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.

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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.

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.

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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.