Welcome to One Education
The rising tide of personal liability in care management
The changing face of enforcement The regulatory environment Recent prosecutions have highlighted the significant legal risks faced by registered managers in care environments, with penalties reaching tens of thousands of pounds for those who fail to maintain adequate standards, in care management . Carl May-Smith, barrister at law firm Browne Jacobson, explains how this growing trend of personal accountability demands careful attention from professionals in the sector. Registered managers in care environments face levels of legal scrutiny and personal liability that are arguably higher than most other regulated sectors. While they have long faced the theoretical risk of prosecution for safety failings, especially in the event of a serious incident, there has been an evolution in accountability in recent years. A regulatory shift in the enforcement of care standards has created a complex landscape that managers must carefully navigate to protect both their residents and their careers. The changing face of enforcement The regulatory environment has transformed dramatically since 2015, when the Care Quality Commission (CQC) expanded its enforcement role. https://www.cqc.org.uk While traditional regulators like police, fire and local authorities typically target organisations and their directors, reserving prosecution of managers for cases of extreme recklessness or bad faith, the CQC has charted a different course. It increasingly holds individual managers accountable, even in cases where they’re not directly involved in incidents. Recent cases highlight this trend’s serious implications. Two managers faced substantial penalties: a £10,000 fine for a Warwickshire care home manager and a £55,000 penalty for a Lancashire facility’s registered manager, both for failing to protect residents adequately. These cases demonstrate the CQC’s willingness to pursue individual prosecutions rather than targeting care organisations themselves. Understanding personal accountability and protecting against liability The scope of personal liability extends far beyond direct involvement in incidents. Managers can face unlimited fines for various offences, including safety regulation breaches and consent issues. Unlike police investigations into wilful neglect or gross negligence manslaughter, which require proof of severe dereliction of duty, CQC prosecutions can stem from systemic failures or breakdowns in process adherence by staff. While following organisational systems generally provides legal protection, managers must maintain active involvement in daily operations. Success requires balancing multiple responsibilities – implementing leadership directives, monitoring staff compliance and maintaining clear communication channels throughout the organisation. Documentation becomes crucial, with comprehensive audit trails serving as vital evidence of diligent management. However, blind adherence to organisational policies isn’t enough. Managers must exercise independent judgement, challenging inappropriate policies and requesting additional resources when necessary. Active management Effective risk management in today’s regulatory environment requires a proactive approach. Managers should maintain detailed records of all communications, especially regarding safety concerns and policy challenges. Regular involvement in daily operations, combined with systematic documentation of decisions and actions, provides the best protection against potential liability. The role demands more than just following procedures; it requires active engagement with both staff and leadership, ensuring that care standards remain high and risks are promptly addressed. While the responsibilities may seem daunting, understanding these obligations and maintaining proper documentation can help managers navigate their duties successfully while protecting themselves from legal consequences. https://www.brownejacobson.com/
Join us at the Care Show Birmingham
🚨 We’re just ONE WEEK away from Care Show Birmingham 2024! 🚨 📅 9-10 October 2024 | 📍 NEC Birmingham 💡 With over 250+ leading suppliers exhibiting, 150+ expert speakers shaping the future of care, and 8 dedicated training zones covering a variety of care-centred topics, this is your chance to elevate your knowledge and network with sector leaders. 💬 Plus, don’t miss out on our Home Care Lounge and Retirement Living Lounge, where you can connect with like-minded professionals. Best of all? It’s FREE to attend for all care professionals! #CareShowBHAM24 Register now for Care Show Birmingham : https://www.careshow.co.uk/?source=socialtakeover_Euromedia Mark your calendars and get ready to be a part of something extraordinary!#CareShowBHAM24 Come and see the Care and Nursing Essentials team on stand number C46 for your FREE copy of the magazine and to subscribe to future issues!
