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CQC Strategy and our plans

CQC Strategy and our plans at Peverel Court Care

 

The Care Quality Commission (CQC) have launched a new strategy which is aimed at changing the way in which care is regulated, so as to improve service delivery for users. We decided to explore how the new CQC strategy will impact the sector, and were pleased to find that at Peverel Court Care we already have projects in progress that align with all four pillars of the new strategy.

 

Whilst announcing the new strategy, the CQC have declared their ambitions for the positive impact it will have on the provision of care services across the country:

What we’ve learned from the past five years puts us in a better position for the future. Our new strategy combines this learning and experience and we’ve developed it with valuable contributions from the public, service providers and all our partners. It means our regulation will be more relevant to the way care is now delivered, more flexible to manage risk and uncertainty, and will enable us to respond in a quicker and more proportionate way as the health and care environment continues to evolve.

This new strategy strengthens our commitment to deliver our purpose: to ensure health and care services provide people with safe, effective, compassionate, high-quality care and to encourage those services to improve. Our strategy is purposefully ambitious, and to implement it we will need to work closely with others to make it a reality. We’ll review this strategy regularly so we can adapt to changes and be prepared for what the future holds.

Our purpose and our role as a regulator won’t change – but how we work will be different.

 

People and communities

CQC Strategy:

Regulation that’s driven by people’s needs and experiences, focusing on what’s important to people and communities when they access, use and move between services

Peverel Court Care:

Two of the five core values on which we focus the Peverel Court Care business directly relate to People and Communities, putting it at the very heart of what we do.

Resident Focus: Commitment to putting our residents first. We develop relationships that make a positive difference in our residents’ lives.
Care For Our Communities: We serve and support a local experience. The unique character of each home is a direct reflection of a community’s people and culture.

During COVID-19, this included our Thinking of You initiative and our innovative use of technology to support both our residents and the community.

 

Smarter regulation

CQC Strategy:

Smarter, more dynamic and flexible regulation that provides up-to-date and high-quality information and ratings, easier ways of working with us and a more proportionate response

Peverel Court Care:

We are acutely aware that the world is constantly evolving, and at Peverel Court Care we’re always looking to be at the forefront of innovation in social care. We have been quick to embrace technology that is able to enhance the service we deliver.

During the COVID-19 pandemic, we were able to quickly implement the use of a number of cutting edge technologies to help mitigate the risks faced by our residents and employees.

Our migration to digital care plans is another example of Peverel Court Care leading the sector to implement solutions which will, in the future, better enable the CQC to remotely monitor and care providers, allowing them to make more timely interventions when necessary. 

It is businesses like ours that blaze a trail which will eventually become ‘the norm’ and facilitate better care across the sector.

 

Safety through learning

CQC Strategy:

Regulating for stronger safety cultures across health and care, prioritising learning and improvement and collaborating to value everyone’s perspectives

Peverel Court Care:

At Peverel Court Care, we firmly believe that ongoing learning and development is integral to maintaining the highest standards of service provision. That’s why we provide our employees with ongoing learning and development opportunities, whatever their role.

We have also introduced a number of career pathways, including for healthcare assistants, supported by learning and development, in order to upskill and train our team for rewarding careers in social care.

 

Accelerating improvement

CQC Strategy:

Enabling health and care services and local systems to access support to help improve the quality of care where it’s needed most

Peverel Court Care:

At Peverel Court Care, we are always keen to embrace new ways of working which will assist our talented team to deliver the best levels of care to our residents. That is one of the reasons why we are helping to shape the future of digital skills in social care by partnering with Skills for Care, Digital Social Care and other stakeholders in developing a resource which can help accelerate innovation in social care across the country.

We have also transitioned to the use of digital care plans which supports the coordination of care teams to ensure that care is still centred around the person. GPs, district nurses and hospitals can all engage remotely with residents based on observations made available to them remotely – enabling coordination to happen between social care and health.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire: Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business, providing exceptional, personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

Care Home Recruitment, Care Management, CQC Inspection, Future of Care, Leadership & Management, Real life, Social Care & Society, Social Care Strategy, Workforce Intelligence

Examining the social care workforce in England

Examining the social care workforce in England - Peverel Court Care

 

As Skills for Care launch their annual ‘State of the Adult Social Care sector and Workforce’ report, we take a look at some of the key findings and how they impact staff recruitment and retention for care businesses in England.

