Falls, Tech

Spotlight on Falls – The voices of lived experience

 

Falls are one of the most feared health emergencies for older people and their families. In our three-part series, we are shining a spotlight on falls, the changes we aspire to make and the impact these will have in reducing falls. We continue this series by hearing from our residents, relatives and staff about their personal and professional experiences of falls.

We know that falls are something our residents and their families dread – and with good reason – as we looked at in our first blog in this series that detailed the impact and implications when a person has a fall.

It’s very important to us, as we explore the latest technology around falls detection and prevention, that we understand first-hand about our residents’ and relatives’ experiences of falls and how they feel about the technological solutions we are considering.

 

What our residents and relatives say about their experiences of falls

Don lives with us at Bartlett’s and told us:

I was a runner, I enjoyed running. I’ve always been willing to test myself, going a little further is always important for me, pushing boundaries, and that’s still there in walking.

My balance over the last year has been deteriorating. I started off by denying I needed a walking stick, then realised it was probably advisable to carry one. So, I carry a stick and try not to use it. I go out for a walk and carry it. I start with leaning on the stick, realise my balance is ok, then I pick the stick up and walk with it.

I have some consciousness of my vulnerability to falls. The most alarming is falling backwards. That doesn’t happen often… It’s when I get tired that my vulnerability to falls is raised. Yesterday I wanted to sit down on the edge of the bed and I missed it. I didn’t hurt myself; I fell on my backside, picked myself up and carried on. But it was a warning to be careful.

Andrea told us about her experiences of caring for her dad before he moved to Bartlett’s:

Dad had multiple falls, both in the house and out of the house, and I had no idea how to deal with that other than call 999. 

Dad calls falls ‘a slow sit down to the floor’. He doesn’t call them falls at all. He gets so tired that he can’t support his weight any more and falls. I don’t think he trips. One time on the drive at his house he fell and crawled on his hands and knees to his car to pull himself up.

I couldn’t be there 24/7 for him, and I would rely on him to either call me to tell me he’s fallen or dad’s pendant alarm company to ring me. But that’s obviously after the event, it’s not helping to prevent the fall.

Heather lives with us at Stone House and told us:

I don’t think of falling, I continue with life, then the beastly falls happen. Recently, I went across the room to take my phone off charge, I didn’t rush, I went quite slowly, but on the way I fell, got my foot trapped and I couldn’t get up. Two nurses who happened to be next door came and got me standing.

I’m not expecting to fall, but unfortunately I do. I lose my balance. I don’t think of it until I go down bang, which is pretty stupid. (Laughs)

Lynn’s mum lives with us at Bartlett’s and told us:

Mum has been getting increasingly unstable and we’ve had two reports now of mum being found on the floor. She’s been fine, but there hasn’t been anybody to witness that (the falls). I don’t think she remembers it, so she can’t report it herself.

Mum used to be somebody who played tennis and badminton and did keep-fit and dog walked two or three times a day. To see her with this frailty and worry about the thought of her lying or sitting on the floor… I feel for her vulnerability and her safety.

Following her mum’s falls, Lynn told us:

Mum’s gait has changed. She definitely needs an arm to lean on, and has a general sense of imbalance and isn’t confident on her feet anymore.

 

What our staff say about how falls impact our residents

Connie is an Administrator at Bartlett’s and told us:

People don’t deliberately fall. You don’t necessarily have that reaction time to think ‘I’ll grab something’. I’ve been on reception, heard a commotion and later found out that it was someone who had a fall in the corridor. It’s quite hard knowing that’s what I heard and later discovering they had an injury, that’s quite tough. Then seeing the knock in their confidence in the coming days. It’s not nice to experience.

Naturally I think some of the residents who are less mobile are more cautious when they are walking. One resident who recently had a fall and was found on the floor, in the coming days she was a lot more hesitant and wary with her steps. Whether she remembered the fall, and on some level emotionally she did, you see that within her. She was almost looking for extra support from staff and had that uncertainty about what to do next.

 

Falls in a person’s own home

As part of our work into falls detection and prevention, we are looking at many different environments – not just those within our Peverel Court Care homes – to understand the challenges for all older people who are vulnerable to falls.

