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The importance of Good Governance for Care Home providers.

The team at Swift Management Services Limited often find that the term ‘Good Governance’ is misused and misunderstood. There is further confusion caused as local authorities and NHS professionals use the term: ‘Clinical Governance’ and bankers and auditors use terms such as ‘good financial governance’. These terms leave some providers in a quandary and we often hear comments such as “What is good governance, what do I have to do?”

We hope that we can help demystify the terminology for providers. In the simplest of terms, Good Governance is: putting processes in place and ensuring that your team do what you say they do. The processes in place should reflect best practice guidelines where they exist.

The management team, or provider needs to be able to demonstrate they monitor processes and take action to ensure that what is happening, is what they believe should be happening. The process of governance includes policies, procedures, forms and documentation, reports, and inspections from providers.

One of the most seen business governance failures is fraud taking place, and business owners not just in the care industry looking back in wonder as to how it happened. The banking policy and good business practice would dictate that all financial transactions are signed by two authorised people, or where transactions are electronic two people authorise them.

In many instances and based on a level of trust, one of the two signatories may sign an entire cheque book of cheques. The second person is then able to complete the cheque and add their signature or in the case of electronic banking one person gives their security information to the second to allow one person to undertake both parts of the authorisation process. For much of the time the process appears to work, and everyone is happy until something goes wrong and fraud is committed. One of the first questions asked is what governance checking was in place. In short, the management of the organisation did not recognise the practice before an issue arose and significant loss occurred.

Above is only one example of poor governance, but throughout the care industry there are multiple areas of the business where good governance is essential. These relate to the business, residents, and their care.

Any provider should be asking themselves if they are able to say that they know with certainty that what is supposed to be happening is happening. One governance tool used in large businesses is the auditor’s report, which should be a tool that is used to advise stakeholders about practice. Some care home providers view the regulatory report as a governance tool. That view is not appropriate, and a regulatory report should never be a governance tool. Governance should be an ongoingmethod of internal review, long before an inspection takes place.

The governance process can include, but is not limited to, provider visit reports, and a review against recognised clinical tools, to ensure that care trends are being maintained and action is being taken to ensure standards of care.

Good Governance and service improvement plans go hand in hand, and can make the difference between grades in effective, caring, responsive, safe, and well led. The Swift Management team can provide good governance audit tools, service improvement plans and provide governance audit reports. Providers who are regularly in a service, may see things so often that despite not being best practice, become the norm, and are no longer seen. Therefore, an external audit report can really help in the governance journey.

To find our more email: info@swiftmangement.org.uk

Or visit our website at www.swiftmangement.org.uk

Time for CQC to recommence the inspection process

At the beginning of the Covid-19 Crisis the Care Quality Commission, the English health and social care regulator ceased undertaking all but essential inspections, to maintain the safety of both the public and their own staff.

They instead established a system known as “The Emergency Support Framework”. This was a way in which they could keep in contact with health care providers across England. The focus remained on the five standards used to monitor health care in England: Caring, Safe, Effective, Responsive, and Well Lead.

Despite the emergency support framework telephone calls being documented and a summary being circulated, the evidence gained was not used to re-evaluate grades or allow action to be taken. As well as gathering information from outside sources and from statutory reporting alongside the emergency support framework calls, it seems the inspection process has stopped.

Only where serious concerns were identified was an inspection considered. We believe the inspection process now needs to start again in earnest. As time goes on and no inspections take place the issues care providers face exacerbate day by day. We fully understand that every provider whether they be rated Outstanding or Inadequate, have gone through a period of enormous pressure managing all the various issues surrounding the Covid-19 Crisis, but there is now a need to focus on inspection.

This may be a strange concept for some to grasp, but it is important to understand the picture faced by some care providers. There are several care providers who have suffered high numbers of deaths during the recent crisis. They have come under criticism from the media when the situation was in some instances out of their control. They will need to demonstrate that all standards are being met. A regulatory review of services will give the public reassurance.

