Attention Nurses: Free Workshop Skin Conditions in Older people

RCN Bath Branch and BMI Bath Clinic are pleased to offer the opportunity to attend a Professional Development workshop on Monday 22nd October at Bath Golf Club, Golf Course Road , Bath, BA2 6JG.      10am til 3pm

'More than Skin Deep'

Speakers and Programme to include

Dr Phillips Consultant Dermatologist: - Treatment of skin conditions in older people & recognition of rashes

Bruna Costa, Centre for Appearance Research at UWE :- Psychological effects of a  change in body image due to skin conditions & scarring

Zach Jones, RCN legal Officer: - Accountability, delegation, documentation and the NMC

Lindsay Cardwell, HCP Southwest Committee -New emerging roles of HCPs – APs and NAs

 RCN Bath Branch will hold their AGM during the lunch break to which all RCN members are cordially invited.

 There is lots of free parking , Lunch is provided and you will receive a RCN certificate for 3 hours of CPD.

Please can you share/circulate the attached poster with your colleagues?

 To book E-mail your name and contact details to    or

Look forward to seeing you there

Sue Thompson
Infection Prevention and Control Lead
BMI Bath Clinic
Claverton Down Road
Coombe Down
Bath  BA2 7BR        
Tel 01225 835555


Oana Cojocaru’s nursing story


“I work for Brunelcare as a Registered Nurse, in Saffron Gardens care home.

My nursing career started in Romania, where I grew up and trained as a nurse, completing my nursing degree and working in a hospital; making diabetes my chosen specialism.

My passion for nursing goes back to my early childhood when I looked after my grandfather at one stage and decided I wanted to be a nurse!

Everything changed for me 12 years ago when I relocated to the UK, and with a lapsed nursing PIN, and starting a family, I found work in the restaurant trade instead for a few years. The health and safety, and food safety aspects of managing a restaurant did have some synergy with my nursing training.

Then, two years ago, with a yearning to work as a nurse again, I enrolled for a ‘Back to Practice’ nursing course with UWE (University of West of England) in Bristol. At the same time I came across Brunelcare’s Saffron Gardens care home and contacted their Clinical Lead Manager to see if Brunelcare would sponsor my University course. They interviewed me and agreed that they would! Not only this, but they employed me on a part-time basis whilst I was completing my course and paid my nursing PIN. I started working for Brunelcare in October 2017 and finished my requalification course in March 2018, when I became a Registered Nurse with Brunelcare’s Saffron Gardens care home.

What I love about my new nursing career with Brunelcare is the relaxed atmosphere in which I work, in comparison to a hospital setting. It’s like ‘being a nurse in your own home’. The work conditions are less rigid, there is less paperwork and clinical time and instead much more time spent with those in your care. I am mum to a toddler so I also enjoy the flexible work contract I currently have, enabling me to make the most of my nursing and my own family.

To those thinking of joining the care home sector as a nurse, I would say don’t believe everything you hear about dementia care. It’s one of the most satisfying nursing environments where you can give people cuddles, dance and sing with them and generally ‘be’ as you would with your own family.

“To find out more visit

Barbara Harris
Nursing Stories: Joel Tano

Joel Tano’s nursing story

“I work for Brunelcare as a Registered Nurse, in Robinson House care home.

I’ve always taken great pride in being a nurse.

My decision to become a nurse happened at University in the Philippines, where I come from. I originally set out to study engineering but soon realised that working with machines didn’t suit me. Instead, I loved the idea of working with people, to be able to change someone’s life by making them better. That really fired a passion in me! So I switched to studying nursing, qualifying with my nursing degree.

After qualifying, I worked for 12 years in a hospital casualty department. From seeing people arrive at the hospital ill, I always derived huge satisfaction from seeing them go home feeling fitter.

My decision to relocate, with my family, to the UK was triggered in 2005 when the UK care organisation ‘Four Seasons’ were recruiting in the Philippines. Hundreds applied, but I was one of just 80 people selected and so me and my family left to set up home in Scotland, where I worked for Four Seasons as a nurse.  After a while I grew increasingly concerned by a lack of career progression, development and support in that role - I had heard there were better nursing opportunities in the South at that time. I set about researching other care organisations and read some good reviews online about Brunelcare. They had vacancies for nurses so I applied, was offered the job and next thing we knew I was moving my family down to Bristol to start another new phase in our lives! So since 2010 I have been working as a Registered Nurse in Brunelcare’s Robinson House care and nursing home, in Bristol.

I have found the charity to be incredibly supportive, from the interview to the current day. Their working conditions are the best I have experienced. They pay for and encourage my continued training and development. They also provide work pattern flexibility, and I have appreciated how supportive they have been of me as a parent. For example, they agreed to me working overtime when I first arrived in Bristol and was house-hunting.