 

Skills for Care are the Sector Skills Council for Adult Social Care in England. They collect workforce data from thousands of care-providing organisations across the public and independent sectors through their National Minimum Dataset for Social Care (NMDS-SC) programme. This data gives us a unique insight into how care businesses are staffed, both regionally and across the country.

Their annual ‘State of the Adult Social Care Sector and Workforce’ report is quite a long read, so we’ve picked out some of the key insights that impact recruitment and retention of staff for care businesses.

 

Turnover of care staff

The turnover rate of staff working in the Adult Social Care sector of 30.8%. This equates to approximately 440,000 leavers in the previous 12 months. It was also shown in the report that Care Workers had the highest turnover rate of direct care-providing roles, at 39.5%; a huge increase of 11.1 percentage points since 2012/13.

Registered Nurses also had a high turnover rate of 34.0%, especially when compared to other regulated professions, such as Social Workers (13.7%) and Occupational Therapists (12.6%).

Around a fifth of Registered Managers left their role in the previous 12 months (22.0%); this was high compared to other managerial roles and equates to around 5,600 leavers in the previous 12 months in total.

 

New starters in care roles

Skills for Care estimates that the rate of new starters in posts over the past 12 months was 39.3%. This equates to around 560,000 workers. Care Workers experienced the highest starter rate, at 48.1%, followed by Registered Nurses at 35.6%.

It should be noted that the starters rate reflects staff that are new to their role. This includes both those who are new to the Adult Social Care sector (34%) and also churn within the sector – which accounts for 66% of the total. This includes those moving between roles or employers; meaning that the sector as a whole has retained the skills and experience of these workers.

However, it also means that a large proportion of employers were going through the recruitment process at any one time, with workers moving between employers with high regularity, and at considerable cost to the sector.

 

Vacancies in the care workforce

There was an estimated increase of 16,500 jobs between 2017 and 2018 in the independent and local authority sectors combined, from a total workforce of 1.36 million to 1.38 million.

Skills for Care estimates that 7.8% of roles in the adult social care sector were vacant at any given time. This represents an average of approximately 122,000 vacancies. The majority, around 77,000, of the vacancies were for Care Worker jobs, with the average vacancy rate for the role 9.0% of the total workforce.

The increase in vacancy rates for direct care-providing roles over recent years could in all probability be linked to the fall in unemployment rates in the UK over that period. Office for National Statistics (ONS) data shows that the unemployment rate was 7.8% in 2012/13, but had fallen to 4.1% by 2018/19. Pay may also be a factor; Retail Assistants earned 13p per hour less than Care Workers in 2012/13, but in 2018/19 earned 10p per hour more on average. This may shift in pay levels may also be contributing to rising vacancy rates within the Adult Social Care sector.

The Registered Nurse vacancy rate was particularly high at 9.9%. This role also had relatively high turnover and starter rates, which is likely a contributory factor to this high vacancy rate. Nurses were added to the UK Shortage Occupation List in 2015 and have remained listed ever since. The Shortage Occupation List is an official list of roles for which the domestic labour market cannot meet the demand to fill vacant posts. Listing is intended to make it easier for employers to recruit migrant workers to fill these vacancies and help reduce skills shortages.

Registered Manager vacancies at 11.4% were double the average of other managerial roles in the sector and equivalent to around 2,900 vacancies at any given point in 2018/19. Skills for Care analysis of Care Quality Commission (CQC) ratings data shows that services without a Registered Manager in post at the time of inspection (or in the year leading up to inspection) were less likely to achieve ‘good’ or ‘outstanding’ CQC ratings.

The overall vacancy rate has risen by 2.3 percentage points between 2012/13 and 2018/19. This rise in vacancies, in the context of a wider workforce that has grown at a slower rate in recent years, suggests that the sector is struggling to keep up with demand as the Adult Social Care sector continues to grow, coupled with the effects of an ageing population.