The homes however that really do need urgent inspection are those that before lockdown were rated inadequate. The team at Swift Management Services Limited undertake support of care homes who need to improve following an inadequate rating and where enforcement action has been taken or is likely to be taken. Looking at one of our client’s stories may illustrate the situation:

We started working with one of our clients in late October 2019 when they had received their second inadequate inspection report. Since our engagement we have worked with the provider and supported them through a change process. We have provided regular updates for both the local authority and CQC. The improvements are clear to see. Under CQC guidelines a home rated inadequate should be inspected within six months. We contacted CQC to ask that the inspection be brought forward. The inspector advised that they had planned an imminent review, and would be within the six- month timeframe. This meant that our client only had a few weeks to wait. Then lockdown happened and the inspection process did not take place.

The home has been left for an additional three months without an inspection. Given the last inspection was the second inadequate inspection, should they be allowed to operate for a further nine plus months if the care was not safe without enforcement action being taken? Fortunately, this is not the case for our client. We are pleased to say our client has move on substantially, the care they provide is of a high standard and this can be evidenced. The difficulty they have is their published rating shows as inadequate. This is preventing them from admitting to the home, as the CQC ratings are very much taken into consideration by both local authorities and private clients alike.

If they are to continue to improve, they need the support of the regulator to review their grades which will allow them to admit new clients.

Any home that is rated as inadequate faces extreme financial hardship, as admission levels fall and costs of improvements increase, with no way of servicing the expenditure over an extended period. This uncertainty influences both the provider and the staff. There is uncertainty all around. Thankfully in our client’s case, the Swift Management Team, have been there to support them, and both the management and the staff appreciate our support, advice, and encouragement. They say that our team are part of the family, but that they are not receiving the recognition they need to take their business forward. They need a regulatory visit to review their grades.

Once the inspection happens, we will await with interest the grade they are given. In many cases a home will move from inadequate to requires improvement as the provider needs to demonstrate a sustained improvement. Given the delay in inspection we will be watching with interest as the sustained improvements can be evidenced to the regulator, through our regular submission of audits, feedback and record keeping.

Whilst we have only mentioned one specific client in this article, they are not the only client we have in the same position. We therefore welcome the inspection process starting again in earnest.

To find our more email: info@swiftmangement.org.uk Or visit our website at www.swiftmangement.org.uk

Time for a review?

In the current climate of scrutiny of care homes, we are all familiar with the increased focus on the availability of PPE, infection control, staff training, the availability of staff, frequent changes of advice, strategy, and direction. It is quite frankly, not easy being registered care service, and our care providers should be celebrated for generally delivering excellent care under immense pressure.

Whilst we are all hopeful that the current wave of Covid-19 is on the wane in most areas of the country, there are pockets where the infection rate has remained higher than anticipated, and the impact of this is going to be felt for some time to come as providers continue to protect people in their care, through maintenance of exemplary hygiene standards, testing (when available) organizing alternative means of contact with relatives and loved ones. We have seen some truly outstanding examples of innovation, from drive-through visits, socially distanced café, Perspex® room dividers with intercoms, cuddle shower curtains, inside/outside parties to name a few.

Over the next few weeks, many providers will need to take stock of what has happened, what worked, what needed to improve, and how things might have been done differently. Maintaining contemporaneous files about what guidance was received, what actions you took based upon the guidance, how this was communicated to residents, staff and visitors are vital as regrettably, somebody will not be content that everything possible was done.

At Swift Management Services we are highly experienced in undertaking comprehensive service reviews to enable providers to have the assurance that they are compliant with all aspects of the Health and Social Care Act.  The current pandemic and the level of response has highlighted that some providers of health and social care struggled to source PPE, maintain staffing levels, deal with outbreaks etc. By reviewing your systems, updating information and resources and testing your Business Continuity Plans together with your Pandemic Preparedness Plans, we can help you ensure that you are in the best possible position to minimise risk in the event of a further wave of Covid-19, and help your business to be fighting fit for the future.

