February 15, 2021

Article

Julie Hopkins, Albert Goodman’s Care Sector Business Developer and Consultant, shares her thoughts on what the sector learnt in 2020 and looks ahead to what providers should consider in 2021.

2020, the year that most of us wish to forget, saw a rampaging Pandemic with a virus continuing to evolve. But science is evolving too and by Spring the most vulnerable in society will at least have been offered their first vaccine, with take up appearing strong in the UK.

At the time of writing this article for the Spring newsletter the Government has announced a further grant for care providers in the form of a ‘Staff Capacity Fund,’ to increase workforce capacity and testing capabilities. With the usual Winter pressures aggravated by Covid-19 causing staff absenteeism, the news was welcomed by care sector Influencers. Only time will tell if it is enough to help stem a workforce crisis.

The NHS is reaching its limits, seeking to discharge patients deemed medically fit to continue their recovery journey in designated care homes, care hotels, and non-designated care homes for longer stays. Those returning to their own homes will be calling upon family members to help, in the midst of the shortage of NHS step-down assistance and community provision.

As the vaccine roll-out continues with the springing up of vaccination centres and a growing army of fully trained vaccinators, the Government has confirmed a target of September for the first vaccine mission. This will result in a gradual phasing out of the lockdown tier system, with continued R-rate monitoring and the economy and more normal daily routines opening up again.

As we learn more about the virus and its evolution so too we will probably learn to live with it. Lessons have and will be learnt, with businesses continuing to evolve and adapt. The care sector has adapted too, after initially slow and confusing guidance. What is now known will be built into current and future business continuity plans.

An increase in occupancy and new businesses

The pandemic resulted in a decrease in care home occupancy as people had a tendency to seek help from family, and domiciliary and supported living care. However, with care homes a priority in the first vaccine roll-out it is anticipated that there will be a return to the care home setting for the more complex and 24/7 care service. New domiciliary and supported living businesses will start up, and franchise care businesses will evolve, to support an ageing population that seeks to live at home as independently as possible until their last few months/years. Thus, the care home offering will see a continued increase in nursing and dementia services, which reflect the increased complexity of an ageing population in the next decade and beyond.

Rethinking design

Covid-19 has affected the design of existing facilities and new care homes, reinforcing the need to update and refurbish, consider larger rooms for social distancing, wet rooms, additional storage space, larger corridors, visitor pods, and increased landscaping for outdoor areas.

The retirement village concept continues in its infancy in the UK and is expected to grow over the next decade, as the baby boom generation seeks to retire and downsize.

Sales and acquisitions on the rise

In 2021 we are expecting to see an upturn in sales and acquisitions in the care market, as pent-up demand returns to the table. The pandemic has resulted in increased financial due diligence, and this is expected to continue. If you’re looking to exit, it is advisable to look at your current business structure and decide whether it is fit for purpose prior to going to market. On the other hand if, as a provider, you are seeking to grow your service, looking at your business structure in what will be an evolving tax climate in 2021 is also to be recommended. A business restructure can breathe new life into a business environment, and 2021 could see a resurgence of this.

Planning for every eventuality

A further impact of the pandemic is a strengthening of risk governance and Board resilience and scenario planning, discussing and having evolving plans ready for any scenario. It is recommended that risk and contingency planning are revisited on a monthly basis alongside updated real-time cash flow forecasting, so that business agility can be actioned at short notice. The availability of multiple supply lines is an example of this. 2020 has given providers the impetus to review staffing structures within a business, and to enhance and create roles such as champions and heads of hospitality and testing. Team well-being is another area which continues to be enhanced not only in the care sector but in society as a whole, alongside environmental improvements as we look towards a greener and more sustainable socio-economic society.

Recruitment and funding

Recruitment, being values driven, remains a constant challenge. The sector needs to attract the right people and to offer a professional, career-driven and well-remunerated job for life. With this in mind we are back to the ‘funding of social care’ debate, which has been kicked into the long grass by successive governments as a topic too toxic to handle. But it will not go away, and on top of all the other challenges that 2021 will bring, the funding of social care does need to be addressed. Whether the funding of social care will be put on the same footing as the NHS, free at the point of delivery, is a question to be debated, with various funding models ranging from a ring fenced care tax (with its origins being the current council precept tax) to an increase in national insurance and/or a further income tax or insurance model. Generations across the decades will no doubt be affected by this debate.

Regulation and inspection

To draw this article to a close I must refer to the regulator. The Care Quality Commission (CQC), whilst currently focussing on safety at inspection, is compiling its themes for its new strategy and opened consultations on its future direction in January. Just as the pandemic has accelerated change in the care sector, the CQC is evolving to govern the next step for the provision of care. There will be an increase in information gathering outside of the care provision, and together with greater use of technology to carry out its audits, there will be greater focus on safety and infection and control measures.

Care providers will continue to adapt, with support from professionals in the sector, ensuring a sustainable and viable offering that will be fit for purpose for a growing social care sector in the decades to come.

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