New Workshop Aims to Revolutionise Dementia Care
A ground-breaking new workshop titled “Introduction to Applied Improvisation within Dementia Care” is set to make waves in dementia care in the UK. Created by Alan Boulter, a former stage manager turned dementia care champion, this workshop introduces innovative improvisation techniques to caregivers, offering a fresh approach to person-centred care for individuals living with dementia. The workshop, already trialled with great success at the Old Vicarage Care Home in Moulsford, Oxfordshire, aims to expand across the UK and beyond, offering carers – both professional and non-professional – tools to connect more effectively with those living with dementia. The unique approach is designed to empower carers with skills that reduce anxiety, foster better communication, and improve the overall well-being of individuals with dementia. Go With The Flow – Connecting Through Creativity The workshop is part of a larger initiative under the umbrella of Go With The Flow – Connecting Through Creativity, a project aimed at integrating creativity into dementia care practices. This initiative is the brainchild of Alan Boulter, who, after a 20-year career working on major theatre productions like Disney’s The Lion King and Jersey Boys, transitioned into the care sector. Boulter, inspired by his personal experiences and professional training, completed dementia champion training at the University of Worcester in 2024. His vision combines his background in performance and improvisation with the skills and knowledge gained in dementia care. “I realised that there was a significant gap in the way dementia care is approached, particularly in the use of creative techniques,” said Boulter. “Improvisation has been used successfully in training doctors and GPs within the NHS, but it is still almost unheard of in dementia care settings. Integrating improvisation means we’re able to create more engaging, person-centred care experiences.” Why Improvisation? Improvisation is a technique that encourages flexibility, creativity, and adaptability – all crucial skills when caring for someone living with dementia. The principles of improvisation include listening, responding in the moment, and building on what others say and do. When applied to dementia care, these techniques help caregivers stay present and responsive to the changing needs of the individuals in their care. Through this workshop, participants learn how to use improvisation to: Boulter’s approach is grounded in Tom Kitwood’s Person-Centred research, such as The Enriched Model of Dementia and Kitwood’s Flower of social and psychological human needs, which emphasises psychological and social needs as essential to improving the quality of life for people with dementia. Improvisation supports these principles by fostering interaction that respects each individual’s humanity and dignity. Workshop Success and Expansion Plans The first trial of the workshop at the Old Vicarage Care Home was met with enthusiastic feedback from care professionals. One anonymous participant stated, “The workshop was eye-opening. It gave me a new way to connect with residents, and I could see how it immediately impacted their mood and engagement. I feel much more equipped to handle challenging situations now.” Building on this success, Boulter aims to offer the workshop to care homes, hospitals, dementia support groups, and charities throughout the UK. His goal is to create a national movement in dementia care that shifts the focus towards creative, person-centred approaches. “We’re not just aiming to train healthcare professionals,” Boulter explained. “This workshop is for anyone who interacts with or cares for an individual living with dementia. It’s about giving people tools to connect, even when communication seems difficult.” Bringing Awareness and Support for Dementia Care Innovation This workshop arrives at a crucial time for dementia care in the UK, where it is estimated that over 900,000 people are currently living with the condition. The demand for innovative, compassionate care strategies has never been higher. Through media outreach and partnerships with universities, dementia charities, and healthcare providers, Go With The Flow – Connecting Through Creativity seeks to bring awareness to these new training techniques and their potential to transform dementia care. Workshops like this are part of a larger effort to improve the quality of life for individuals living with dementia and to equip carers with the skills they need to provide high-quality, compassionate care. This initiative aligns with broader healthcare goals to enhance dementia care, particularly in light of the growing ageing population in the UK. A New Movement in Dementia Care Boulter’s vision goes beyond just offering workshops; he hopes to create a national conversation about the importance of creativity in dementia care. He believes that these techniques can reshape how care is provided across the country, making it more flexible, compassionate, and person-centred. “Improvisation is about connection, presence, and creativity,” Boulter said. “In dementia care, these qualities are essential. We want to build a movement that empowers carers to think outside the box and approach each person as a unique individual.” Boulter wants to make this training available to as many people as possible by creating a new generation of carers who have the skills and attitude to make a real difference in the lives of those living with dementia. Join the Movement Introduction to Applied Improvisation within Dementia Care is more than just a workshop—it’s the beginning of a movement to transform dementia care in the UK. Care homes, hospitals, and organisations across the country are encouraged to learn more about the programme and consider offering the training to their staff. For more information about Go With The Flow – Connecting Through Creativity and to register for upcoming workshops, please visit www.connectingthroughcreativity.com.