The financial burden to providers during a pandemic is considerable, ranging from the increased cost of PPE, additional staffing, waste disposal costs to provision of Covid secure facilities that ordinarily may not be required. We are also seeing a collateral effect on food costs.  With so many providers facing extreme financial pressure, it is important to review the service in the context of fees received from local authorities, which is acknowledged and has failed to keep pace with the true cost of care. At Swift Management Services we have an experienced team of consultants with wide-ranging skill sets from nurses, registered managers, and board level executives all of whom can assist in a comprehensive strategic review.

This will enable you to have the necessary information to approach commissioners to secure realistic fees or redesign your service together with registration changes to best suit the local market.

We are currently offering providers a free no-obligation discussion about how we can assist you.

Care Home Engagement Surveys can help more than you think!

How Prepared are you for Covid

As the lockdown eases, the care home industry will be looking forward to returning to normal. Engagement Surveys can help this process in a number of ways.

There will have been lessons learned in so many aspects of care home life during the lockdown and it is a real opportunity to demonstrate that the provider has good levels of governance in place and lessons have been learned and acted upon for the future.

Another aspect of Engagement Surveys from an external provider can be the validation of the services you provide to both the public and the regulators.

Many care home providers who were expecting the regulators to call, due to inadequate rating being awarded within the last six months, will have worked extremely hard to make service improvements. Given that the regulators are not maintaining their usual inspection regime, if an inadequate rated home has complied with the notice of decision issued by the regulator, they are unlikely to have had a revisit. This will impact on the published rating and this is likely to impact on referrals.

Using engagement survey results to demonstrate satisfaction and service improvement can be an invaluable way to demonstrate a responsive and well-led service. The results can be published on your website to counterbalance a regulatory report or indeed confirm a great report.

Swift Management Services offer both Resident and Relative and Employee engagement surveys and the subsequent report to the provider is anonymised, the data is benchmarked year on year and can be benchmarked against industry standards. We provide templates for actions from surveys. Our team can further assist with advice to complete action plans and keep your teams informed if required.

Our engagement surveys can be digital, or paper-based, and all reports are presented in an easy to understand PDF document which is easily adapted for use on your own web pages or printed as required.

We are able to offer “Off the Shelf” surveys and we are also able to provide bespoke surveys as required.

Many Care Home Providers use internal staff and resident surveys and may consider an external survey as an extravagance, this is most certainly not the case. We have found staff to be more open and truthful in an external survey as the anonymity aspect gives more confidence.

The public and the regulators take more comfort from a survey that has been managed externally as the results are collated externally from the company.

The results are presented in an easy to understand format which enables the participants and the readers to see that comments have been taken on-board and action if required has or is being taken. An external engagement survey can be a really valuable tool for any care home operator.

As a provider there is a need to be constantly monitoring and building your business, our engagement packages gives you the reassurance that your business is moving in the right direction and there are no surprises around the corner.

To find our more email: info@swiftmangement.org.uk

Or visit our website at www.swiftmangement.org.uk

The Swift Management KLOE Inspection process

CQC has a framework of inspection based on what is known as “the KLOE’s”. The term KLOE stands for Key Lines of Enquiry. They are based on best practice and the evidence from the KLOE goes to make up the care providers rating in the five categories of Safe, Effective, Caring, Responsive, and Well Led.

Some of our provider’s comment that their inspection report is repetitive and one or two points have been used in a number of categories, this is because the KLOE inspected has an impact on more than one categories, for example, a medication error caused by a number of staff members could impact on Safe, Caring and Well Led.

The information that CQC gathers throughout the year from many different sources is used as part of the inspection process and allows the inspection team to focus on various aspects of your service using the KLOE’s. When the inspection takes place the inspector already has a lot of information about your service and so it is important for the Manager and the team at the home to showcase the excellent work they do.

