Christmas card competition, disappointing CQC ratings and a new service in Guildford

2nd December 2015

I visited 17 services last week and was particularly impressed with the efforts made by the team at The Droveway in Brighton to make their service look really festive. There were lots of lovely quality Christmas decorations and clearly a great deal of thought had gone into planning the layout. This doesn’t surprise me as they are a staff team who are very committed to the people they support. I spoke to the Manager, Clara, who asked me to include in my blog a thanks to CMG for all the support that has been provided to a member of staff in her team. Very sadly, her husband, who also worked for CMG, passed away last week. He had been very poorly for a number of months. Clara said that she couldn’t praise CMG enough for all of the practical and emotional support that her member of staff had received.

On the subject of Christmas, every year, we have a Christmas card competition, where we encourage people we support to send in their ideas and artwork. The winning Christmas Card then gets printed and issued, not only within CMG, but to all our external stakeholders. Hotly contended, the competition had over 80 fantastic entries and the winning entry came from two people we support at our Kempshott Road service. They will receive copies of the Christmas Card to send to their own friends and family! Second and third place winners received vouchers to spend.

Last week was a disappointing week for CMG because we received 3 draft inspection reports, all of which were rated as ‘requires improvement’. This is a fairly new experience for us as the vast majority of inspection reports from CQC are rated ‘good’. In two cases, I agreed with the rating and the reason in both cases is fundamentally the same. Both services both had quite a high turnover of home managers. One left, they were replaced by a second, who didn’t stay for very long for different reasons and then we had to recruit a third manger. The disruption which that caused particularly to consistency of paperwork, had an impact on quality. Once again, it shows the importance of having a good and consistent manager. In the third case, I do think CQC were rather picky and not proportionate. They found us as ‘requires improvement’ on two out of five areas, ‘responsive’ and ‘well-led’, which meant the overall service was rated as ‘requires improvement’. There was one issue of concern under responsive and around ten positive comments from the inspector and the same under ‘well-led’. In the case of ‘well-led’, the issue of concern has already been addressed by the new manager in the service and was acknowledged by the inspector. We will have a look to see whether there is scope to challenge this one.

Finally, I would like to welcome, the people we support and their staff from Raymond Crescent in Guildford who joined CMG a couple of weeks ago. I am very impressed with the staff team whose person centred values very much fit with our approach in CMG and I hope the people we support will be able to get actively involved in the various activities we organise throughout the company. One of them is a talented artist and I’ve agreed with him that we will look to hold a display of his material in our central office in Leatherhead.

Annual staff awards and book of celebration

24th November 2015 3 Comments

This week’s blog is all about our Annual Staff Awards which we held on Thursday evening last week in a hotel in London Kensington. All finalists in the categories below were invited, along with a CMG colleague, to attend the awards presentation which included a dinner and disco. The night recognised some of the exceptional work that our staff do on a daily basis and we had some fantastic nominations this year, which made the judging especially difficult. Our judging panel included myself and Rachael our Operations Director, along with 2 of the people we support. Many of the nominations were both inspiring and moving and included information on how staff had helped some of the people we support achieve some incredible outcomes.

I have to say this reflects CMG at its very best. I am always the first to admit that we don’t always get things right, and sometimes we are guilty of appointing the wrong staff, but when we do get it right, the people we employ are a huge credit to us and more importantly the people we support. Sir William Wells, our Chairman handed the awards out to all finalists on the night and was also extremely impressed with the calibre of staff collecting awards.

I would like to thank everyone who nominated this year, especially family members who took the time to write in. In recognition of some of their amazing nominations we have produced a ‘book of celebration’ which includes extracts from their quotes, along with quotes from entries sent in by people we support. Please do let us know if you would like a copy of this.

And of course, a huge well done to all the finalists who won awards, they were all very well deserved. And also thank you to all our other staff, who might not of made it as a finalist but are none the less doing an outstanding job.