Ruth supports her mum who lives in her own home. Ruth’s mum has had a series of falls, and Ruth recounted her feelings about her mum’s first fall to us:

I was pretty shocked, there was a lot of blood. The hearth was marble, so mum had fallen down on something very hard….. the unsteadiness, there was a trip involved as well… I was very frightened for her. I think we all know that head injuries can result in life changing events and a risk to life, and because of the amount of blood that was there, I felt very shaky… I felt a bit all over the place if I’m honest.

Following her mum’s first fall, Ruth told us:

We felt that mum’s memory had declined. She was finding it quite difficult to recall dates and facts about things. She lost confidence, she didn’t want to leave the house… she didn’t really want to walk. Emotionally, mum is a very strong woman… but what I did notice 6 months later is that mum couldn’t remember having a fall.

 

How can we support older people with earlier detection of falls risks?

Ideally we’d like to be able to prevent every fall, but experts agree that such aims are unrealistic. The focus of current technological solutions is around detecting falls risks, particularly when someone starts to move around, for example by getting out of bed at night. 

Sensor monitoring in resident’s bedrooms is one solution we are considering for Peverel Court Care homes. Sensor monitoring detects changes in noise, picking up when someone starts to move, which could be particularly helpful at night in reducing the number of night-time checks staff do that can disturb residents. We asked our residents and relatives who participated in our research interviews on falls what they thought of this technology.

Don said:

So long as it’s not obtrusive, I won’t notice it. I’m trusting the technology to help me.

Andrea, Don’s daughter, told us:

I wouldn’t want it (sensor monitoring) to totally replace any human checks, but if it could reduce the number of checks staff make that would be useful. It’s not a mistrust of the technology, it’s just nice to see someone in the night if you’re unsure and you’ve woken up. Sometimes dad gets a bit disorientated.

I remember my grandmother, she had a fall and broke her hip, and that was life changing for her. So anything that helps to prevent falls is good.

Lynn echoed Don and Andrea’s views. She said: 

It just seems a real benefit to have some sort of monitoring that is there… overnight in rooms, because who knows when somebody gets out of bed and decides they want to wander around the room or go to the toilet. To have that constantly monitored has got to be a good thing. I know staff pop in every now and again, but things happen in between visits so I think that can only lead to a better outcome.

 

What are the key considerations when introducing new falls detection technology?

Whilst we are keen to explore new falls technology, we know there are many considerations to implementing this to ensure our core values of providing the highest standards of care and support for our residents are upheld.

We explored this topic with Connie who told us:

When we’re looking at the sensor* technology we definitely need to keep the level of privacy, making sure that it’s non-intrusive. 

I think for residents especially, they need to know that there are no trip hazards. For instance, the mats that go on the floor (that we currently use to detect movement), they are potentially a trip hazard. I’ve always wondered why they are used, because I don’t think they’re that effective in preventing falls, which they are designed to alert (us to) if they are on the floor. 

I think with the sensor* monitoring, keeping the autonomy of the resident is really important, that’s one that the residents would say themselves. 

Removing the need for nighttime hourly checks would be really beneficial for residents, especially those with dementia. Sleep is incredibly important, it has an effect on their day-to-day moods, their balance, their lives. I think that would be the main benefit.

 

What’s next?

In our third and final blog of this series, we will look at the future of falls prevention and how different digital solutions and advancing technology can assist us at Peverel Court Care.

 

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.

 

*Sensor monitoring/technology is also referenced as acoustic monitoring/technology by some of our interviewees.

Falls, Tech

Spotlight on Falls

 

Falls are one of the most feared health emergencies for older people and their families. In our three-part series, we will be shining a spotlight on falls, the changes we aspire to make and the impact these will have in reducing falls. We begin by looking at how falls impact older people and the implications for a person when they fall.

The potential to have a fall is something many older people and their families dread. Whether the person lives at home, is in hospital or in a care home, having a fall can have significant and far-reaching consequences. It’s something many health and social care staff also fear and often find difficult to mitigate against and manage. 

 

What do we know about falls?

The 2018 ‘NICE impact report on falls and fragility fractures’ said:

Older people are more likely to fall. They are also more likely to suffer significant consequences, such as a loss of independence and confidence, leading to physical and mental deterioration and frailty. This increases the risk of a person experiencing multimorbidity, which is when a person has 2 or more long-term health conditions. It can also increase their risk of further falls and fractures.

In 2015/16, NHS Improvement reported that 204,269 inpatient falls were voluntarily reported by acute trusts, with a fall rate of 2.8 falls per 100 patients. However, many falls occur at home and go unreported, so the true incidence of all falls is unknown. It is estimated that approximately 30% of people older than 65 fall at least once a year; this is around 3 million people in England.

