ is part of our onboarding

process. After we've done an assessment,

the next meeting we do with the family

lets them choose the caregiver that they

are happiest with.

‘Beware the shadow you cast’, is

something I say a lot. That means we

don't always need to be with somebody

12 hours a day; if our interactions are

positive, then they last for hours after

we've left.

Unfortunately, the sector now talks

about care provision in a very impersonal

way, which is deeply ironic given the

person-centred orientation that we're

supposed to have. We talk about

‘service-users’ like it doesn't matter what

someone's name is, and we talk about

carers like they're disposable sometimes.

To my mind, the most valuable resource

in any care business is the care team.

Unfortunately, we are one of relatively

few organisations that think this way.

What are the biggest challenges you

are facing as a business?

The challenges remain the challenges

in the wider sector. Even though we've

given ourselves an advantage when it

comes to the recruitment, we would >


“Talking about tax rises

is not a vote-winner,

but it is the inevitable

consequence of what

we're facing as a

country”

> still like more of them because demand

is overwhelming. The combination of

an ageing population and the social and

population dynamics within the UK

mean that we simply have more elderly

people than other countries have.

Outside of that, one of the challenges

that we face is that the sector as a whole,

and its approach to its staff as a whole,

has led to a culture and a belief from

many who work in care that some of

the practises are accepted as normal. We

would argue that some of the things that

go on are absolutely not normal.

For example, we sometimes tell a

worker that we pay for their travel time

and mileage, and they don't understand

what that means because not being paid

for travel time has been normalised

at other providers. That's problematic

for me. We need to have an honest

conversation about the fact that travel

time is work, and therefore people need

paying for it.

Do you believe Labour will make

improvements in social care where the

Conservatives were unable to?

The main parties are spending lots of

time pointing out what their differences

are. The one thing they seem to agree

on is that they don't want to talk about

social care. The one place where there

is cross-party unity, ironically, is on a

conspiracy of silence on social care. It’s

ridiculous because, no matter which

flavour of government we get, it's the one

inevitable fight that we're going to have

to face over the next five to 10 years –

someone actually needs to do something

about it.

There are elements of Labour’s policy

which are interesting. The suggestion

that zero-hour contracts will be scrapped

is one I support. I absolutely believe that

travel time is paid work and therefore

people should be paid for that work. I

also believe that the pay rate for home

care workers is disgracefully low in many

instances. For Angela Rayner to suggest

they’ll review care worker pay, that's

terrific. How it's going to be funded is a

massive question mark, however.

Equally, I don't share the enthusiasm

that some have for the nationalisation of

the social care sector. If I'm completely

honest, many of the problems that exist

today exist because of local authority

commissioning of care. There's an

argument to say that there are plenty

of innovative approaches which are

being made in the private sector which

the government could learn from. Just

centralising it is not going to be a fix to

this. It needs resourcing properly, and it

also needs the right approach to strategy,

because it's not just about money.

I talk about what Visiting Angels

pays, I talk about proper contracts, and

people say to me, “It's all right for you,

Dan, you're a private provider, you can

afford to do all of that.” What they don’t

understand is that it's not just about

money.

A substantial amount of the work

we do is about culture and employee

engagement. It's about recognising what

the stress points are in the job and trying

to do something to alleviate those. At its

very core, being care-centric is trying to

see the world of a carer through their eyes.

Proper pay and proper contracts are

just the start point for a discussion.

What you've then got to do is try and


leader’s spotlight | care

engage with the sector in a way to not

only do something about safeguarding

those that work in care currently, but

also do something about making the

job more appealing to a proportion of

society that currently doesn’t want to

work in care.

There is an arrogance from everybody

involved in decision-making within

the country because they won’t accept

that population dynamics are the major

driver of what we're experiencing right

now. The baby boomer generation was

exceptionally large, and the generation

following it is smaller and the generation

following that is smaller again. It’s not

about European migration, and it's not

about pay rates and contracts. It's about

the fact that every part of society is

facing a search for fewer workers. And,

relatively speaking, care jobs are harder,

more complex and more stressful than it

is to sit on a till in Tesco.