When I compare my work in a care and nursing home with life in hospital; the work in hospital was very fast turnaround, allowing very little time to get to know the people you were caring for. By complete contrast, at Robinson House I am with those I care for from their arrival with us to the end of their lives. There was also not so much training and support available to me in my hospital position as there has been with Brunelcare. My role is now all about day-to-day nursing and end of life care, and we specialise in dementia care too. My nursing role still has variety and has evolved over time, for example we have more high dependency needs that I am focused on now. Our care home excels in palliative care, for which we have been recognised with a Care & Support West award recently. A care home is definitely not a stagnant place to work, I sometimes hear them described that way.

I enjoy the higher level of interaction I have with those I care for. I have also experienced valuable growth not only in my work but personally too. I feel rewarded with my great job and the happy family life I have here in Bristol, working with Brunelcare.“

“To find out more visit

Barbara Harris
NURSING STORIES: Edwin Jose and Opportunities for Promotion

Edwin Jose’s nursing story

 “I am the Deputy Manager for Brunelcare’s Glastonbury care home.

I qualified as a nurse in India in 2008 and worked as a cardiac ITU nurse in a hospital for nearly two years.

It became my ambition to work in health care management and in 2010 I decided to move to the UK to complete post graduate diploma in health care management in  Leeds and later I undertook an MBA in General Management, specialising in HR. I was particularly interested in exploring employee motivation and performance in care homes, making this my study focus. Whilst completing my full-time study I also worked part-time as a Senior Carer in a BUPA care home, until the end 2013.

Once I had gained my MBA my sister recommended that I apply for a job with Brunelcare; she was working for Brunelcare at their Glastonbury care home. So I applied and joined them in January 2014 as a Unit Care Leader. My career has progressed quickly since then, with three promotions: to Registered Nurse (when my PIN was granted), becoming a Senior Nurse and then in March 2018 I was appointed as the Deputy Manager for the care home.

The thing I enjoy most about being a nurse is that I love the people living here. Highlights about working for Brunelcare include the incredible support I have received from senior management, the training I have received - which is more than I have received in other organisations. Our staffing ratios and employee long service is above average, and was something that felt encouraging when applying to work for Brunelcare.

In my current role I enjoy a good working atmosphere; I can plan my day and that of our teams. My role entails a lead responsibility for management, support and direction of the care services, managing medications in the home (Glastonbury provides 24/7 nursing care) and spending plenty of time with our residents. The main aspect of my Deputy Management role is the care planning, for example we carefully build an individual’s tailored care plan over several weeks and then continue to develop it overtime. I also carry out pre-assessments, that is, visiting people before they move in to the care home to assess their situation, care needs and agree when they might join us.

The aspect about my job that I most enjoy is the freedom to explore new ideas, new approaches to the care we provide and seeing the benefits of the training and support we receive working for Brunelcare.”

“To find out more visit

Care Home NewsBarbara Harris
MY VOICE MY CHOICE: Giving Disabled People in Weston Super Mare A Voice

My Voice, My Choice

Please promote!:

• My Voice, My Choice has been funded by the Big Lottery Fund.

• My Voice, My Choice is being organised by Leonard Cheshire, a registered charity providing services for disabled people.

• The aim of the My Voice, My Choice project is to allow disabled people to speak up about the accessibility of community services in the Weston-super-Mare Area and have their voices heard.

3 workshops will take place between September and December 2018 that will allow disabled adults to share stories, meet new people, provide ideas and suggest new ways of accessing the community.

People who take part in the My Voice, My Choice workshops will be invited to a larger final event in January 2019 that will:

• Show the results of the workshops.

• Provide the opportunity for organisations that have taken part in the workshops to say what services they can provide to make things better for local disabled people.

• Allow senior representatives from organisations and authorities to be told about the results of the My Voice, My Choice project and talk about any changes that can be made.

Workshop 1 - Wednesday, 26th September 2018

Volunteering, Education and Employment

Workshop 2 - Wednesday, 31st October 2018

Transport, Access and Safety

Workshop 3 – Thursday, 22nd November 2018

Activities, Lifestyle and Health

All 3 workshops will take place at:

The Campus, Highlands Lane, Weston-super-Mare, BS24 7DX

10 am until 2:30 pm and a light lunch will be provided.

There are 20 spaces in each workshop and each space will be allocated to the people who register first. REGISTRATION FORMS

Spaces are limited so please book your place early to avoid disappointment.

More information and registration forms are available from 07419 736961

General NewsBarbara Harris
Dance Your Heart Away at Rosedale

We at Rosedale feel that everyday someone who is living with a dementia should dance their heart away, using the BUTTERFLY APPROACH we go the extra mile to not only live in the moment with our residents but to dress up and be who we are, fun love and laughter matters and it truly makes a difference to the people living and working here, everyday is a fun day.