The 2022 Age and Ageing Journal published the first ‘World guidelines for falls prevention and management for older adults’ that said: 

Falls occur at all ages and are an inevitable part of a bipedal gait and physical activity. They occur in 30% of adults aged over 65 years annually, for whom the consequences are more serious, despite concerted efforts of researchers and clinicians to understand, assess and manage their risks and causes. In addition to personal distress, falls and fall-related injuries are a serious health care problem because of their association with subsequent morbidity, disability, hospitalisation, institutionalisation and mortality.

In Europe, total deaths and disability-adjusted life years due to falls have increased steadily since 1990. The Global Burden of Disease study reported nearly 17 million years of life lost from falls in 2017. Related societal and economic consequences are substantial. In high-income countries, approximately 1% of health care costs are fall-related expenditures.

Note: NICE (National Institute for Health and Care Excellence) are currently updating their guidance on Falls and their new recommendations will be published in August 2024.

 

Falls and care homes

With these statistics in mind our Associate Director, Preet Shergill, has made falls the subject of his NHS Digital Academy TOPOL Fellowship (TOPOL Fellowships were borne out of the 2019 Review conducted by Eric Topol MD entitled ‘Preparing the healthcare workforce to deliver the digital future’). In his first blog for the NHS Digital Academy about his fellowship entitled ‘Empowering social care through digital innovation: My Topol Digital Fellowship journey’ Preet said:

The public health data highlights the urgent need for falls prevention strategies, given the impending exponential growth in the 85+ age group. In my local county of Buckinghamshire, the number of people over 85 is projected to rise by 78% over the next 12 years. The total annual cost of fragility fractures to the UK, including social care, is estimated at £4.4 billion.

 

What are the current challenges around falls?

As we go into the autumn and winter seasons, falls join flu, Covid and many other seasonal challenges making NHS-related headlines every year. Falls outside are more likely in cold and icy conditions, and falls inside become more common when people are unwell with infections and more confused, tired or struggling with their balance.

Once a person has a fall, shock and distress are highly likely, making the psychological impact immediate. The physical consequences can, at worst, mean broken bones – hip fractures are especially common and often life-changing or life-shortening – and, if the person has hit their head, potentially the consequences can be fatal. 

Even if these worst-case scenarios are avoided, a fall often means going to hospital for a precautionary scan and tests, an in-patient stay may be needed, pain may be difficult to assess and control, and bruising and any cuts can take a long time to heal. 

With extended waiting times for ambulances, overstretched A and E departments, shortages of beds on wards, and the difficulties for an older person or a person with dementia when they are in an unfamiliar environment (that can often lead to further falls, loss of independence, weight loss and incontinence), going to hospital alone can be a traumatic experience.

Even if a person’s physical injuries heal, the physiological ones often remain. The person may repeatedly think about how they fell and what the cause was. They may become fearful of walking, or lose confidence in maintaining aspects of their independence that they feel may have either led to their fall or could lead to another fall. It then becomes a vicious circle of reduced mobility, with the physical consequences of pressure ulcer risks and greater chances of infections like UTI’s, and greater dependence, which can often erode feelings of self-worth and self-esteem.

 

Falls matter to everyone

Because falls have such a massive impact on the lives of people who fall and their families, we believe they are a vital issue for us to understand more about. We need to find innovative ways to prevent falls and, should a fall still occur, manage a person’s recovery as effectively as possible through modern rehabilitation techniques – like our personalised, at-home physio service – to ensure the best quality of life for our residents.

We will never be able to prevent every fall, or indeed the physical and psychological effects a person may be living with from a fall prior to moving into a Peverel Court Care Home. What we can do, however, is change the narrative and our approaches to find new solutions and ways of thinking.

 

What’s next?

In our second blog of this series, we will hear from some of our residents, families, staff and other healthcare professionals about their personal and professional experiences of falls. We will also discuss how digital transformation can lead to a positive impact in reducing falls.

 

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.

Events, Wellbeing

The benefits of Animal Therapy in Care Homes

 

Amazing Animals Therapy Monkeys – Stone House Nursing Home.

Who?