Working in social care can be extremely challenging at times, and I know that all the staff we recognised last week, put their hearts and souls into the jobs they do and are dedicated to ensuring the people we support receive the best possible care. As one family member wrote: “She is always positive and smiling and treats all residents as if they were her brothers and sisters. She has helped to create a warm and loving household.”

Team of the year
Manager of the year
Deputy Manager of the year
Lead Support Worker of the year
Support Worker of the year
Night staff of the year
Excellence in social inclusion
Excellence in inclusive communication
Excellence in promoting employment
Excellence in positive behaviour support
Outreach Support Worker of the Year
Best contribution from head office
Outstanding contribution to CMG
20 years long service
15 years long service

Social inclusion, recruitment and the transforming care agenda

16th November 2015 2 Comments

I can’t write this week’s blog without first mentioning the appalling murders in Paris. I was shocked and appalled when I opened my paper on Saturday morning to see the dreadful scenes in this wonderful city. I really hope there will be no more carnage like this but I worry that we will see the same thing on the streets of London. I have been thinking all weekend about the poor people in France who must be going through such a terrible ordeal.

Last week I visited 11 services including eight in Wales. I was particularly impressed by several social inclusion initiatives including the following:
– A person we support at Cwm Hyfryd does voluntary work at a local garden centre.
– A person we support at Ty Newydd has his own allotment. As well as being very proud of the vegetables that he grows, this has helped him get to know a number of local people.
– A person we support at Kingsland Crescent is an active member of the pool team at his local pub.

We continue to experience a difficult time trying to recruit staff. Having spoken to colleagues working for other provider organisations, it is a not a unique challenge facing CMG. I heard last week that unemployment is at its lowest level for seven years in this country which must be a contributory factor. We are working hard to keep our agency usage to a minimum but it is higher than I would like.

We are implementing several initiatives to address the recruitment situation. This includes targeted recruitment at older people, including those who have retired but want to work part-time. We are also looking to recruit apprentices. I think there is scope in some cases for us to be better at retaining staff and we are holding retention workshops with our managers across the organisation to look at what strategies can work. We are also launching our ‘Next Steps’ programme in December which will be a development programme aiming to help people with potential in CMG to obtain the skills they need to get promotion with us.

I attended a meeting of the Transforming Care Provider Forum last week. We discussed the recent NHS England report about the programme to reduce in-patient beds for people with learning disabilities by up to 50% over 3 years. There were a number of provider representatives at the meeting and I was impressed with the way that NHS England and the Local Government Association took on board our ideas and suggestions. The provider sector has a huge wealth of experience and expertise, including managing the moves of many thousands of people from long stay hospitals into community settings over the years much of which is direct relevance to the transforming care programme.

CQC inspections, DUQ and NHS England’s quangos

3rd November 2015

I visited 12 services last week including all those in the London Borough of Sutton. I met a number of long standing staff working in those services who are the real backbone of CMG. We are introducing a recognition scheme for long service scheme in the New Year as a way of thanking people who have stayed with CMG over many years.

We have experienced a considerable number of CQC inspections in the last couple of weeks as the regulator tries to catch up with its back log and hit its target of services being inspected by September 2016. A big congratulations to Florence Regonye and her two teams at 1 and 5 Fengates in Surrey. Both services received very good inspection reports and were rated as ‘good’ in each of the five areas that CQC looks at: safe, effective, responsive, caring and well-led and were rated as good overall. We are hoping that we may get one of two more ‘outstanding’ rated services following this recent round of inspections. However there are a couple of services which may be rated as ‘requires improvement’. This is either because there has been concerns about the performance of the registered manager which we have been addressing or because there has been several changes of manager in a relatively short period of time, disrupting continuity in the service. Registered Managers are absolutely key to ensuring that high quality services are delivered. I would personally like to see them given a higher status in social care and the recognition of the difficult, challenging and professional job that they do.