 

Social and political influences on the care workforce

At present, Brexit does not appear to be a major contributory factor to the high vacancy rate. The number of people with an EU nationality in the Adult Social Care workforce has continued to rise since the referendum. However, according to Skills for Care, Brexit continues to have the potential to cause future supply issues for the Adult Social Care workforce, depending on the immigration rules applied post-Brexit.

Around 84% of the Adult Social Care workforce in the year 2018/19 were British. Around 8%, or approximately 115,000 workers, were of an EU nationality, and 9%, or about 134,000 workers, were of a non-EU nationality. Therefore, on average, the Adult Social Care sector had a slightly greater reliance on non-EU workers than EU Workers. As a whole, the overall nationality of the Adult Social Care sector was more diverse than the population of England, which is 8% non-British. However, there are regional variations: for example London had the highest proportion of non-British workers, followed by the South East. Care businesses in these regions are, therefore, more sensitive to future changes to immigration policy than those in other parts of the country.

The proportion of Registered Nurses who cited British as their nationality increased from 60% in 2012/13 to 64% in 2018/19. Over the same time period, the proportion of Registered Nurses with an EU nationality has risen from 8% to 18%. Non-EU Registered Nurse numbers have therefore fallen considerably in this time.

Following the Government’s white paper on ‘The UK’s future skills-based immigration system’ in December 2018, the specifics of immigration post-Brexit remain unclear. There could be a significant impact on the supply of workers to the Adult Social Care sector in the future.

 

Preparing the care sector for an ageing population

The ‘Projecting Older People Population Information System’ (POPPI) uses figures taken from Office for National Statistics data to estimate the composition of our future population based on age bands. POPPI shows that the number of people aged 65 and above is projected to increase between 2018 and 2035 from 10.2 million to 14.1 million people in England, an increase of around 38%.

Between 2012 and 2017, the population aged 65 and over increased by 2.1% per year on average. This was faster than the population aged 75 and over, which increased by 1.5% per year on average. However, between 2017 and 2018, the population aged 75 and over grew at a faster rate (2.1%) than the over 65 group (1.5%) for the first time. The population aged 75 and over is projected to increase at a faster rate up to 2025, with the highest growth expected between 2020 and 2025 (an 18.8% increase).

Using models, the number of Adult Social Care jobs in each Local Authority area in England were compared with the corresponding number of people aged 65 and over, or aged 75 and over, in the population there. These two factors were found to be strongly correlated. On average, the more people aged 65 and over, or 75 and over, in an area, the larger the Adult Social Care workforce was found to be. The ‘Aged 65 and over’ model shows that, on average in 2018, for every seven people aged 65 and over in the population, one Adult Social Care job was required. The ‘Aged 75 and over’ model shows that, on average in 2018, for every three people aged 75 and over in the population, one adult social care job was required.

These models were then applied to POPPI estimates of the number of people aged 65 and over, and 75 and over, in 2020, 2025, 2030 and 2035 to create a forecast for the number of Adult Social Care jobs required going forward. The models project that if the Adult Social Care workforce grows proportionally to the projected number of people aged 65 and over in the population, then a 36% increase (580,000 new jobs) will be required by 2035. If the workforce grows proportionally to the number of people aged 75 and over in the population, then a 50% increase (800,000 new jobs) will be required by 2035.

 

Successful recruitment and retention leads to successful care businesses

Skills for Care published research in which employers with a staff turnover rate of less than 10% were asked to consider what they believe contributes to their success, in relation to recruitment and retention. Results included:

      • investing in learning and development (94%)
      • embedding the values of the organisation (92%)
      • celebrating the organisation’s and individual achievements (86%)
      • involving colleagues in decision making (81%)

At Peverel Court Care we have taken a number of measures to aid us with retaining our fantastic staff, including our learning and development programme and the introduction of career pathways for a number of roles. We have also implemented a Recognition and Rewards programme for our team, so we can constantly remind them how valued they are by our management team.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire: Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business, providing personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

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