Enjoyable mealtime provision for residents living with dysphagia.
“Swallowing difficulties, also known as dysphagia, are a common condition within a care setting due to the wide range of conditions that can proceed it and the increased likelihood of these developing with age. It’s estimated that up to 70% of care home residents live with the condition. “Dysphagia is managed through the modification of foods and fluids, the aim of which is for food to require less or no chewing to get the food to a safe texture. Therefore, it’s important for homes to have a suitable dining provision available for those needing a texture modified diet with meals that are tasty, nutritious and, importantly, safe for them to eat. “When choosing the most suitable provision of texture modified meals, elements such as safety and assurance, choice and variety, cost and nutritional value all need to all be considered. “If these are factors are not taken into consideration and food presentation and flavours are poor then residents may be deterred from eating a full portion, which risks a lack of nutritional intake and developing malnutrition. “We all know the phrase ‘we eat with our eyes’ to be true, and this is even more important for those living with dysphagia. When serving a texture modified meal, visual appearance plays an essential role in meal enjoyment and alleviating possible feelings of embarrassment, encouraging residents to eat everything on their plate. “Eating is also a social activity, and the enjoyment of food is enhanced by sharing it with others. Providing well-presented texture modified meals can help residents to dine with dignity and enjoy their mealtimes with other residents, or friends and family that may be visiting. “Similarly, having ample choice and variety for residents requiring a specialist diet helps to reduce the risk of menu fatigue and allows them to still enjoy all their favourite flavours and not feel to be “missing out” compared to what others may be eating. “At apetito, creating food that both tastes great and provides good nutrition for residents has been our mission from day one. Whatever an individual’s dietary needs, ethnic preference, or taste, it’s about offering them something good to eat.” New Innovations for World Leading Range Expanding on an already extensive range of world-leading specialist nutrition meals, apetito has launched a new and improved range of Level 4 Purée dishes designed to bring joy and dignity back to mealtimes for residents with dysphagia. Maia Fergus-O’Grady, Dietitian and Senior Category Executive for Specialist Nutrition at apetito speaks on the exciting innovations to the range and how this has provided a step-change in its texture-modified offering for care homes: “After listening closely to customer feedback and preferences, we have made some significant changes to our Purée range to greatly improve our offering for residents. One key refinement has been bringing all our Puréed dishes into the smaller ‘Purée Petite’ portion size that are still packed full of flavour and meet the BDA guidelines for ‘Energy Dense’. “We understand that this smaller portion size is much more manageable for those living with dysphagia and ensures those with smaller appetites are receiving sufficient calories and protein – nutrients which are crucially important as we age. “We know how important mealtimes are for residents in care homes, and so further enhancing the dining experience has been a key focus for us. We’ve taken the step of incorporating many more puréed sauces and gravies into the range to elevate the flavours across our texture-modified meals and allow those living with dysphagia to enjoy all the dishes they love in a safe texture. “In addition to this we have introduced an array of brand-new side dishes to some of the meals, including sweetcorn and green beans, that are typically considered ‘higher risk’ and difficult to blend at home. We’re extremely proud to be making these vegetables accessible to those living with dysphagia and expanding on the variety offered within our range. “Another important update is improving the allergens within the meals by making several of our Purée dishes gluten-free. 11 are now made without all 14 recognised allergens* and many more are made without milk and soya. This gives wider choice for residents living with special dietary requirements and helps homes provide more options to avoid menu fatigue. “We are confident that our improved range of Purée meals will allow care homes to provide safe and even more varied meals to residents living with dysphagia.” As part of this range regeneration, apetito have introduced five brand-new Purée meals into its Level 4 range, including a Purée Chicken Korma, Purée Fish Pie, Purée Bean Chilli and two potato-topped pies, Purée Cottage Pie, and Purée Shepherd’s Pie. This launch also sees 12 revamped Purée meals, with improvements that mark an exciting evolution for the world-leading range that is created in line with IDDSI guidance. Get in touch! apetito offers a world-leading texture modified solution that could help your care home to meet residents’ complex dietary needs. Find out more at apetito.link/carehomes Book your VIP experience! apetito is bringing its exclusive VIP Lounge back to Care Show Birmingham on 9th and 10th October, speaking to teams about how its service can support care homes to deliver quality mealtimes and drive both cost and time efficiencies within catering operations. If you would like to speak to a member of the team, book your space at https://apetito.link/care-show-oct24 *Please note that “Made Without” does not mean “Free From”. Made without means that the identified ingredient is not part of the recipe, but very small amounts could be present. The intended purpose is to enable the avoidance of an ingredient disliked due to its taste or texture. Food ‘made without’ an ingredient may not be suitable for someone living with food hypersensitivity.