On the subject of Registered Managers, I jointly facilitated a workshop for Registered Managers, together with Sarah Maguire, from Choice Support, on Friday, looking at implementation of the Driving Up Quality Code. As well as carrying out self assessments of your organisation, using the Code, it can also be used at an individual service level as a way of getting feedback from families, people we support and external professionals and a really effective way of both Driving Up Quality and demonstrating that the service is well-led to CQC. I was very impressed with the calibre of the managers we met, a number of whom, had already been involved in doing a self assessment, either in their organisation or their service. One of the things that we explored at the workshop was culture. We all know that the culture of organisations is important but it is quite an intangible concept. With the help of the managers, we identified a number of measurable criteria of what makes a good culture in a social care organisation. We will be looking forward to share this nationally through the Driving Up Quality steering group and I would also like to share it in future on my blog.

To end with, I would just like to comment on the NHS England report which was published on Friday, which sets the target of closing between 30 and 50% of hospital beds for people with learning disabilities. I fully support the ambition, but I was rather concerned that the report lacked substance on how the change will happen. NHS England appears to believe that establishing 49 quangos involving local government, CCG’s and NHS England specialist commissioning will deliver this complex change. After many years of dealing with such quangos when I was in the NHS, I am feeling rather sceptical that the bureaucratic challenges involved can be overcome and the service change driven through. NHS England is also assuming that 49 highly competent people can be identified to lead each of these quangos effectively. Unfortunately I doubt there are 49 people in the country with the experience and skills to drive through such complex project management. I also don’t think that the money provided by NHS England to support change is anywhere near sufficient. For example, £15 million of capital is being made available to develop new schemes. Given that a number of people leaving hospitals will have particularly complex needs requiring specially designed and expensive accommodation, that money might only house 30-40 people when new services are required for 1,200 to 1,300.

Promoting social inclusion, staff retention and the controversial issue of individuals’ benefit income

29th October 2015 3 Comments

I visited 13 services last week and was impressed with a number of examples of social inclusion which I noticed. This included, for example, a young woman who lives at Cleveland House and who has been supported to be an active volunteer working on behalf of her local children’s hospice and two young people living in Redhill who are active members of a mainstream Taekwondo club.
We continue to promote social inclusion and I do an email every week to everyone in CMG highlighting any examples of good practice that I have come across on my travels. We will also be publishing shortly our latest social inclusion newsletter which is packed full of great examples from around CMG of encouraging and supporting people to become active members of their community.

Recruitment continues to be a challenge for us, particularly in specific areas like Hampshire. Talking to other providers, it is not purely a problem for us. We have reviewed our staff turnover rates, which vary and in some areas, are higher than we would like. We are implementing a programme of workshops with managers to look at what we can do to improve our retention rates. We have also put together our ‘Next Steps’ programme, the aim of which is to provide a structured development programme for people in CMG with potential who want to be promoted and develop their career with us. Our mantra is that we want you to come to CMG for a career, not just a job.

In my blog this week, I want to highlight a concern, which I know will be controversial. We have a number of situations in CMG where families are appointee for their son or daughter. In principle, that is absolutely fine, however, on some occasions, families don’t pass over all of their son or daughter’s benefit income and it would appear on occasion, that this income is used to subsidise their household budget. I can think of people in CMG who aren’t able to participate in the range of activities they would like because their benefit income isn’t all passed over. We also have occasions where families hang on to an individual’s mobility car and use it for their own transport. I think this is unacceptable and to me it is a safeguarding issue. However, when we flag these concerns to Local Authorities, we often find they are very reluctant to challenge families. It is the people we support who lose out then and I would like to see the Local Authorities take a more active stance on this issue.

Catherine House, Celebrating Culture and Finding Your Way conference

21st October 2015

I visited 13 services last week and was particularly impressed by our new Catherine House service in Camberley. It was only opened in the summer and it already has an established and enthusiastic staff team, led by their dedicated and hard working manager, Sonia. They have developed a strong ethos on promoting independence and social inclusion for the young people that they support and are doing some great work teaching people basic cooking skills including the importance of healthy eating and are actively supporting them to participate in a range of activities in the community. For example they are currently supporting a young man to apply to do voluntary work at his local radio station. It is also clear that the tenants are actively supported to help shape the way the service is run and that their views are important. I was impressed with the accessible minutes of their regular tenants’ meetings, which demonstrate people’s active involvement.