We understand that having a dementia is like being on a stormy sea at times with no sense of direction, we help everyday by being person centred, feeling based being together, creating intense feelings within all of us.

We break down institutional barriers and create an atmosphere that matters to the people that live here.


Outstanding! Official! Ash View House, Kingswood

The owners, managers, staff and residents of Ash View House are delighted to announce that, following an unannounced inspection by the Care Quality Commission on the 20th May 2018, the service has been awarded with an overall ‘Outstanding’ rating. This is all the more exceptional because only 2% of all registered Care Homes in the UK are currently awarded this level of recognition.

Ash View House is a specialist residential care home, providing support to people with autistic spectrum disorders and mental health conditions. The Home opened in Spring 2008 and has continued to develop and improve, to offer the highest possible standards of care and support, with a significant emphasis on person centered care and promoting independence.

CQC Overall Summary

The inspection took place on 20 May 2018 and was unannounced.

Ash View House accommodates 17 people in three adapted buildings. Ash View House is a care home. People in the care home receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

There was a registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There was a culture of dynamic risk taking at Ash View House. This was supported by very well trained staff and really up to date systems and procedures in place, to keep people and others safe. This meant people thrived in an environment where they could develop and live a really fulfilling life but still be supported to stay safe.

People, relatives, professionals and staff gave exceptionally positive feedback about Ash view House; Comments included "The care is excellent, the staff are amazing." "The staff strive to improve all the time, the owner is also lovely", and "I would recommend this place to anyone, you are here with people who try to look after you and do the very best they can."

The whole team were led by the management who were exceptionally committed to providing people with a highly responsive and very flexible service. Care was goal and aspirations led and this meant people thrived and planned to achieve long-term goals and outcomes. One person told us "It's brilliant here they let me decide what I want to do and help me do it". Another person told us "It's the best home I have ever been in I can do so many things here, I went greyhound racing which I enjoyed a lot."

Care was creatively planned to respond to people's individual needs or goals. Activities were highly personalised to people's specific interests. Care plans were personalised with information co-written with people at the home. This supported staff to provide high quality care and support. People, relatives and staff were at the centre of Ash View House's quality checking programme. The management team followed a wide range of systems to gain their feedback and views. Systems included regular meetings and a range of satisfaction surveys.

People, relatives and staff, told us the home was very well run and well-led by the management team. One person told us "I see the owner all the time I can talk to him about anything". Another person said, "They are always asking what you think; it makes you feel you matter and are involved".

The whole team's total commitment to delivering a truly person centred service has been embedded even further into all aspects of the service. Staff who have shown specific interests in particular areas, such as safe responses to behaviours that challenge were designated 'Leads'. These leads continued to play a key role in developing and improving practice as well as sharing learning and acting as role models.

The management team and staff they led had a good understanding and appreciation of people's needs. The team were creative in the ways they provide person centred care. This put people at the centre and 'heart' of how the home was run. The management continued to find new and creative ways to support people to have an exceptionally fulfilled quality of life.

For further information, and to obtain a full copy of the report, please contact John Duggan on 0117 9353599 or

Barbara Harris
AbleCare join Alive! in an All Aboard "Floating memories" Adventure

AbleCare use Alive! to enhance the activities they offer to their residents who participated in the Floating Memories activities detailed below:

Alive is the UK’s leading charity enriching the lives of older people in care and training their carers. We engage older people through a range of creative activity sessions in over 350 care homes across nine counties, and train and support care staff to deliver outstanding care at every opportunity

Through our partnership with All Aboard Watersports we’ve been providing an exciting and unique experience for some of Bristol’s care home residents. Alive ‘Floating Memories’ sessions enable older people to get out on the water to take in the sights of Bristol’s harbour, whilst learning about some of its fascinating history and sharing their memories of the area. The sessions were provided for free as part of the Come on Board project, funded by Bristol Ageing Better.

Taking place on a fully accessible boat with a front ramp meant the trips were accessible for all, including those in wheelchairs. Each trip around the harbour lasted 45 minutes to an hour, with time for a cup of tea afterwards. Alive facilitators accompanied the residents and talked with them about local history around the harbour and played music to add to the experience. Sea shanties have been a huge hit, with residents enjoying singing ‘Haul Away for Rosie’ and making up their own verses.

Bristol’s harbour is full of unique history, including the S.S. Great Britain, the old shipyards and steam cranes. Residents saw all this from the boat and discussed the history behind it.  One Floating Memories trip coincided with the Bristol Harbour Festival, meaning there were hundreds of boats on the water, which was an amazing experience. Highlights of other trips included getting up close to a £75m super yacht and watching peregrine falcons swoop over the water!