When you're talking about societal

level problems, we need big-picture

thinking. Tinkering around the edges

frustrates me. It’s a five- or 10-year

project, and it needs cross-party

agreement and better integration

between the NHS and social care.

There needs to be more of an honest

conversation and honest politicians are

not things that are in large supply. The

reality is that no party can say they’ll

properly address social care without

talking about the cost. The reason

nobody was willing to talk about it

much pre-election was that talking about

tax rises is not a vote winner, but it is the

inevitable consequence of what we're

facing as a country.

How do we get through to politicians

and get them to address the problems

we’re talking about?

There's a narrative shift that's needed.

It’s not just down to lazy politicians.

Everybody within the entire sphere

of this, whether it’s at client level,

commissioning level, employers,

employees, councils, media, politicians,

civil servants – everybody needs to own

the bit of this that they're responsible for.

I cannot abide the argument from care

providers who say they cannot afford to

pay staff better. I cannot abide the lack

of responsibility in saying the reason

their staff are paid so poorly is because

of the local authority. Employers decide

what employees get paid. If you cannot

tender at an economic rate, you should

not tender at an uneconomic rate.

What do you think of the not-forprofit

model?

As a commercial individual I would say

there has to be some element of a profit

motive in order for people to consider

investing in something which requires

investment. If you take the profit

motive away from it, then you are fully

dependent on people doing it because

it's the right thing to do or, or it being

funded centrally. The problem with that

is, you get an inherent lack of efficiency

when it’s someone else’s money.

It's a conversation about where the

money comes from that needs to be had,

and right now it’s coming from the wrong

places. At the moment it's coming from

care workers being paid minimum wage

or less. Paid driving is the wrong place for

it to come from. It absolutely should not

be coming out of the pockets of some of

the poorest paid workers in the country.

We can talk about unpaid carers as well,

or a system where agency workers earn

huge hourly rates compared to other care

workers. The last people who should be

propping the system up are the workers

who are already not paid enough and the

private clients who are already paying for

100% of their own care, but that's the

predominant business model right now.

What else is going on with Visiting

Angels at the moment?

We're involved in Home Care’s Got

Talent, which includes Visiting Angels

and several other providers. It’s the

first year doing it. We have seen the

Care Sector’s Got Talent initiative, but

unfortunately most of it tends to be

residential, so what we're trying to do

with this is specifically target home care.

The Homecare Association is involved

and we're doing it for The Care Workers

Charity, and as much as anything I value

the opportunity to celebrate how talented

carers are, especially home care workers.

I think that the job of the domiciliary

care worker is even harder than that

of a residential care worker because it

has to be more diverse. When you're

in domiciliary care, you don’t have a

catering team or an entertainment team

or a medication team – the home care

worker does all of that – so this is our

chance to shine a spotlight on that.


care | opinion

Care workers’ demands from Labour

As Labour settles into being in government again after more than a decade of Tory

rule, Care Workers Charity (CWC) CEO Karolina Gerlich explains the demands of the

people who prop up the UK’s struggling social care sector – the country’s care workers

As the new Prime Minister

takes office, the Care

Workers’ Charity sends our

congratulations to Keir Starmer and

the new Labour government. We

welcome their commitment to fair

pay and security for all workers and

are interested to hear more about

their idea for a National Care Service.

While contributing significantly to UK

society, both economically and socially,

conversations on care have, for too long,

focused on cost and not enough on

value. We need to change this and call

on the new government to meet with

care sector leaders and care workers, as

well as show that social care is going to

be a real priority going forward. With

an ageing, population the care sector is

forecast to grow by 25% over the next 10

years. These are conversations that need

to be happening now. It is with this in

mind that we lay out our immediate and

long-term asks for care workers across

the UK.

The first 100 days

Meet with care workers: One of

the most impactful gestures the new

Prime Minister can make is to meet

with frontline care workers. At the

Care Workers’ Charity, we hear from

thousands of care workers every year

and would be pleased to work with the

government to arrange this opportunity.

