Care Fees Planning

Care Sector Briefing

What will your care sector business be doing over the next 5 years?

A recent Barclays Bank online provider survey showed that 65% of care home operators believe the National Living Wage will affect the viability of their business. According to  Paul Birley, Head of Healthcare at Barclays the care sector challenges are evolving;  ‘3 years ago our survey said the biggest issue was reputational risk, last year it was fee cuts. This year staffing and recruitment is uppermost in most providers’ minds’.

Phil Burgan of MMCG Care Homes is concerned  ‘ Even if some of this plays out, it means that so many providers will, over the next 5 years, be juggling with business viability, struggling to pay the wages but resisting reducing staff numbers in order to maintain quality, and/ or organising a measured and timely withdrawal from the market. Real Time management information and good to outstanding CQC reports will become key. In the meantime, we see that the Care Quality Commission (CQC) will be using the next five years to reinvent itself.

It is evident that CQC needs to get this iteration of its strategy right. In practical terms it needs to warm up to challenge and be prepared to respond with the evidence to support its argument and be transparent. A good way to gain respect is to work with providers who have person centred care at the core of everything that they do. Advice and guidance is no bad thing and contributes to a more respectful and understanding atmosphere. The care sector wants and needs a regulator.

Let’s have a look at whether what needs to be done is reflected in what CQC proposes should be done over the next five years. The consultation period is almost over at the time of writing this but it will be interesting to study the comparison. In their consultation, CQC have chosen 6 main themes:

  1. Improving its use of data and information
  2. Implementing a single shared view of quality
  3. Targeting and tailoring its inspection activity
  4. Developing a more flexible approach to registration
  5. Assessing how well hospitals use resources
  6. Developing methods to assess quality for populations and across local areas

The data issue is difficult for the social care sector whereas hospitals are much easier to collect data on. There is pressure for providers to ensure their NHS Choices information is monitored and kept up to date, and to ensure

that their local authority information portals are also monitored and kept up to date. If they do not, then local commissioners will not be able to see vacancies in care homes and channel placements.

The need for a single shared view of quality has been around for a long time. Certainly, providers have been asking for this for years but by pulling away from inspecting Local Authorities (LA), CQC may well have made it very difficult for them to make any progress unless they reverse their decision to keep away from LAs. The sector as whole would also like to see NHS commissioners included in the regulatory perspective as well as LAs. Without this in place first, then it is difficult to see how CQC will be able to influence a single view of quality.

Care Sector Challenges

There is a lot of alliteration in the next strategic objective but it could so easily be taken as meaning cutting to size and narrowing the focus. If this is so, the danger is that the frequency of onsite inspections may reduce, largely because CQC has to operate within a tightening budget (we have seen evidence of this when experts by experience hourly rates were under threat of halving). Continued and increasing gaps between inspections could put the provider and residents at risk.

Of course the registration process needs attention. The fact that this has become a strategic objective suggests that CQC recognise how important it is to improve the process and make it easier where the registrants are already known to them.

The efficient use of resources should always be in the top line of strategic business planning. In terms of how this translates to social care, hospitals would do well to focus on their discharge processes to minimise delays and thereby save money as well as beds. The money saved can move across to social care via the Better Care Fund.

The final objective needs some careful thought. A lot has been said about creating care pathways for people so that the journey for them is transparent and clear, having a single care manager and point of contact. The Symphony Project in Somerset is what this is all about and the Better Care Fund is the financial vehicle. It can only work if health and social care are fully integrated and there is a single budget to fund the care pathway. There is an opportunity not to be missed for the regulator to encourage integration both financially and culturally.

It will certainly be interesting to see the published conclusions from the consultation later in May 2016.

If you’d like a free consultation for your business please do not hesitate to contact our specialist care team, they’ll be happy to discuss all care sector challenges with you.


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