The sessions weren’t just about the history of Bristol, they also provided a wonderful opportunity for residents to reminisce. One gentleman told us how he had seen the S. S. Great Britain being towed back into the harbour in 1970 and he remembered how broken it was. Another resident shared how they used to work in transportation, and so recognised so many buildings and places from the water.

Activities like these help to connect older people in care to the wider community and gives them an opportunity to explore the city they live in. It also shows just what breadth of activities can be possible for care home residents. The Come on Board Project runs until the end of 2019 and during that time we will be taking many more older people out onto the water.

All the residents and carers have told us how much they enjoyed the trip around the harbour and how good it was to do something different. At the end of each trip, the most common question was “When can we come again?”

For more information about Alive please visit:

Follow Alive on Facebook and Twitter: @aliveactivities  

To find out more about Come on Board please visit:

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Government Asleep on the Job.

The Tomlinson Blake Employment Tribunal ruling that sleep-in shifts be paid the national minimum wage sent shockwaves through the care industry. Notwithstanding opinion on whether workers should be paid this, the prospect of a £400m back-pay bill combined with rigorous HMRC enforcement threatened the very foundations of the UK’s social care model generating immense uncertainty in the sector.

In this context, the Court of Appeal’s emphatic rejection of the decision in July prompted a sigh of relief and was hailed as  Bright Line Decision by Walker Morris. Relief is short-lived unfortunately! Unison has now lodged an appeal against this decision in the Supreme Court. Whilst the grounds for appeal are not generally available yet, it is unlikely that the Supreme Court will sit before Summer / Autumn 2019

So the mayhem continues, the government appears to be doing little and the uncertainty is set to continue for another year at a time when "Care providers throughout the UK will now face further uncertainty at a time when consistency and continuity of the law is greatly needed." (Matthew Wort, Partner at Anthony Collins Solicitors

You can browse a series of articles and information sources from professionals in the field which are listed below. They give different  perspectives but all of them call for clarity and proper funding;  all express anxiety at the  immense complexity caused by the situation with both Unison and Mencap laying  blame firmly at the Government’s door.

Reading them a summary of the issues seems to be:

  • Agreement on what a realistic payment for “Sleep-In” shifts should be. The Court of Appeal: “It would not be a natural use of language, in a context which distinguishes between (actually) working and being available for work, to describe someone as “working” when they are positively expected to be asleep throughout all or most of the relevant period.”  V Unison: ‘Sleep-in shifts involve significant caring responsibilities, often for very vulnerable people. With too few staff on at night, most care workers are often on their feet all shift, only grabbing a few minutes sleep if they can. That’s why it’s such a disgrace that workers have been paid a pittance for sleep-ins – with some getting just £30 for a ten-hour shift.”
  • The ruling is not a blanket ruling but must be considered on a case by case basis puts additional strain on the employment element of care businesses, defining ‘specific activities’ and providing clarity.
  • Back payment? Have some workers been paid? What commitments and expectations are in place as a result of the original decision? Will these still be valid?
  • Ongoing payments: Will those organisations now paying NMW feel they can stop?  Some providers have parked paying out back pay and definitely moved back to flat rate payments going forward. What will be the impact of this decision on the already precarious recruitment situation and poor morale in care?
  • Are commissioners now funding Sleep-Ins on a NMW rate on an ongoing basis? Will they continue pending the Appeal?
  • What about the Social Care Compliance Scheme? This blog from James Taylor of the Access Group suggests it will continue but questions how it will operate.
  • What are HMRC’s instructions about enforcement?
  • What will the government do? “There needs to be a clear set of rules about exactly when NLW applies, and for government to fund these vital statutory services to avoid any future crises. Without this decisive action, our staff remain in an uncertain position with regards to their pay.” 

James Sage from Royds Withy King in the Guardian:

Walker Morris: Bright Line Decision:

Civil Society Article:




Nurseline: At the Forefront of Collaborative Working

Trust. Respect. Collaboration.

Collaborative working in health and social care delivers many benefits and opportunities both to the individual being supported and those who make up their network of support. By working in partnership with professionals, organisations and family members, social and healthcare providers are able to tailor approaches and services to meet the individual’s care and support needs – helping each person achieve their goals and aspirations.

As Trevor Mapondera, CEO, Nurseline Healthcare, comments: “Social care is at the forefront of employing innovative collaborative working practices which have a real benefit not only to the service users being supported and their loved ones, but also for everyone involved in the individual’s network of support.”