This will not only show that social care

is a priority, but also provide a platform

to hear first-hand the challenges and

aspirations of the workforce. Those on

the frontline are the experts in care and

“Let us work

together to build a

brighter future for

those who care for

us all.”

have insight into workforce wellbeing,

retention of new starters, the practical

impact of care regulations, responsible

uses of AI and so much more to share.

Meet with care sector leaders:

Care leaders are ready to meet with

the new government to share their

extensive knowledge and expertise. This

includes representatives from the care

workforce, people drawing on social care

and unpaid carers. By sharing proven

strategies and policy recommendations,

we want to collaborate on sustainable

solutions to enhance the quality and

accessibility of care services.

A timeframe for the Fair Pay

Agreement: Care workers deserve fair

compensation for their indispensable

work. They are continually listed as one

of the lowest paying roles in the UK

and paid, on average, 36% less than for

NHS equivalent roles. We urge the new

government to set a clear timeframe

on the fair pay agreement. The pay

agreement should consider not only

hourly rates (which should not be less

than £15) but also pay progression, sick

pay, pay for travel time and mandatory

training.

More information on National Care

Service: The concept of a National

Care Service is an interesting idea, yet

many details remain unclear. Providing

more information and a concrete plan

will help stakeholders understand the

future direction and structure of social

care in England. We know that care

workers have the skills to deliver the

changes discussed, but we would like

to see plans which include how care

workers' wages will rise in line with any

additional responsibilities in health care

and monitoring.

Award a bonus to all care workers:

Care work is fundamental to society, and

care workers have shown exceptional

dedication and resilience, including

during the height of the COVID-19

pandemic. While other nations have

awarded bonuses to their care workers,

England has yet to do so. The new

Karolina Gerlich

government should immediately provide

this bonus as a token of appreciation

and recognition of the hard work and

sacrifices made by care workers during

this crisis, before and beyond.

Long-term goals

An advisory board of care workers:

Work with the Care Workers’ Charity

to ensure that the voices of care workers

are consistently heard. We propose the

establishment of an advisory board

within the Department of Health and

Social Care (DHSC). This board should

be composed of care workers from

various settings and regions, providing

a direct line of communication between

those who deliver care and those who

formulate policies. This would be the

first step towards creating a professional

body that truly represents care workers

and addresses their needs.

Release the care worker wellbeing

survey: The well-being of care workers is

paramount. We call on the government

to release the results of the recent wellbeing

survey. This was completed by

over 7,000 care workers and will provide

invaluable insights into their mental

health and job satisfaction, allowing for

timely interventions and support.

Ensure sustainable funding for local


“While other nations

have awarded

bonuses to their care

workers, England has

yet to do so.”

authorities: Funding is the lifeblood of

an effective social care system. We urge

the government to release sufficient

funding to local authorities specifically

earmarked for social care. This funding

should include provisions for care

worker well-being and be guaranteed for

at least five years. Such a commitment

will ensure stability and allow for longterm

planning and improvements in the

care sector.

Establish a professional body for

care workers: Establishing a national

professional body for care workers

would foster a sense of belonging and set

out professional standards. Registration

for care workers in England, as already

implemented in Scotland, Wales and

Northern Ireland, would provide advice

and support, governance, education and

advocacy. Creating a national training

framework for social care with clear

opportunities for development and

progression would support recruitment

and retention and prevent the need to

repeat training when starting with a new

employer.

Final thoughts

As the new government begins its

journey, we are here to collaborate and

support efforts to enhance the social care

sector. By addressing these immediate

and long-term asks, the government

will not only improve the lives of care

workers but also ensure that people

drawing on social care receive the best

possible care and unpaid carers the best

support.

Care workers have proven time and

again their commitment to their roles.

It is now time for the government to

show an equal commitment to them.