We had our annual Celebrating Culture event on Thursday last week (formerly known as Black History Celebrations). It was a fantastic event which was kindly opened by the Lady Mayor of Croydon. We had a fabulous turn out of around 400 people we support and staff and the large room at Fairfield Halls in Croydon was decorated with flags from around the world, all made by people we support. There were a whole range of fun events and activities including a marvellous Asian drumming and dance group. It was great to see a number of people we support spontaneously get up and participate in the dancing. I would also like to say a big thank you to Onyi Ogueri and his team who planned the event so well and to all of the staff and people we support who went to a huge effort to cook absolutely fabulous food from all around the world.

We are really looking forward to the conference we are co-hosting with Bringing Us Together on Saturday 30th January 2016 at Imber Court Sports and Social Club in Surrey. The programme for this Conference we are calling ‘Finding Your Way’ has now been finalised and there is a fantastic combination of external keynote speakers along with a number of relevant workshops. The conference is aimed at any family of a disabled young person, to help them to better understand the maze that is the social care system and help them build skills to ensure they and their family member have ‘choice and control’. If you would like to see a copy of the programme, or buy a ticket, please contact katie@bringingustogether.org.uk.

One of the workshops on the day is going to be about Positive Behaviour Support and will be facilitated by our Clinical Director, Michael Fullerton. Positive Behaviour Support is an approach we use a lot in CMG to help people who present challenging behaviour so that they don’t need to be challenging in order to get their needs met. We see challenging behaviour as a form of communication with a number of potential functions, for example, to get attention, or to avoid too many demands. By looking at incidents and their patterns, we can work out what is causing someone’s behaviour and help the staff team put a strategy in place so that the individual doesn’t feel the need to be challenging because their needs are understood and met. For example we would want to make sure they had a busy, structured programme of activity with staff giving positive re-enforcement, for example, saying ‘well done that was really good’ when they engage positively in an activity. Michael will cover the basic principles of positive behaviour support and also what to look out for when looking for a provider.

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A great annual conference for our Registered Managers

14th October 2015

I was on annual leave last week and am busy catching up with a hectic schedule this week. Before I went on leave we had our annual conference for all our Registered Managers in CMG. I was really pleased with the great feedback we had for this conference with many saying it was “the best yet”. Everyone who completed the evaluation form at the end of the day agreed that the conference had been useful, motivational and inspiring.

We had some excellent keynote presentations and I would once again like to thank all our speakers for helping to make the day so beneficial. Sharon Allen, OBE, Chief Executive of Skills for Care talked about managing a skilled, knowledgeable and person centred workforce. Jo Grace, Founder of The Sensory Project gave us an inspired presentation on sharing sensory stories with people we support. Gary Bourlet who is the Co-Development Lead from People First England, talked about his organisation that is helping to promote rights for people with learning disabilities.

We also had an incredibly inspirational talk from Geoff Holt, MBE, who is a yachtsman and disability sports ambassador. When Geoff was 18, he was paralysed from the neck down in an accident. Since then he has gone on to make some remarkable achievements in sailing. He entered the history books in 2007 when he sailed solo around Great Britain and in 2010 he became the first quadriplegic to sail unassisted across the Atlantic. Geoff is a great example of how all barriers can be overcome with determination, the right support and positive risk taking. Geoff also talked of his ‘Wet Wheels’ charity, which enables people with any disability to experience sailing which for some would not only be the first time they have ever been on a boat, but also the first time they would have felt water spray on their face. What a great sensory experience and I know a lot of our services will be looking at this as an activity for the people they support.

The day also included workshops where discussions were facilitated, in different subject areas including: ‘relationships and sexuality for people we support’; ‘how to achieve a CQC outstanding rated service’ and ‘an introduction to Neuro Linguistic Programming’. Jo Grace, also hosted a workshop on ‘what makes a good sensory story’ and demonstrated some excellent examples of sensory stories.