Northern Healthcare Rated ‘Good’ by CQC in Latest Inspection
Northern Healthcare has been awarded a ‘Good’ rating by the Care Quality Commission (CQC) following an inspection carried out between 3 June 2024 and 12 June 2024. The rating reflects the company’s “open, honest and transparent culture,” as recognised by the CQC. The report commended Northern Healthcare for its unwavering dedication to delivering safe, effective, and compassionate care for individuals with mental health conditions, learning disabilities, and autism. The inspection found that the organisation’s PROUD values—Positive, Respectful, Open and Honest, Understanding, Dedicated—are deeply embedded in both daily support and governance, with staff fully aware of how to incorporate these principles into their work. Northern Healthcare provides supported living services nationwide for individuals with a range of needs, offering 24/7 care and support to help them build independence within a safe and nurturing environment. In a report published on 13 September 2024, the CQC detailed how Northern Healthcare is safe, effective, caring, responsive and well-led, highlighting the company’s commitment to delivering person-centred care and maintaining high standards across the board. Key Highlights of the Report: Safe Care Practices: The CQC praised Northern Healthcare for its robust safety protocols, noting: “The provider took the appropriate steps to keep people as safe from harm as possible.” The report highlighted the effective recruitment and training processes, which ensure that staff are well-prepared to deliver care. Regular risk assessments are carried out to make sure that individuals are supported according to their specific needs. Effective Services: Inspectors recognised Northern Healthcare’s success in delivering support that improves the quality of life for individuals. The CQC observed: “Staff were confident in explaining what people’s support needs were and explained ways they best supported people to ensure they remained safe.” The use of regularly updated electronic care plans ensures that care is tailored to each individual’s needs, allowing for flexibility as those needs evolve. Compassionate and Caring Team: The CQC report praised the caring and compassionate approach of the Northern Healthcare team. “Staff and people supported had developed good relationships,” the report noted, highlighting the genuine concern staff demonstrate for the individuals they support, using a person-centred approach that respects each person’s preferences and dignity. Responsive Care: Northern Healthcare was also recognised for its ability to respond swiftly to the changing needs of individuals ensuring that individuals receive the right support at the right time, promoting independence and positive outcomes. The CQC stated: “People were listened to, and the provider acted on people’s views.” Strong Leadership: Leadership at Northern Healthcare was commended for fostering a positive work environment and driving continuous improvement. The report described the leadership team as “well-structured, with a good skill mix among senior leaders,” and noted that staff felt supported and listened to, with effective governance systems in place to maintain high standards of care. Nicola Forshaw, CEO of Northern Healthcare, expressed her gratitude for the recognition: “We are incredibly proud to receive a ‘Good’ rating from the Care Quality Commission. This accomplishment reflects our team’s dedication to providing exceptional care and support to our community. This achievement is a result of the hard work and dedication displayed by each and every team member. Together, we have created an environment that upholds the highest standards of care while also maintaining the warmth, respect, and professionalism that define our approach. “The trust and confidence that each individual we support places in our services motivates us to reach new heights, ensuring the best possible care for our community. We are deeply grateful for the support of our colleagues in Adult Health and Social Care, whose collaboration helps make this possible. “The ‘Good’ rating acknowledges not only our adherence to regulatory standards but also the positive impact we have on the lives of those we support. We are proud of this recognition and remain committed to continuous improvement and growth.” Northern Healthcare remains dedicated to ongoing improvements, with plans already in place to further enhance the services provided. The CQC’s feedback will serve as a guide for future initiatives. Dawn Cropper, Operations Director of Northern Healthcare, added: “We are absolutely thrilled to receive a ‘Good’ rating from the CQC. This achievement is a reflection of the passion and commitment our team members bring to their work every day. Our goal has always been to provide outstanding care to the people we support, and this rating shows that we are on the right path. www.northernhealthcare.org.uk
Baby Born in Care Home Car Park