Recognising their contributions through

fair pay, bonuses, wellbeing support

and a voice in policymaking will lay

the foundation for a more robust and

resilient social care system. The care

sector is at a pivotal moment. The

decisions made in the coming days,

weeks and months will shape the future

of social care. We are hopeful and look

forward to supporting meaningful

improvements for the lives of care

workers and the overall quality of social

care. Let us work together to build a

brighter future for those who care for us

all.


care | surveys & data

Benefits of role-specific

diabetes training

Hallmark Luxury Care Homes is improving life for residents with diabetes, says

Julie Rayner, care quality governance and compliance director for Hallmark

The care home sector is

experiencing a marked rise in

acuity within their populations

with residents moving into care homes

at a later stage in their lives, usually when

the common illness of old age (such as

COPD, diabetes, dementia and heart

disease) are more pronounced. This

means that care home nurses and carers

need to have a wide breath of knowledge

about many common illnesses.

At Hallmark, our nurses and carers

benefit from a wide range of training

opportunities and are skilled in

providing person-centred care to older

people who choose to live in one of our

care homes. However, we are always

"Activities, case studies

and real-life examples,

delivered by experienced

professionals

leading the sessions,

further embedded

the knowledge and

promoted best practice.”

striving to improve and while we were

able to provide our care team with

some knowledge on the management

of diabetes and our registered nurses

brought with them knowledge from

their studies or from previous roles,

we were aware that team knowledge in

respect of the management of diabetes,

particularly the assessment of the

diabetic foot, could be improved.

We were also aware of the work of the

National Advisory Panel on Care Home

Diabetes and its subsequent guidance

which highlighted to us that further

action was needed to ensure that team

members not only had the skills and

knowledge to provide high-quality care

for people living with diabetes, but they

also had the confidence to advocate for

residents and to work collaboratively

with external primary care partners

and specialist teams to achieve better

outcomes for residents.

We worked with DUET Diabetes to

Summary of the training days

Workshop Team roles Numbers attended

Day 1, morning Diabetes awareness and blood glucose monitoring & Nurses 217

glucometer training (including a practical session) Nurse assistants

Senior care assistants

Day 1, afternoon Diabetic foot screening (including a ‘hands on feet’ Nurses 214

practical session)

Nurse assistants

Senior care assistants

Day 2, morning Diabetes awareness nurse extension Nurses 61

Nurse assistants

Day 2, afternoon Diabetic foot screening competency Nurses 58

Nurse assistants


plan and implement a virtual pilot in

2021, after which DUET Diabetes was

commissioned to provide bespoke, inhouse

training starting in May 2022.

The training was delivered as

interactive, holistic workshops in two

parts (see table left). Activities, case

studies and real-life examples, delivered

by experienced professionals leading

the sessions, further embedded the

knowledge and promoted best practice.

The impact of the training on teams’

confidence, knowledge and ability

to write a robust, person-centred

diabetes-management care plan has

been evidenced through our clinical

monitoring activities and this, coupled

alongside the skills our team now has

to assess residents’ risk of developing

diabetic foot ulcers, means wellbeing

and health outcomes have improved.

For example, following the training,

and using her new knowledge, one

dementia care manager discussed a

resident’s diabetes medication and

erratic glucose levels with the GP. This

discussion resulted in the GP changing

the resident’s medication; consequently,

the resident is happy that her blood

glucose levels are now well-managed.

The diabetes specialist at the GP surgery

is amazed by the improvement in this

resident’s condition and her diabetic

control.

Other teams have highlighted the

impact the training has had on their

ability to examine and categorise foot

damage. One staff member commented:

“We have found the risk assessment of

the diabetic foot [tool] to be useful.

Learners’ self-assessed overall response

to the training programme.

Recently we have had two residents

who had foot ulcers, both living with

type 2 diabetes. These were originally

documented as pressure ulcers; however,

after using the tool, they were found and

confirmed by a GP to be diabetic ulcers.”

This diagnosis was then reflected in the

residents’ wound-care treatment plan.

Implementation of the risk

examination of the diabetic foot tool has

also delivered positive outcomes for two

other residents at another of our homes:

• Diabetic foot checks helped to identify

early foot oedema for one resident,

which allowed for timely and effective

intervention.