Research into the benefits of collaborative working has been undertaken by many respected institutions including Oxford University. The findings of one piece of research into collaborative working in healthcare, clearly demonstrates that patient outcomes, quality of care and the cost of care delivery are all optimised when an approach based on trust, respect and collaboration, focused on the care and support needs of the patient or person being supported, is employed.

Key benefits of collaborative working include:

  • sharing of knowledge, best practice, responsibility for planning, risk assessments and decision making
  • development of innovative approaches
  • reducing inefficiencies through integrated services and shared costs 
  • Quality Assurance

Trevor continues: “At Nurseline, we ensure that we provide real ROI whilst consistently delivering high quality care and support. Everyone in The Nurseline Family – the people who work for us, with us, and who are supported by us – are able to benefit from the collaborative approaches we employ and the partnerships we have developed.”

This Autumn, Trevor will be speaking at an event in the South West where he will share his insights into the benefits of collaborative working. 

If you would like to find out more or would like to continue the discussion, please get in touch!

Lucy Osude, Nurseline Healthcare

Career and Jobs Hub Bristol Offer Participation Opportunity

Bristol City Council have introduced an exciting new venture to improve the recruitment crisis in the Care Sector. The Hub operates in the Galleries in Bristol and is open several days a week. You can access the site here

Lucia Dorrington's letter offering Care Providers the opportunity to participate in the hub can be found here, if you missed it.

Barbara Harris
Energy Intensive Industries: Impact on Care Providers

To ensure the UK meets its low carbon targets, the Government has introduced several policies that are driving renewable growth. However, they’ve also increased the cost of electricity and made UK prices higher than in other countries.

To help Energy Intensive Industries (EIIs) in the UK compete with their EU counterparts, the Government suggested they should be exempt from some Third Party Charges (TPCs). The cost of the exemption would be paid for through an increase in costs for non-EII businesses.

Power Direct ask how much this is costing you and what is the impact on your business,

What is the Energy Intensive Industries (EII) exemption costing your business?

In an effort to meet low carbon targets, the government has introduced several policies that are aimed at reducing greenhouse gas emissions by incentivising increases in renewable energy. This has had the effect of driving up retail electricity prices, which in turn, has put pressure on UK businesses to remain competitive with those in other countries that are paying lower energy bills.

In response, the government introduced a scheme to reduce the cost of energy for businesses classed as Energy Intensive Industries (EII), in a bid to ensure that UK businesses can remain competitive. It meant that EIIs should be exempt from the costs of the Renewable Obligations (RO) scheme, the Contracts for Difference (CfD) scheme and the Feed in Tariff (FiT) scheme.

The businesses qualifying for the EII exemption are those where energy usage makes up a significant part of production, such as those within steel, chemicals, engineering and brick-making industries.

What does it mean for your business?

Earlier this month, the government announced that it is now considering widening the eligibility for the current EII exemption.

The proposed changes would mean more British businesses benefiting from a reduction in their energy bills.

But if you’re not one of those qualifying businesses, what impact will it have?

Most businesses won’t be eligible for the EII exemption. It means that, as with the current scheme, these businesses will face higher costs for their energy, in order to subsidise the scheme.

What can you do to minimise the impact?

In order to keep rising energy costs in check, you might find that you will benefit from a fully-fixed, fully inclusive contract that looks to take into account future regulatory and non-energy cost changes. This means you can be confident your costs will remain fully-fixed for the entire period of the contract, and you won’t get any unwelcome surprises along the way!

Next steps

For an informal discussion about the best energy solution for your business, call Power Direct Ltd’s friendly team of energy consultants on +44 (0)1452 347 549



Christie showcase excellent performance

Offer levels for our clients’ healthcare businesses are an impressive 40% ahead of last year and we have concluded 15% more deals via our national network of 16 offices. There is strong demand for all sizes of care homes, with deals brokered on 11 bed facilities through to 80 bed care homes. Buyer demand throughout the UK is from new entrants, existing operators and private equity groups/funds. Contact us now for market leading advice.

Bristol 0117 468 500; Cardiff 02920 023 123; Exeter 01392 285 600

Download the report


Barbara Harris
Cabot Training is a new Commercial Partner

Cabot Training were delighted to join Care and Support South West as commercial partners this summer. Having worked with many organisations including Milestones Trust, Brandon Trust, Care Futures, Newkey, Aspects2 and many more, it was a natural choice to demonstrate to all members that we are more than a training company.

Cabot has a range of associates with a proven track record to grow your business and maximise the potential of your staff. In this Newsletter we get the opportunity to meet the team. For further information contact

Karen Brasier

Karen has experience of working in all of the above organisations and during this time has delivered both ILM Qualifications to hundreds of Senior Support workers and also a range of tailor made training days for managers. It is her belief to inspire individuals to believe in themselves and simply provide them with the confidence to do their job!