There is never a good time for the inspection team to arrive, we all know in a care home, every day is different, and something is always pulling the manager in one direction or another. That said the inspection is a snapshot of the home and depending on how everyone performs will significantly influence the outcome of the inspection. The Swift Management KLOE inspection documentation is designed to help at the time of your CQC inspection as it signposts the good practice.

When we carry out a KLOE inspection you will receive a visit from two consultants, usually unannounced but pre-arranged. This is to make the inspection as real as possible. One consultant carries out an inspection in much the same way as an inspector from CQC would do.

Whilst the second Consultant works with the manager to draw out evidence good or otherwise to support every KLOE. This then provides the home with a comprehensive report, which not only givens you a summary of the day, but details the evidence seen along with an assessment of standards and potential grade for each KLOE. The assessment can then be fed into the Service plan to make any improvements. The very positive aspect of this style of report is the evidence used to make the assessment is listed, meaning if used at the time of a CQC inspection, the manager is able to put forward all the evidence they will need to make their assessment. Given that an inspection is a snapshot of the care home, the more detail you provide the better the picture of the home will be. The Swift Management KLOE inspection report has assisted our clients to have at hand the evidence they need ensuring nothing is missed.

Where things need improvement the service plan produced by Swift Management provides the inspectors with a transparent and honest action plan, with not only the issues but how, and by whom the action is going to be taken and how they are going to be monitored. Any inspector knows that there is no perfect care home, and there are always improvements to be made, but a home that knows, understands, and owns the issues before they are pointed out by a CQC inspection is certainly well led.

Our clients have found our KLOE inspection audits have assisted in the formal CQC inspection process for many reasons. The first being staff have practiced an inspection. The second being there is an action plan to address issues before they are raised. The third being the inspectors are provided with the evidence they need to make a sound judgment because nothing is missed.

To find our more email: info@swiftmangement.org.uk

Or visit our website at www.swiftmangement.org.uk

Retaining a Consultancy can be a cost effective way to grow your business.

Many care home providers look to a care consultancy firm when the going gets tough, usually due to the costs involved they leave it to late. With our retained consultant package, you don’t have to wait for a crisis to hit. Enjoy the benefits an expert consultant can bring without the worry of high costs.

Swift Management Services Limited recognize the difficulties the care industry faces and particularly in 2020. Therefore, we have designed a pay monthly package to enable homes to grow and prosper. From as little as £295 per month + VAT (payable by direct debit) we can offer our basic package of support based on a 12-month program including:

  • 6 X Managers Supervisions.
  • Dedicated Care Consultant.
  • Access to our experienced team of Consultants when a specific issue needs a specific specialist.
  • A tailored Service plan using our proven system.
  • 6 X Support visits to review progress and provide a governance report.
  • 1 X Unannounced KLOE inspection.
  • Unlimited Telephone and Email Support.
  • Access to all the information relating to your home on our server.
  • Assistance with policy writing and review.
  • 15% discount on all other Swift Management Services throughout the year.

This package of support is designed to enhance any service, plus provide the governance detail that goes towards your “Well Led” Rating.

When providers look at client based outcomes, they will automatically improve their ratings with the regulators, profitability, staff morale, reputation and occupancy. Coupling these automatic improvements with systems and service reviews, a consultancy can offer so much more to a client than simply crisis management.

We are suggesting that we avoid the crisis and ensure that your business goes from strength to strength.

Our clients have already benefitted in many ways from our services, including:

  • Increasing Inspection Ratings
  • Client Fee Reviews
  • Crisis and Interim Management
  • Support at Regulatory or Local Authority Meetings
  • Registration support for new businesses
  • Staff and Resident Satisfaction Surveys
  • Bespoke Policies and Procedures

As a provider you need to be constantly monitoring and building your business, this package gives you the reassurance that your business is moving in the right direction and there are no surprises around the corner.

To find our more email: info@swiftmangement.org.uk

Or visit our website at www.swiftmangement.org.uk

Technology changed the way we work and just in time for the lockdown

As a company built on the expertise of Nurses and Care Professionals, we are all about the people we work with. The care industry until recently has been less than up to date with the digital age. Both these factors meant that the Swift Management Team preferred to hold face to face meetings, use direct marketing and work on paper based systems.