• Doing foot screening for another

resident helped identify oversized

shoes which was a contributing factor

to the number of falls the resident was

having. This resident now has betterfitting

shoes which has improved her

gait and reduced the number of falls.

These examples demonstrate how the

training delivered by DUET Diabetes

has also affected other aspects of risk

identification and care delivery in our

care homes.

The impact of the training was

evaluated and the figures below clearly

show the positive outcomes in regards to

staff knowledge and confidence. >

Has this workshop improved your knowledge and skills for caring for/

managing someone with diabetes?

n Yes

n No


care | surveys & data

> Learners’ self-assessed

knowledge/confidence levels

pre- and post-workshop

attendance (average across the

programme)

It’s clear that residents and teams have

been positively impacted by delivery of

the training. The teams across Hallmark’s

homes are more confident and can

"Other teams have

highlighted the

impact the training

has had on their

ability to examine

and categorise foot

damage.”

have more informed conversations

with external professionals about the

management of residents’ diabetes.

Elsewhere, care plans have improved,

residents are experiencing better

outcomes and external professionals are

now confident that their patients are

receiving high-quality and evidencebased

diabetes care.

Team members attended the training

to improve knowledge and confidence

relevant to their role, however it soon

became clear that there was a wider

benefit. The prevalence of diabetes in

the UK meant that at every workshop

at least one team member divulged that

they or family members were living with

diabetes. Therefore, the information

being learnt, the discussions and

activities were also supporting them on a

personal level.

What are our next steps? Hallmark

and DUET are now working in

partnership to develop a programme of

blended learning (including

interactive e-learning, workbooks

and virtual classrooms) to extend this

valuable training to a wider audience

and to refresh the knowledge of

our team who attended the initial

workshops.

In conclusion, our experience of

implementing non-mandatory training

for a condition with high prevalence in

the care home setting makes sense on

many levels. Whether viewed through

a training evaluation lens or a personal

lens, the increase in knowledge and

confidence has empowered our teams,

enabling us as an organisation to deliver

high-quality, person-centred, safe and

responsive care for people living with

diabetes so that they maintain or even

improve their quality of life.


Tom Owen, director of My Home Life England, offers hints and tips

on how to engage with your local community

registered managers | care

Managers, guide to…

connecting with the community

At My Home Life England, part

of the School of Health and

Psychological Sciences at City,

University of London, we have supported

the care sector for more than 18 years, and

an essential part of our work recognises the

importance of connections between people

and communities. We’ve led community

engagement initiatives across many

different care settings, the learning from

which has informed a range of resources

to support the sector, such as toolkits and

videos. We often hear incredible examples

of communities supporting their local care

settings – and vice versa.

From the local rugby club coming into

a care home once a month and chatting

with sports fans and ex-players, to the

local supermarket donating provisions

– it doesn’t need to be grand gestures,

what matters is the relationship and

sustained connection. It contributes to a

greater quality of life and a more positive

culture within the care setting.

You reaching out has reciprocal

community benefits too – it creates

volunteering opportunities and gives

individuals the opportunity to learn

from other community members,

breaking down stigma around ageing

and disability. Take a pause and think

about what you have to offer your

community – and there will be plenty.

1. Identify and thank the people,

groups and organisations that

your care setting already has good

relationships with. It’s always

nice for people to know they’re

appreciated and it’s also helpful to

recognise where you’ve already got

good connections. Thanking people

may lead to them considering how

else they could support you, and what

could be possible together.

2. Pin down your possibilities. Who

in the community could you easily

connect with, but don’t yet? It could

be a faith group attended by a team

member, the school where the chef ’s

children go, or the café just around

the corner.

3. Ask people living in, and connected

to, the care setting for their ideas.

This will help build a picture of the

possible relationships you could

develop and, importantly, what

support they could give you, and

what you have to offer them. What

individuals, groups and organisations

might people in the care setting wish

to reconnect with? Maybe there’s

a society someone used to be an

active member of, or a business that

someone used to be involved with.