Her greatest love is to provide FISH Training! Training that can change mindset and develops a culture of can do  into the workplace.

Samantha Brooks

Sam was in the Army for over 17 years as an Educational and Training Officer. During her years of service, she was involved in the design, development, delivery and evaluation of numerous leadership and management training courses, as well being an experienced facilitator, specialising in the personal development of others. She has taught on numerous ILM courses, as well as general management and leadership, communication and functional skills, values and standards, cultural awareness and equality and diversity.

Paddy Maclennan

Paddy has over 17 years of experience as a human resources manager, after starting his career in sales and marketing. Before starting his own business he was the Head of Personnel, Welfare and Development with Stage Electrics Partnership in Bristol where he ensured the welfare and training of 270 staff

Running a business is highly rewarding but making sure your staff are looked after can take huge amounts of time. While there is no doubt your staff are a huge asset to your business, it’s important to remember that you are, too.

Mary Stoate

Mary worked in the NHS as a radiographer for over 23 years before becoming an independent Management Lecturer and Management and Training Consultant. She has worked in a variety of public and private organisations, designing and delivering ‘in-house’ and accredited programmes.

In addition to her Radiographic and teaching qualifications Mary has the Professional Diploma in Management: Managing Health and Social Care and an MBA

Frances Fawcett (MInstLM, FITOL)

After almost two decades with IT companies including Borland International, Canon (UK) and Microsoft Corporation, Frances spent several years providing marketing consultancy and global programme management to a variety of small and large companies. This included global management of a licensing programme for Microsoft Corporation

Frances is a Practitioner of Neuro Linguistic Programming, a member of the Institute of Leadership and Management, and a Fellow of the Institute of Training and Occupational Learning.

Mik's "Words from the Care Face" 2

Blog 2 – How many inspectors do we need?

Our The issues we face report was developed from a series of conversations with Registered Managers and people providing care and support services. It is designed to provide a voice for the sector based on the actual experiences of those who work in it. 

Providers find themselves inspected by CQC, local authority quality assurance or contract compliance teams and at times Healthwatch. All of these bodies have slightly different approaches and report on their findings. Providers are told public money is tight and experience this in their day to day operations and yet there is funding for three different bodies to come in and effectively do the same job.

Often these organisations have slightly different thoughts about what they want to see and yet providers who are already busy can’t be running parallel systems. They need to be running a single set of systems.

Would it not be better to have a single inspection body (potentially with representatives from these different stakeholders) and one agreed approach?

Would it also not be better for the regulator(s) to provide documents and templates which they agree represent Best Practice and which providers can use as a baseline and adapt them to meet their own requirements? Then people don’t have to second guess what’s wanted and to keep reinventing the wheel.

Providers appreciate having inspectors who they can talk to and who can offer them advice. Would it be better to have an ongoing and supportive relationship between services and their regulator(s) so that inspections can reflect a more thorough and ongoing assessment of a service rather than the current ‘snapshot’?

What are your thoughts?

If you are interested in looking at the full ‘The issues we face’ report, you can download a copy here.

Alarm at CMA Guidance and Support from RWK

At the conference, Royds Withy King spoke of their concern at the impact of the new proposals in the report from the CMA enquiry into the care market and offer support to Care Association members. They emphasis that their focus is to protect the Care Provider whereas the CMA look to protect the consumer only.

"It is now becoming clearer to us that it is imperative that care providers review their service user contracts. There is more information about our service user contracts on our website here and there are downloadable documents with more information below.

The Care Association Alliance say: 

"The draft CMA Guidance came out last week and is far more extensive than we expected. As a result we think most providers are going to have to make changes to their contracts and admissions processes in order to be compliant, particularly around the following:

1.       The provision of prescribed information to prospective residents at three separate stages: on first contact, before they accept an offer of a place and on confirmation and finalisation of the offer

2.       Charging of upfront fees and deposits

3.       Charging fees on death.

4.       Increasing fees

5.       The use of guarantors

6.       FNC payments

7.       Fees when a person is absent"

Royds Withy King are offering a model contract with guidance notes at discounted rates (with 5% rebate for the care association). The discount is dependent upon the numbers of members who sign up. There is a separate contract for residential/nursing and homecare."

They are also offering a bespoke option if providers want a tailored version of the contract and detailed advice on implementation.

These attachments provide full details:

Conference Commentary, Slides and Downloads

The C&SW Conference enjoyed record numbers of delegates and exhibitors this year and for the first time was sponsored by three of our Commercial Partners; Care Planner, Nurseline Healthcare and Nourish Care. The delegate numbers were north of 150 and the exhibitors numbered around 23.