Here at Amazing Animals, we have been involved in the professional training and supplying of a wide range of animals for the media industry for four decades. Established in 1977, our company has the largest workforce of qualified and experienced animal experts for this type of work in the UK. 

https://www.amazinganimals.co.uk/ 

Why?

As care specialists, Peverel Court Care know how much of a positive effect animal therapy can have on those living with dementia. That’s why we welcomed therapy monkeys from Amazing Animals to Stone House Nursing Home. 

Making invaluable connections and partnerships with organisations, such as Amazing Animals, helps to enrich the lives of those residing with us, many of those living with dementia. Interaction with animals has well-documented benefits to older people mentally, emotionally and physically, by improving emotional, social and cognitive abilities. 

When visiting our homes, animals help improve the lives of our residents, including those living with dementia, by bettering motor skills, making them feel happier and lifted, encouraging interaction and also triggering reminiscing conversations. 

 

 

Testimonials 

Resident – Ronnie Cann:

What did you think of the experience? – “Amazing, the best thing I’ve ever seen!”

Would you like to experience it again? – “Yes, I would!”

Resident – Olive Nicolle:

What did you think of the experience? “I loved it, I saw similar monkeys on the nature programme last night!” [laughing]

Would you like to experience it again? “Yes definitely, it was nice to meet them.”

Resident – Philippa Graham:

What did you think of the experience? “It was funny, they visited me in my room. They were very cute!” [laughing]

Would you like to experience it again? “Yes, I would thank you.”

 

 

Business, Community, Leadership & Management, Real life, Social Care & Society, Stone House, Training & Development, Wellbeing, Workforce Development

“I like to think I make a difference in the residents’ lives every day”. An interview with Becky Hannigan

Becky Hannigan Carer at Stone House Peverel Court Care

 

It’s been a challenging year for the adult care sector. As we approach the end of 2020, we thought it would be a good time to catch up with one of our team to find out how they’re feeling.

 

For most of our team, choosing a career working in adult social care isn’t based purely on the money they will earn. There are far more holistic benefits for carers; from the sense of satisfaction they gain from helping residents to the feeling of their colleagues being like an extended family.

We spoke to Becky Hannigan, who is 25 and one of the younger carers at Stone House Nursing Care Home near Aylesbury in Buckinghamshire. We asked her about her experience of working for Peverel Court Care and the benefits, and challenges, of life as a carer.

 

How long have you been a part of the Peverel Court Care team?

I have worked at Peverel Court Care for 3 years and 9 months now. Stone House has been a bit like an extended family to me, we’re all very close.

 

What were you doing before you joined us at Stone House?

Before working at Peverel Court I volunteered in the foundation years in a Primary School and then went on to catering for nearly 2 years.

 

What made you decide that a career in care was a good option for you?

I’ve always had a great interest in the healthcare sector, especially since my family have been in the healthcare profession for generations. Stone House is very close to my heart too, as my Grandad & Nanny lived there during their time as nurses for St John’s Hospital in Stone.

 

How have you found the reality of working in care, compared to what you were expecting?

It’s more challenging than I first thought. A lot of people come into it thinking it’s going to be an easy job. It’s mentally challenging as well as physically. I didn’t realise the kind of connections you make with the people around you; they become like a second family and it can make the job much more special and rewarding.

 

With the media coverage of COVID this year, did you have any concerns about working in a care home during this period?

I’d be lying if I said I didn’t have concerns. It was an uncertain time and everyone was a bit worried, but my biggest concern – and what I think helped me get through it – was focusing on my residents. Not only in keeping them safe, but to keep life as normal as possible for them and to prevent them from feeling lonely or isolated with not having visitors in.

 

Do you as feel safe as is reasonably possible working in Stone House?

I do feel safe working at Stone House. I have a great team by my side and we are very open and honest with each other. Especially during the challenges that this year has thrown our way, we have regular team meetings to discuss new guidelines, to ask any questions or raise any concerns we might have. We also have weekly swab tests, which provides great reassurance and allows me to be able to fulfil my job with confidence. I think it’s important knowing you have a safe space and team around you.

 

Do you think there is any more we could be doing to protect staff and residents?

No, I think Peverel Court does a great job with that already.

 

How well supported do you feel by management and colleagues?

I feel really well supported in my role by my manager and the rest of the team. For example, a resident recently passed away which was quite upsetting for me. My manager asked to see me privately away from everyone to make sure I was okay and if there was anything I needed or he could do to help.