4. Ask questions. What could the

community do to support the little

things that matter to people living

in the setting, the staff and relatives?

And what could you offer them in

return? What hobbies do people

have that they would like to continue

pursuing? What would make a

difference to those around you?

5. Focus on your communication.

When getting the message out to the

community that you want to build

new connections, be really clear

about what you want to achieve,

what the benefit will be for them, and

what actions people should take in

response. Think about the best ways

to communicate with different groups

(face-to-face, email or letter).

6. Connecting with your community

can have business benefits. We

heard of a domiciliary care agency

that offered free information sessions

about dementia to the community.

As well as being educational, this gift

helped transform public perception

of the provider from one focused

on profits, to one that cared about

its wider community. As well as a

more informed community and an

improved provider reputation, this

also led to new business enquiries.

7. Consider holding an event such as a

coffee morning to invite people in.

Tom Owen

8. Put yourself in an organisation’s

shoes and consider what it might

need – for example, a meeting space

in the care home, or offering to sell its

products in the care home reception.

We’ve heard of care homes reaching

out to local businesses and offering

them the chance to have their jams

sold in the care home reception, to be

admired and purchased by visitors.

This led to an uptick in sales for the

small businesses, which then came

into the care home to give a talk all

about making jam, sparking intrigue

and conversations among those who

lived there.

9. If you’re starting an

intergenerational link, prepare

each generation for meeting

beforehand, so they know what to

expect. This helps in creating positive

outcomes for both older people and

the youngsters, including boosting

the knowledge and wellbeing of

both generations and creating a more

united community.

10. Starting small can help the

relationship to grow – it doesn’t

necessarily need to be anything big

or complicated. For more ideas, visit:

myhomelife.org.uk/communityconnections


care | team members

Employee of the month

Angel Kho, head chef at Barchester’s Cherry Blossom Manor in Basingstoke,

Hampshire, shares her experience of providing a great dining experience for residents

Tell us about your background in care

Originally from the Philippines, I

followed in the footsteps of my mother,

who also worked for Barchester, and

joined the company in 2012 as a host

(waitress) at Wimbledon Beaumont

Care Home. Since then I have never

looked back. I worked my way up

through the ranks until I moved to

Cherry Blossom Manor in 2020 and

became head chef. I absolutely love

my job. I like to chat to the residents

to find out their likes and dislikes so I

can present their food exactly the way

they like it. I love to come up with new

ways to surprise and delight residents

with nutritious and flavoursome homecooked

meals.

I was voted ‘Chef of the year 2023’

in the Barchester Care Awards, in

competition with the whole Barchester

estate of 260 care homes and hospitals,

to win this coveted award.

What is special about working at Cherry

Blossom Manor?

Working at Cherry Blossom is a deeply

fulfilling and rewarding experience.

The opportunity to make a positive

impact on the lives of the residents and

provide them with care and support

through nutrition brings immense joy

and satisfaction. First and foremost, the

relationship I build with the residents

are the heart and soul of why I love

working at Cherry Blossom. Each

resident has a unique story to tell, and

a lifetime of experience and wisdom to

share. I love spending time with them,

listening to their stories and engaging in

meaningful conversations.

How do you vary your menu to provide

choice for residents?

Creating my menu involves finding out

the residents’ likes and dislikes. Every

month the home has a residents’ meeting

and they talk about the menu and

each resident has unique preferences,

dietary restrictions and cultural

background. Taking time to get to know

them individually allows me to tailor

Angel Kho

their menu choices; this may involve

incorporating favourite ingredients, or

recreating cherished family recipes.

How do you meet residents’ nutritional

and health needs?

I attend clinical governance meetings,

in particular to find out the nutritional

status of residents who are at risk. I also

make time to attend monthly resident

meetings and talk about themed lunches

and get suggestions for the menu. The

team has a daily stand-up meeting where

I get updated on any illnesses or changes

to diet modifications. I go around the

home with the ‘resident of the day’ and

discuss likes and dislikes. The home has

a quarterly relatives’ meeting to listen to

family feedback and suggestions about

food service.