When I say this, I do not mean we were total technophobe’s we did use technology, but we certainly did not use technology as fully as we could have.

In early January we started discussions with our web design company Vikinguru Interactive, looking at ways in which we could improve our website, and increase its usefulness. As part of these discussions, we decided to change our email hosting and servers all at the same time. Although the advice was excellent, for a group of people who talk to people it was hard to imagine why we would require some of the technology we now had available to use as part of this major upgrade. We were learning all about Blogs and Wikki’s social media and much more.

In early March we held our staff conference and rolled out many of the new apps available to use and demonstrated their use. At this point Covid-19 was not the daily discussion point it is now, and the UK was going about its business even if the panic buying had started.

Over the coming weeks the team became proficient with the new software. Then the UK began to change, people were self-Isolating, travel was becoming more restrictive and we could not justify our team driving around the country to visit care homes, who were at the time considering reducing visitors or closing to visitors altogether.

In order to maintain the support, our customers wanted without putting either our consultant or the care homes at risk we began to unpack some of the tools we had in our technology armory but thought we would never use.

As a result, our clients now have access to the files we hold for them giving all of us real-time information as we work together on projects. We now hold meetings using Skype or MS Teams meaning those costly time-consuming meetings can be managed without leaving home. We have also been able to provide bespoke face to face type training over the internet, with online question papers and instant marking.

Our teams have been collaborating on projects in ways we have never done before. As we look to a future without infection and without lockdown, we have looked at how we can help those operators who have struggled during the last few months and whilst needing support simply do not feel the time is right, as they need to recover financially. We have decided to respond to this need by keeping our new technology working for us in the new world after Covid-19. This has meant we are able to put together low-cost packages of support for care home providers, as we use technology to assist our consultants to support our clients. They say something good comes from every disaster, and whilst we mourn the tragic loss of life, celebrate the excellent dedication of the NHS and Social Care Staff along with every other front line worker, here at Swift Management Services Limited, we know that our methods of working have been enhanced by the need to use technology more fully.

To find out more email: info@swiftmangement.org.uk

Or visit our website at www.swiftmangement.org.uk

NHS Nightingale Hospital

Proud to have been a small part in providing 4000 additional beds for the NHS at the Nightingale Hospital

The nursing team at Swift Management Services Limited was delighted to be part of the commissioning team which transformed the Excel Exhibition Centre in East London into a 4000-bed hospital to treat Covid-19 patients who need ventilation to support their breathing.

We were not as you might expect part of the nursing team, instead of part of the Facilities Management Commissioning team, working with the amazing staff of the NHS to pull together what is the first of possibly many Nightingale Hospitals across the UK.

The NHS team supported by the Army as mentors, designed and started to build a hospital that opened its doors in only nine days. The thousands of people involved from NHS executives & staff, along with contractors and consultants worked day and night to bring this hospital into use. This is something that can normally take years to achieve. The teams worked on individual parts of the project; every possible consideration was taken into account to ensure that the new field hospital could provide the very best of NHS care that we have all become used to in the current health crisis. Within just 9 days the hospital was taking shape. The hospital wards were named and the equipment was being installed.

There was a training centre established to train the new staff for the hospital on a day by day basis. It was remarkable to see who everyone pulled together. Whilst the project is an NHS project the army leant a hand as mentors to ensure that we all kept pace and we had thought of everything.

In what was known as the Auditorium a massive canteen was opened to feed the workforce and what an amazing job they did, given the hundreds of staff which they fed without falter every day. Whilst everyone working on the project hopes it will never be fully utilised as that would mean the virus continues, everyone has worked so very hard to make this happen and the team at Swift Management Services Limited are proud to have been a very small part of an enormous project.

We are so very proud of everyone who has been involved and we salute the Clinical Team who will work 24 hours a day to preserve life. It goes to show when there is a crisis the UK spirit still steps up to the challenge and it this case it was the NHS.