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Wall of achievement, rigid Local Authority procurement and People First England

30th September 2015

I managed to visit 24 services last week and saw a number of things which impressed me. I thought the Macmillan coffee morning at Goldstone Crescent in Brighton was a real success with a good turnout. The people we support and their staff team went to a lot of trouble and baked some fabulous cakes. I am always pleased when the people we support take an active role in raising money for charity, rather than just being the passive recipient of welfare benefits. I was also very impressed by the ‘wall of achievement’ that has been set up at our 283 Dyke Road service in Brighton. Whenever one of the tenants living there achieves something important, it is put up on the wall of achievements to celebrate their success. Talking to the people who live there, it is really important to them to have that recognition. Our Chetwynd Road supported living service in Portsmouth does something similar.

Periodically in my blog, I have a bit of a rant about Local Authority procurement and I’m afraid this is going to be another of those occasions. I visited a property last week which I thought would be very suitable for refurbishment for supported living flats. We have a housing partner who is potentially interested in buying the flats and I understand from the Local Authority concerned that they have a need for that type of service. However, their procurement department made it clear that the choice of provider would have to go through their framework agreement and there would be no certainty that we would be selected. We have come across this procurement-led approach before and the reality is that it will put providers off going to the effort of identifying and developing services if there is no certainty at the end of the day that they will be the chosen provider. Given that there is inadequate provision in the country and housing associations, who are the main providers of accommodation for supported living, lack investment capital and in some cases have chosen to focus on general needs rather than special need housing, it seems to me that Local Authorities are shooting themselves in the foot by taking an overly rigid view. Other Local Authorities that we deal with are much more pragmatic, if they have a need for a service, they are very happy to support us developing one. In practice, this means that those Authorities, who take a more pragmatic view, are more likely to have new service provision developed than those dominated by overly dogmatic procurement processes. In my view, the procurement process has too much power in some Local Authorities.

On a more positive note, I am pleased to report that CMG, along with 4 other providers have made a donation to enable the establishment of People First England. We are really hopeful that this will grow into a national voice for people with learning disabilities including, hopefully, a parliament covering the whole country where people we support can represent their peers and speak to government and other influential bodies about what people with learning disabilities need and want.

Recruiting staff, Transforming Care and staff consultation process

22nd September 2015

I visited 16 services last week and was impressed with a lot of what I saw. For example, I spoke to someone we support at 59 Bury Road in Hampshire who told me how much she was looking forward to going to her voluntary job at the Sue Ryder foundation. When I asked her why, she said it was because she had made friends there that she really liked. A member of staff also told me how well this lady had done learning valuable travel skills, catching the bus there and back. Next door at 57 Bury Road, I observed some really good active support and I was particularly impressed by the excellent rapport of the staff at our Old Street service with the profoundly disabled people that they support. I also came across one service where I was concerned that there wasn’t a great deal happening. But checking the daily diaries demonstrated, that whilst people were doing some in-house activity, there is scope for them to do a lot more and this is something we are going to address. I regularly look at daily diaries on my visits to CMG services and they are a really good guide as to the quality of life that people are having.

A challenge for us in some areas is recruiting and retaining good staff. Pay can be an issue, but I think sometimes we recruit the wrong staff who we subsequently dismiss and I’m not sure we always support new staff well enough. Working in care, particularly with people with complex or profound disabilities or very challenging behaviours, can be an overwhelming experience and in some cases, I don’t think we give some people, new to care, the level of support that they need. I have always been extremely impressed by the calibre of staff recruited by Debbie Leinster, our Old Street Manager. When I was there on Friday, I was once again impressed that every single member of staff I met was lovely and I would have been very happy if they were supporting a member of my family. I spoke to Debbie about how she ensures that she only recruits the right people. She is very picky and looks specifically for people with get up and go who are also kind and caring. She also makes sure that they spend time with the people living in Old Street and she will only select staff who interact positively and respectfully with them. Once new starters start, she makes sure to keep an eye out for them and checks regularly with them whether they are okay. She monitors their confidence levels and gradually exposes them to additional responsibilities at a pace that is right for them. She has an open door policy and staff know that they can approach her at any time. I know these all sound obvious, but I’m not sure they happen everywhere. We are going to be running workshops on recruitment and retention for our managers to make sure everyone is able to perform to the same standard.