Opening the day: David Smallacombe (CEO Care and Support West) opened the day by inviting the three sponsors to say a few words about why they had decided to become commercial partners with C&SW and why in particular they had agreed to sponsor the event.  He went on to set out the kind of support C&SW members could expect from him, Angela Roberts (Dep CEO), Mik Alban (Development Director) and Barbara Harris (IT support and newsletter writer) and closed his introduction by inviting non-members present to sign up to be a C&SW member via a special conference day deal on cost.  

The keynote speakers were Mei-Ling Huang (Royds Withy King Legal) and Professor Martin Green (Care England) in the morning and Deborah Ivanova (CQC) and Mick Feather (Citation --- also a C&SW commercial partner) in the afternoon. The remaining time in both the morning and afternoon programme was taken up with round table delegate discussions focused on what the keynote speakers had presented. The keynote PPT slides can be accessed via the links in this document; notes from the round table discussions are both on the C&SW web site and can be accessed here: Notes on Innovation

Mei-Ling’s presentation and talk focused on Service User Contracts, CQC and Local Authority Commissioners while Martin's presentation highlighted the importance of Sustainability, Maintenance and Growth. Both were variously critical of Local Authority Commissioners, CQC and Central Government and in particular Martin expressed his dissatisfaction with the latest boost to health funding making a total investment from government of £148b while social care sits at £18b. Mei wondered about local authority processes and highlighted the recent Competition Market Authority’s move to challenge care provider self-funder service users contracts and warned that both the CMA and CQC would be looking to focus on these. One of the highlights of the morning was a challenge to Martin Green from the delegate audience by a local authority commissioner. A couple of sparing rounds between them certainly livened up the audience!! 

The afternoon session saw a focus in Debbie's presentation on CQC and its task to Maintain Quality in Regulated Services while Mick chose to go with Improving Care Ratings and Keeping Quality Visible. Debbie, as you will see from her PPT slides had a great deal to say about the first element of the four CQC strategic priorities i.e. 1. encouraging improvement through innovation and sustainability in care. Mick's presentation took the audience through a number of the new KLOE’s and linked them to how best providers can improve their care ratings at the same time as keeping quality firmly at the centre of their work in order to obtain an Outstanding rating. He reminded people that always aiming for Outstanding is the route to take rather than being happy with Good!!

Some comments from speakers and delegates/Exhibitors

I thought it was a great event.  Thanks very much for allowing us to speak.  The joint session with Martin Green was fun and, I think, useful.

My reflections on the day are that it was great to see such a big and varied group of providers, managers and others come together all with a view to improving care and strengthening the sector.  There are a lot of issues to be managed these days but it’s heartening to know that CSW members have the can-do spirit and determination required not just to “stay alive” but to thrive. 

I thought the conference was an excellent opportunity for the care sector to come together, and to look at the current challenges, but also think about the way in which we can develop a diversify to meet these challenges”

Thanks for organising such a stimulating conference. It was useful to have the opportunity to be both a delegate and an exhibitor which is a helpful feature of C&SW conferences. It was perhaps the smoothest of starts that I have had: very easy to get set up and made to feel welcome. The day was well organised. 

Closing the day Len Collacott (Chair of C&SW) said:

"Firstly a few thankyous.  I am sure we all agree that this has been, as usual, a great conference. That takes a great amount of work so we need to thank David Smallacombe for his time energy and efforts (and his team). And a great thank you to all our thought provoking speakers. I wanted to do a brief recap of today’s event and mark out some of what I thought were the highlights.

·         Trevor from Nurseline- a great introduction. I have to question him- when he said ‘we will be using this service in 50 years’ time’- not me mate- at my age. We will have to get going a lot quicker than that!

·         Mei Ling- Always our X factor- often the fear factor- and always reminds me of the Gladiators. Contenders, are you ready?!

·         Martin Green- as entertaining as ever. This time he came as a double act with Vince, the commissioner from BANES.  We have to give a 10/10 to Vince for his willingness to stand his corner. It was good to have 3 rounds between Martin and Vince. Many thanks.

·         Debbie- Terrific to get the thoughts direct from the horse’s mouth of CQC. I do have to wonder though about the variance between what Debbie said about CQC looking to give support and guidance and what Martin said about CQC and its culture of being too ready to take enforcement action.

.         Mik Feather- A great opening song. What I took from Mik’s performance was from the same song sheet as Sean Fitzpatrick, the former All Blacks captain who said ‘In order to win, you just have to do the simple things well’ That is very true and his advice to remain calm when the CQC inspector arrives is very valid.

So, we face challenges. The biggest one is the integration of health and social care. That needs to be taken on seriously and speeded up. Martin has just told us the figures. A budget of £148billion for health and £18billion for social care. I want us to get our hands on a good deal of that because I am convinced that we, our industry, can provide much better value for money with it and we will all benefit.