Social Care Workers PPE

How Prepared are you for Covid

A few our client’s staff have contacted us very worried that they do not have the same levels of PPE as hospital staff. There are also lots of discussions on social media and we do not want to add to the confusion. The guidance appears to change regularly as everyone understands more about the Covid-19 virus. Therefore, the information we are giving is correct as of 5th April 2020. We have done the research, so you do not have to!

The advice currently available states that Covid-19 is an infection passed by droplets expelled from an infected persons body by coughing or sneezing it may also be passed by aerosol actions during specific medical procedures, such as placing a tube into a persons windpipe to place them onto a ventilator or during the removal of the same tube. Therefore, some hospital staff are seen wearing more complex PPE that care home staff are being provided with.

The advice from the government on the wearing of PPE for staff who are caring for residents with no signs of the disease are as follows:

If neither the care worker nor the individual receiving care and support is symptomatic, then no personal protective equipment is required above and beyond normal good hygiene practices.

General interventions may include increased cleaning activity to reduce risk of retention of virus on hard surfaces, and keeping property properly ventilated by opening windows whenever safe and appropriate. [1]

Many staff have been concerned about not being issued with full protective PPE as shown in the picture below.

This level of PPE is NOT required in a care home setting to keep care workers safe.

The government has issued guidance for care home staff who are caring for people diagnosed with Covid-19 and this guidance clearly states:

Care workers should use personal protective equipment (PPE) for activities that bring them into close personal contact, such as washing and bathing, personal hygiene and contact with bodily fluids.

Aprons, gloves and fluid repellent surgical masks should be used in these situations. If there is a risk of splashing, then eye protection will minimise risk.

New personal protective equipment must be used for each episode of care. It is essential that personal protective equipment is stored securely within disposable rubbish bags.

These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being put in the usual household waste bin. [2]

It is understandable why care workers are worried as I have not been able to source a picture with the correct level of PPE despite an extensive search. The picture to the left shows someone wearing scrubs and PPE.  Scrubs are not required, a normal clean uniform is adequate.

References:

[1] https://www.gov.uk/government/publications/covid-19-residential-care-supported-living-and-home-care-guidance/covid-19-guidance-on-home-care-provision

[2] https://www.gov.uk/government/publications/covid-19-residential-care-supported-living-and-home-care-guidance/covid-19-guidance-on-home-care-provision

Diversity in Care things to consider

During this period of extreme pressure within Health and Social Care, there is so much being talked about in terms of care and dealing with the immediate problem of Covid-19 and quite rightly so. However, are we considering the needs of everyone we care for as isolation, sickness and care of bereaved relatives are real challenges as social isolation and travel restrictions change regularly.

For a long time now, we have been discussing caring for clients and looking at Diversity, this is certainly something that CQC have been looking at over recent months. It has become apparent to the team at Swift Management that many care home operators and managers do not really understand the true meaning of diversity. When we visit homes and speak to staff about diversity they usual talk about the racial mix of both staff and residents, they talk about the different religions represented by residents in the home and who the various clergy might visit on a frequent or infrequent basis.

What people seem to sidestep are those residents from the LGBTQ community and when you ask, they simply say, we don’t have any LGBTQ residents in the home. As a team we have looked back over our years in social care and between us all, we can only count less than 10 residents who were openly LGBTQ. Given between the team we have over 100 years’ experience in health and social care, the numbers of LGBTQ residents must be higher.

To understand the reluctance of our older population to open up about their sexuality it is useful to understand the background in which they grew up. The UK was not the open and accepting place it is today. Homosexual was illegal until 1967; up until that point being “Gay” carried a prison sentence. Police would raid houses early in the morning to catch people sleeping together, often encouraged by local communities making complaints about their neighbours. Courts would in some cases issue prison sentences or offer an alternative of “Voluntary” Electric Shock Therapy to assist in changing their sexuality. This Treatment was only stopped in the late 1970’s when Homosexuality was declassified as a mental illness. In less than 55 years the changes in society for the LGBTQ community has vastly changed. Therefore, for those who grow up prior to 1967 many will bear the scars of the society they grew up with.