 

We aim to make all of our team feel valued and appreciated; does that come across as we hope?

I do feel valued and appreciated, for example working over the past 6 months has been challenging and uncertain and receiving vouchers as a thanks for our hard work was uplifting and rewarding. It was a nice surprise for us in a difficult time. Also with Perkbox and the perks we receive from that as well as “Employee of the Quarter” where we also receive vouchers helps us to feel valued.

 

Do you have any tips on anything we could do to improve our recruiting and onboarding process?

Have regular private meetings with new staff, just to see how they are getting on and if anyone is struggling as it is a very challenging but rewarding job.

 

In what ways do you feel like you’re able to make a difference to the team and to our residents?

I like to think I make a difference in the residents’ lives every day. I’ve found that in this job it’s the small things that go a long way, such as just sitting and having a cup of tea with a resident and taking the time to chat about their day can improve their mood. Also setting up a small church session with bible readings, prayers and singing along to hymns has made a massive difference for them to still be able to receive their religious and spiritual needs.

 

How do you see your future in the care sector progressing?

Since I started at Peverel Court Care I have experienced a few different roles. For example I have worked as a laundry assistant, domestic assistant, I worked in the kitchen. I now provide care as well as my role as an activity coordinator. During my time here I have also seen more of the clinical side of things; that has peaked my interest and got me thinking I might like to do a course in nursing and progress within the company in that way, as I have seen others do.

 

Would you recommend a career in adult social care, and in particular with Peverel Court Care, to your friends, family or others considering a future in care?

I have previously recommended people to work at Peverel Court Care such as my cousin and my close friend. I will continue to recommend people as I feel it is a very rewarding job and the homes have a family feel to them.

 

Is there anything else you’d like to add about your experiences of working for Peverel Court Care, or in the adult care sector in general?

Peverel Court Care has shaped me as a person and helped my knowledge and confidence grow. I have learned to be more understanding and patient towards cognitive impairment as this is something I had not experienced before working in adult care. In my personal opinion everyone should take the opportunity to work in adult care at some point as it is an amazing learning experience and has taught me some valuable life lessons.

 

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.

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.

Workforce Development

Happy staff means happy residents

At Peverel Court Care, it isn’t just our responsibility to look after our residents, but also to take care of our staff.

We have dozens of care staff working daily in our three care homes; Bartletts Residential Care Home, Stone House Nursing Care Home and Merryfield Nursing Care Home. We know that the way they feel about their work directly affects our residents.

We were surprised to hear recently that despite social care being the most popular of all apprenticeships for young people for the fourth consecutive year, more people are leaving care and support roles than any other sector.

If staff are leaving at an unsustainable rate then they aren’t happy. A rapidly changing workforce and unsatisfied staff are not in the best interest of residents. Unhappy staff don’t deliver good care.

For residents, those who take care of them are like a second family. Daily contact with skilled staff is the least residents expect. At Peverel Court Care, we go the extra mile, making sure that our staff are recruited with the right values and, just as importantly, feel happy, supported and comfortable.

One of the ways we make sure this happens is by working hard to make sure staff feel supported and appreciated every time they come to work.

Beverley Webb is Senior Care Lead and has worked with Peverel Court Care for nine years. She says she has no concerns about feeling underappreciated.

“Peverel Court Care have provided me with all mandatory training, as well as desired training. They have an open door policy if I have any concerns or queries or require information. They’re always there to help.”

Beverley says that this dedication to her wellbeing makes her job enjoyable.

“I am able to give one hundred percent commitment and feel I am valued in all I do within the company from all levels, from junior care staff to the manager and above.”

We want to be sure that we’re giving our residents the best care possible, so we’re dedicated to doing all we can to encourage our staff to stay working with us. They’re on our frontlines and looking after our residents every single day, so we need to be sure they’re committed to providing the same level of high quality care that we are as an organisation. If we invest in taking care of them, we know they’ll be extra committed to maintaining the high standards we expect them to.

Beverley believes that Peverel Court Care’s commitment to her wellbeing has a direct impact on the care and attention she provides.

“I look forward to coming into work and have a smile on my face, which has a tremendous effect on our residents.”

Taking care of residents and looking after our employees go hand in hand at Peverel Court Care, and that’s why we know that we provide some of the best care available.

If you want to hear more about our team, please visit our About Us page. If you’re interested in working with us, please have a look at our ‘Work With Us’ page.

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