Baby Born In Care Home Car Park Visits For A Heartwarming Reunion At less than 100 days old, newborn Louis Illsley surprised the residents of Bagshot Gardens Care Home, some of whom are approaching 100 years old. Louis was born in the care home’s car park on Wednesday 28th August, after his mother went into intense contractions while the couple were on their way to Frimley Hospital. Parents Jess Hannam and Joe Illsley, who already have a son, Logan, as well as Joe’s brother Alfie, whom they have special guardianship over, decided to name their newborn Louis, with the middle name ‘Avery’ to honour the care home’s role in his birth. In a heartwarming reunion, Jess and Joe Hannam returned to the luxury care home on Wednesday 11th September to introduce their newborn to the staff and residents who helped during his unexpected arrival. They met with the entire team and residents at Bagshot Gardens Care Home, who cooed and cuddled little Louis. Weeks earlier, Jess went into intense contractions, forcing the couple to pull into the care home’s car park. With no time to spare, and under the guidance of a 999 operator, Louis was delivered safely by Joe, with the help of the care home staff. Bagshot Gardens Care Home staff provided towels, blankets, and warm water to keep mother and baby safe and comfortable until the ambulance arrived. During their return to the care home, the couple surprised the staff and residents with a box of goodies as a gesture of gratitude. In return, the care home presented the family with a baby hamper, including a personalised baby grow embroidered with “Avery”. Susan Bedford, Care Assistant at Bagshot Gardens Care Home, was one of the first to assist Joe in delivering his son. She said, “Meeting the baby was very emotional. We have residents here who are nearly 100 years old, and then there’s baby Louis, who isn’t even 100 days old yet. It really makes you realise how precious life is. I’m glad to see that they’re all doing well, and that baby Louis is healthy.” The visit to Bagshot Gardens Care Home was not just a special moment for Jess and Joe but also for the residents, who were delighted to meet the newborn and share in the joy of his arrival. As baby Louis wrapped his hand around Betty’s finger, a resident at the care home, she said, “I am very much lost for words, but what an amazing experience.” Bagshot Gardens Care Home, is in Bagshot, Surrey, and part of the Avery Healthcare Group, is proud to have played a part in such a significant moment for this family and continues to provide exceptional care and support to both its residents and the wider community. https://www.averyhealthcare.co.uk/care-homes/surrey/bagshot/bagshot-gardens/
Celebrate Professional Care Workers Week 2024
The Care Workers’ Charity is proud to announce the seventh annual Professional Care Workers Week, a week-long celebration dedicated to recognising the outstanding contributions of care workers across the UK. Taking place from 16th – 20th September 2024, this event highlights the essential role they play in our communities and honours their commitment to providing compassionate care. This week is an opportunity to bring their stories to the forefront and to say a collective “thank you” for the work they do every day. What to Expect How You Can Get Involved Mark your calendars for 16th – 20th September 2024. For more information , on how to get involved, or to donate, please visit Welcome to Professional Care Workers Week 2024 The Charity provides immediate financial aid through crisis grants and offers vital mental health support. We advocate for fair treatment and pay and recognition of care workers as a skilled workforce. With over £6.1 million granted to more than 12,800 care workers, 500+ individuals benefiting from mental health initiatives, and active engagement in advocacy efforts, we’re at the forefront of ensuring workers receive the support they deserve. www.careworkerscharity.org.uk
Caring for carers; recent claims trends in care homes sector
The strain upon care homes and care workers caused by the COVID-19 pandemic has been well-documented. Encouragingly, however, we are now seeing some very positive trends in the sector. Occupancy rates are increasing, staff retention is improving, and the need to rely on agency staff has reduced. There remain, however, several emerging claims trends that underscore the need for care and nursing homes to ensure their records are properly maintained, and that their staff are appropriately trained and fully compliant with the home’s policies and procedures. Currently, a significant volume of legal claims in the sector relate to missed medication or incorrectly dispensed medication. These claims usually arise because the dispensing policy is either inadequate or is not being adhered to – which can make these cases challenging to defend. In many cases, deficiencies in protocols for dispensing mediation are being exacerbated by staffing constraints. If, for example, there is just