You may argue that many groups in society over the years have suffered at the hands of others, whether that be due to race or religion etc. But this persecution in the UK was never legalised persecution in the same was as it was for the LGBTQ community. Many residents particularly those living with dementia will not be able to understand they have a right to be open. We as social care providers have a duty to encourage openness in both our staff and our residents, to ensure our LGBTQ residents can live their lives as they wish and without fear. This is particularly important when people are nearing the end of their lives, wanting to prepare it is just as important for the partners who are also in the same position and need to be able to grieve.

Be amongst the first care homes to truly recognise diversity. To find out more about being a truly diverse care home operator why not contact us: info@swiftmanagement.org.uk we are able to assist with your diversity plan and involve others in training and educating your staff about this very important aspect of so many people’s lives.

Why use a Consultancy Team

Caring for the Care Provider

The Care Home Support Team at Swift Management Services have recently met to review the past year and to plan the year ahead. During these discussions we quickly came to understand that our clients often leave contacting us very late on in a situation. Many providers call us when they are in trouble with an inadequate inspection report or worse, or they are trying to obtain outstanding ratings. Is that the only reason that a consultancy can be used and should this not be turned on its head to make the best use of a consultancy team?

During the last year the team has help companies write policies and procedures, worked to resolve inadequate ratings, supported providers after they have been issued with notices of decision including regulation 31 closures, resolved large scale safeguarding enquires on behalf of providers working in partnership with the local authority. We have also helped two new companies successfully register as providers with the Care Quality Commission as well as acting as expert witnesses.

One of the advantages of engaging a Consultancy team as opposed to a single consultant is, the breadth of skills our clients can count on. We work closely with a number of expert firms of solicitors to ensure that we can provide a truly 360o service. Every client has a lead consultant who ensures we have the right person working with you every step of the way.

But why is it time to change peoples thinking as to why they need a consultant?

Whether you own or manage a care home or work in the most junior role within one, we all entered this industry to improve the lives of the people we care for. It is not just about the money, after all there are far more profitable businesses to be in.

When providers look at client based outcomes, they will automatically improve their ratings with the regulators, profitability, staff morale, reputation and occupancy. Coupling these automatic improvements with systems and service reviews, a consultancy can offer so much more to a client than simply crisis management. In essence we are suggesting that we avoid the crisis in the first place.

Our dedicated team offer packages of sustained support to clients to see them through the good times as well as the more challenging times.

Interim management is also something the industry is reluctant to engage in. It is well recognised that care homes are “only as good as the manager” yet when there is a vacancy many operators leave the post vacant and expect the deputy to “cope”. Many times we have seen services deteriorate quickly when the home is without a manager.

The care home support team want you to achieve great outcomes for your clients, and work in partnership with you to make it happen. This method of working will ensure that grades are maintained and improved upon, without the need to crisis management and because we have the right people working for us, we will ensure that you have the very best person for the job in hand.

Flexible contracts and payment plans mean that having a consultant need not be confined to the emergencies or to meet the aspirations of the board, but to keep the service on track and improve the lives of the residents we all want to care for.

For more information why not get in touch to discuss your needs and options.

enquires@swiftmanagement.org.uk

Covid-19 Advice for Small Providers

As many corporate companies prepare for staff to work from home and put contingencies plans in place for a national major outbreak of Covid-19, Local Authorities are asking care home providers to consider their own plan. Within service lead industries including healthcare, it is highly unlikely that many staff will be able to work from home and reduce contact with others as far as possible. Yet many providers care for elderly and other clients with chronic pathology, which places them at greater risk of the most serious symptoms of the virus. Swift Management have been asked by many of it’s clients to assist in the process of contingency planning.

CQC have written to providers; the statement below is an extract-

“Dear colleague,

We are writing to share an update on how we are responding to the outbreak of Covid-19, as well as how we plan to approach any future decisions as the situation develops.