How do you care for residents living with

dementia?

Some of the residents living with

dementia don’t have verbal capacity to

communicate. When this is the case, I

use a ‘show plates’ technique to facilitate

their food choice. I also check their

care plans for nutrition and hydration

and consider if there are any religious

or cultural preferences when it comes

to food. I make bite-size finger food for

residents living with dementia which is

easier to up pick and eat.

What’s your most popular dish?

The most popular dish at Cherry

Blossom is curry. Every time the home

has curry on the menu, residents really

enjoy it. In addition to its unique

flavour, curry also stands out because

of its vibrant colours. Braised beef with

peppercorn sauce is a popular dish too.

The residents enjoy the tender beef and

say it melts in their mouths.

How do you make the dining experience

special for residents and their families?

In addition to the food itself, the

presentation and ambience of the dining

area plays a crucial role in making the

residents feel special. I strive to create

an inviting atmosphere by setting up

beautifully arranged tables, using fresh

flowers and playing soft music in the

background. These details contribute to a

sense of dignity and enhance the overall

dining experience. Personalisation is key

when it comes to making the residents

and their families feel special.


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care | norrms’ blog

The truth about dementia

Regular columnist Norrms McNarama reflects on what it’s like to live with dementia, and reacts to

the Alzheimer’s Society video that’s causing so many discussions

I

have dementia. It’s a terminal disease.

I am slowly dying and disappearing

right in front of my family’s eyes, bit

by bit, each and every day. They say a

cure could be 10 to 20 years away from

now – too late for me. I have dementia

but I am not daft.

I lost my father and wonderful

grandmother to this awful disease so

I know what my future holds. I wake

each and every night, screaming and

shouting, fighting enemies who are

completely invisible to anybody else.

I hear my mum shout my name. I see

and feel my dog slide up to me on the

settee. Both have been dead for years.

I’ve seen myself walk out of a lift while

sitting in a cafe and I have felt myself

dying in bed trying to call my angel

Elaine’s name to tell her I love her before

I do. I look into my children’s eyes and

wonder who they are about to become,

how they will manage and who will

stand guard over them all, as I have done

for so many years.

Even after all these years I still come

across so called ‘friends’ who cross the

road from me now rather than say ‘hello’,

almost as though they think it might be

contagious. I have to be held by the hand

at all times as I have lost all my road

sense and would walk straight in front of

a car in an instant.

Most days I disappear into a world of

my own. I used to say nothing bad ever

happened in my world; now, sometimes

it seems totally the opposite. I want to

scream and shout sometimes, but I know

if I do, people will look at me and think:

“Must be his dementia”. The slightest

thing goes wrong and it’s the end of the

world as far as I am concerned. Things I

used to take in my stride are now totally

devastating, and yet…

I smile. We smile. We all smile.

Through thick and thin, we smile. We

go out into the big bad world every

day and try to make people understand

why I, and others, feel like this and why

this disease makes you feel as if you are

Norrms McNamara

the loneliest person in the world, even

though you are surrounded by love.

Why do we smile and go out there

every day?

Because we are born to fight. Because

when I get up in the morning, I put my

boots on and not my slippers. We are

genetically made up to fend off all that is

thrown at us and make the best of what

we have. Where do we get the strength

from? Nobody knows, but somehow we

get up in the mornings, day after day,

and face whatever is thrown at us.

Why do we do this every day?

Because we have hope. Because we

hope one day all will be well, or at least

be a little better tomorrow than today,

and that is enough for us to hold onto.

That little bit of hope is enough to feed

our soul, help us breath, speak our words

and have our voices heard; just that little

bit of hope can do so much. So please my

friends, whatever situation you are in,

whatever your health may be like, please

hold on tight to that little bit of hope,

because, even something so small that

can’t be seen, touched, tasted, heard or

smelt can bring a little happiness to each

and every heart in the world.

Norrms is diagnosed with Lewy bodies

dementia.


norrms’ blog | care


Caring Times, July/August 2024

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