one person who’s responsible for both dispensing and checking medication, then there is no independent ‘audit’ of which medications were handed to which service user. We cannot emphasise enough the importance of having strict dispensing policies in place, which staff are able to adhere to, to mitigate the risk of these claims. Claims for negligent care sadly also remain quite commonplace in this sector. Typically, these claims include service user falls and claims alleging poor management of service users with impaired mobility, often leading to skin viability issues. It is vital to the successful defence of these claims that the risks are adequately assessed, that care plans are sufficiently detailed and are reviewed and updated on a regular basis, and that accurate records are maintained. As well as having detailed policies and plans in place, care homes also need to ensure that all treatment records are accurately maintained. Shortcomings in record keeping have become more evident in recent years in part because of the problems many care homes have been facing in recruiting and retaining staff. Unfortunately, if the service user’s records are not properly maintained, it becomes very difficult to defend these types of negligence claims. Staffing issues can themselves be a fertile breeding ground for legal claims. There have been several recent cases where the training of new staff has not been up to standard, or where agency workers for whom English is not a first language have not been made aware of the full detail of care plans and risk assessments, leading to deficiencies in aspects of the care. The number of claims in which violence plays a part is also significant. Once again gaps in record keeping can be an aggravating factor. If a risk assessment or care plan is not updated as soon as a spontaneous physical act is witnessed, there may be a missed opportunity to arrange the additional support that a service user may require, and the risk of recurrence is increased leading to the issue becoming even more challenging to manage effectively. It is also crucial that carers are properly trained in how to de-escalate and manage violent incidents. We would strongly recommend to all of our care home clients that they arrange specialist training, including in relation to safe and lawful use of restraint, to help their staff manage these risks effectively. Supporting staff The challenge of recruiting and retaining employees has long been recognised in the sector, with staff shortages being further aggravated by the cost of living crisis and the impact of Brexit. As mentioned above, staffing shortages can often be a contributory factor to legal claims by service users. Stress claims by staff are also, unfortunately, on the rise. This is perhaps unsurprising given the extremely challenging conditions that many staff had to work though during the pandemic. It is vital that even the smallest care homes take this issue seriously. We recommend that all care homes where possible should have access to an HR facility to help deal with these issues, and that there is a clear HR process to follow as soon as colleagues exhibit early signs of stress. As well as being the right thing to do, taking these steps without delay can make any stress-related claims more defensible. That said, it does appear that the staffing picture is now improving and many care and nursing homes are taking positive steps to drive recruitment and improve staff retention across the sector. Whilst often challenging, care work is also, of course, hugely important to society and immensely rewarding for the care providers. Care home managers are working hard to ease some of the financial pressures on their staff and to support them in other ways. For example, managers are increasingly implementing new shift patterns to enable staff with families to work more flexibly; instead of a 12-hour shift, for example, staff can be offered a pattern of four hours on, four hours off, four hours on, four hours off. There is no doubt that dealing with legal claims and issues can be very stressful and difficult for all concerned. However, it is important to remember that care home managers are not expected to do this on their own and that support and guidance is always on hand via their insurers. The key is to involve insurers as early as possible once there is a claim, or a circumstance that may give rise to a later claim. The insurers will then be able to arrange the appropriate advice and support. Prompt, early notification of claims and circumstances is of course a requirement of most insurance policies. However, our experience is that early engagement with insurers and their legal teams often makes a very significant difference in achieving a better outcome to a claim or legal case. It will also provide much-needed support for any colleagues who may be involved and will help to protect the business from any associated reputational and financial harm. https://www.alteainsurance.com