Many thanks for attending today and have a safe journey home."


Mik Alban's 'Words from the Care Face'

What do you think social care staff are worth?

Our The issues we face report was developed from a series of conversations with Registered Managers and people providing care and support services. It is designed to provide a voice for the sector based on the actual experiences of those who work in it. 

It is well documented that the sector is facing significant pressures not least in relation to insufficient funding and an inability to recruit and retain the staff it needs. In order for the sector to survive never mind thrive, things will have to change. We make a series of recommendations throughout the report which are designed to resolve the issues we face. We would like to use this blog to share some of these recommendations with you and to get your thoughts.

In their 2017 ‘The adult social care sector and workforce’ report, Skills for Care highlight that the average staff turnover for staff directly employed in the adult social care sector is 32% ad that this rises to 39.5% for front line care workers. The average turnover rate across all sectors is estimated to be in the region of 15% so the social care sector clearly has a specific problem in retaining staff.  

When we spoke to managers about this they were clear that:

#  staff recruitment and retention are as bad as it has ever been despite them dedicating more time and effort to it.

#  Non-UK nationals are a vital part of many staff teams. Without them many services would increasingly struggle to operate.

#  Pay rates are a key issue. Care and support work is not a minimum wage job and staff can earn the same or more in other sectors without the same level of stress, responsibility and disruption to their lives.

#  Many people are either unable or unwilling to work the anti-social hours and shift patterns required in social care.

The Care and Support Statutory Guidance (The statutory guidance to the Care Act 2014) which is the guidance that local authorities need to follow states:

“People working in the care sector play a central role in providing high quality services. Local authorities must consider how to help foster, enhance and appropriately incentivise this vital workforce to underpin effective, high quality services ...” (Chapter 4.28)

“It should also allow retention of staff commensurate with delivering services to the agreed quality, and encourage innovation and improvement”. (Chapter 4.31)

There is clearly work to do.

In order to create a payment model for staff which would encourage their recruitment and retention and enable the sector to meet the requirements society has of it both now and in the future, we recommend:

1.    Basic rates of pay for front line care and support staff need to be sufficiently above the National Minimum / Living Wage to enable the sector to recruit the staff it needs.

2.    The ‘actual’ Living Wage as advocated by the Living Wage Foundation is used as a starting point. This is currently £8.75 an hour outside London. We believe staff working in this sector deserve an actual living wage. Using this as the baseline values staff and sends out the right message.

3.    There should be a pay enhancement to recompense staff for working anti-social hours.

4.    There should be a pay enhancement for staff who are required to work split shifts or to lone work.

5.    There should be a pay enhancement for staff who are required to support or care for people with complex needs.

6.    There should be a pay enhancement to reward experience / length of service.

7.    There should be further incentivising premiums for staff to take on greater levels of responsibility i.e. Senior Carers, Senior Support Workers, Team Leaders, Deputy Managers.  

What are your thoughts? Will the sector survive unless we can financially reward people properly for the work that they do?

If you are interested in looking at the full ‘The issues we face’ report, you can download a copy here.


There was a record number of nominations this year demonstrating the breadth of care delivered by social care providers across the region and beyond. The panel met in June to discuss the nominees and agreed on the finalists in each category. You can see the list here .

Bookings are now being taken for the Awards Gala Dinner at the Ashton Gate Football Stadium on 20th October. You can make your booking here


It is Stop Abuse Week next week. It's important that the care sector get behind this initiative to help stamp out abuse. Here are some materials to help improve awareness.

Here are 10 signs of possible Adult Abuse cited by Bristol Safeguarding team; you can share these with staff.

  1. Look out for unexplained bruises and injuries
  2. Be alert to subtle changes in behaviour – take note if is someone very subdued, has lost their self-esteem or changes how they act in the presence of a particular person
  3. If a person begins to isolate themselves and stops seeing friends and family it may be a sign that something is wrong
  4. Any change in appetite and weight loss or gain can be a cause for concern
  5. Unexplained signs of distress, tearfulness or anger may signal a problem
  6. If someone has possessions go missing, an unexplained lack of money or failure to pay bills this may be a sign of financial abuse
  7. Being unclean, unkempt or hungry may signal neglect or self-neglect
  8. Discouraging visits from relatives or friends on a regular basis should raise alarm bell
  9. Missed appointments – failing to show up at GP appointments or regular meetings could be a cause for concern
  10. If someone shows unusual distress at being close to someone, or at receiving personal care, this could be a sign of physical or sexual abuse

Signs of abuse can often be difficult to detect, so it’s important to trust your gut instinct. If in doubt, speak out.