We will always act in the best interests of people who use services – so while it’s appropriate to recognise the need for you to focus on delivering care, we will always balance this with our responsibility to check that the safety of service users is maintained.

This is a fast-moving situation which may involve us changing what we do and how we do it. We have, therefore, established three key principles that we will use to make sure services continue to be safe, whilst limiting the impact on you and our own colleagues.

  • We will be focusing our activity where it is needed most to ensure people receive safe care – this means concentrating on those areas where we see that the risk to the quality of care is the highest and where we can make the biggest difference.
  • We will support providers by looking at how we can act flexibly and proportionately to reduce the asks that we make of you – including reducing what you need to do to prepare for inspection and looking at what we can do to limit our need to be on site.
  • We will honour our duty of care to our colleagues at CQC.
Covid-19

We will still be carrying out inspections, but inspection managers will be reviewing inspection plans on an ongoing basis to make sure our activity is aligned with the very latest position. Most inspections will continue as planned in the short term, we will keep the position under review and may decide to postpone an inspection, perhaps with relatively short notice. We will take a pragmatic and flexible approach to how and when we regulate as and when this situation develops, and we commit to continuing conversations with providers and their representative organisations.” (Ian Trenholm, Chief Executive Care Quality Commission March 2020)

To ensure that our clients are ready, we are assisting them to consider the situation, undertake a risk assessment and write a contingency plan.

We appreciate that every care provider has an infection control policy, we are encouraging them to ensure that staff have refreshed themselves on the policy including ensuring staff understand the importance of the correct techniques for handwashing.

When planning for a risk assessment consider:

Staff, Visitors, staffing levels, The Physical Environment and wider issues such as supply chains.

Visitors: Visitors should be advised not to visit the home if they are exhibiting flu like symptoms unless it is absolutely essential. They should be asked to use hand gels and wash hands on arrival and on leaving. In the event of an outbreak within a care home, Public Health England will advise on visiting controls.

Staff: Ensure staff have the knowledge to protect themselves and others from the risk of infection, that they are able to wash their hand effectively, and understand their duty to the residents, by either self-isolating, isolating residents and or excluding visitors who may be high risk. Staff should also have the confidence to ask visitors to use hand gels etc. Public Health England will be on hand to assist any care home which has an outbreak.

Staffing Levels: CQC is clear that standards of care must be maintained. Consider how you would maintain staffing levels in the event of an emergency, it is also important to consider that other healthcare organisations will be looking to fill gaps in staffing. So, consider carefully how this will be managed. Consider that you might need additional staff, from agencies, is it possible to bring staff from within the organisation or from another care home? What staff groups are absolutely essential, and could other staff help with some tasks if required? Encourage your staff to be flexible.

The Physical Environment: This is not complicated for most care homes as they have already considered infection control measures. Review the need for Alcohol Gel dispensers, clinical waste bins and soap and paper towel dispensers. Do you need more? Regularly check stock levels of both cleaning and clinical equipment, do you have sufficient stock levels as usual and some additional stock in case your supplier lets you down? Remember some people are stock piling and that means supplies may run out if you plan to order just in time, so please consider ordering early, but taking care not to stock pile.

Are there additional items that you want to keep in stock?

This is the opportunity to review the environment and perhaps put in place those items you have been meaning to put into place for ages.

The Supply Chain: At this stage it is hard to predict if the supply chain will be affected. Other than the issues we already know about such as difficulty in obtaining face masks, alcholol gels and toilet rolls, other items may become highly sought after. Consider what impact it would have if the supply chain which you rely upon breaks down due to their staff being ill or unable to deliver the supplies you normally order, do you have an alternative? Could you use local shops, do you have back up supplies.

Risk Assesments and action plans may be requested in the near future by contracting authorities so be prepared. Swift Management Services are happy to talk these plans through with you or indeed write them for you just contact us on enquiries@swiftmanagement.org.uk

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