We have just completed the second round of our consultation process with staff representatives discussing proposed changes to our sick pay policy linked to pay rises. Sarah Evans, our Head of HR and I have been round the country to meet ten different staff representatives groups in this second round and we did the same in the our first round about six weeks ago. Every CMG service has a staff representative and we meet them on a regional basis. I have been extremely impressed with their positive attitude and we have had a really good dialogue with them. They weren’t keen on our initial proposal so we completely changed it. All the points contained in our revised proposal have come from the staff representatives and generally it has been well received. We will be making a final decision, based on their feedback, in the next couple of weeks and will be writing to people to give them one final opportunity to comment.

On the subject of proposals, we have now finalised our proposal on behalf of the provider sector in England as to how we can help implement NHS England’s Transforming Care (Winterbourne View) programme to move more people from assessment and treatment units and develop appropriate services in the community for people who present significant challenges. I think it is a really good proposal and it reflects the genuine desire by providers to help these complex people live good quality lives in the community as they deserve. We will hopefully be discussing it with NHS England later this week.

On a final point, I attended a positive behaviour support network meeting in Surrey last week run by the county council. I was very impressed to see a number of family members there actively engaged. I think some Local Authorities are better than others at engaging with and listening to families and I would like to pay tribute to Surrey working with families as partners and recognising the expertise that they bring.

Visiting services, NHS England’s provider forum and a new conference for families of disabled children

15th September 2015

I visited ten services this week and was really impressed at our Walsingham home in Hove at the warm, friendly, inclusive and person centred atmosphere at a birthday party for one of the people we support. The staff had clearly gone to a lot of trouble to organise it and it reminded me of the importance of recruiting staff with the right values who really care about the people they support as well as understanding and agreeing with our focus on promoting independence.

As you know, ‘attention to detail’ is an important phrase for us at CMG and I was a bit concerned to visit one of our services and see a pictorial rota not being used properly and out of date. It is great that we take an active role promoting total communication ensuring that we are enabling the people we support to communicate with us in the way that works best for them, including the use of pictures. However, those systems, won’t work unless they are always kept up to date.

I would like to congratulate the staff team of our Craignish service in Croydon who received an extremely positive CQC report where each of the five areas looked at by CQC were rated ‘good’ and the service was rated ‘good’ overall.

A group of representatives of the provider sector from the Housing and Support Alliance, VODG, ARC, Care England and ACEVO met last week, to look at what we can do to help with the implementation of the transforming care programme. This is the NHS England programme for helping people move from assessment and treatment units into the community. The provider sector has a huge amount of expertise in supporting people who can be very complex and challenging to live successful lives in ordinary settings in the community and I am always unsure our expertise and views are fully taken into account in planning the move into the community of possibly 2,000 people. We put forward some really constructive ideas and a paper will be prepared for consideration at the NHS England provider forum meeting in early October. I really hope NHS England and other statutory bodies take account of our suggestions and really engage with providers so that we can help make the changes needed.

Over the next couple of months, I am going to be mentioning the ‘Finding Your Way’ conference (a jointly hosted conference by CMG and Bringing Us Together) which will be held on the 30th January 2016 in Surrey and is for any families of disabled children. Today I am briefly going to talk about the workshop on housing and support options which will be included on the conference agenda. This session is about helping families get the information they need to make the right choices when they are looking for accommodation with support for their loved ones. It can be a very confusing picture with residential care and supported living and a variety of different funding mechanisms including Local Authority, NHS, housing benefit and direct payments. The purpose of the workshop will be to explain the similarities and differences between residential care and supported living, how the money works and also how families can go about getting the right information to make the right choices. If you would like more information or tickets for this event, please contact Debs or Katie: debs@bringingustogether.org.uk or katie@bringingustogether.org.uk.

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