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A great annual conference for our Registered Managers

14th October 2015  Add comments

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  Add comments

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.

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Recruiting staff, Transforming Care and staff consultation process

22nd September 2015  Add comments

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.

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

15th September 2015  Add comments

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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Athletics Championship, CMG in Bloom and pay rise consultation

1st September 2015  Add comments

We held our annual Athletics Championships last week at the David Weir Leisure Centre in Sutton, Surrey. Over 200 people attended including people we support, staff and family members. This is such a highlight in our annual events calendar and it is always great to see so many people attending and taking part in sporting events with such enthusiasm. We handed out over 60 medals to people we support giving them the opportunity to showcase their sporting abilities and learn new skills. Events ranged from 100m sprints to long jump and wheelchair basketball and I hosted a taster Tai Chi session. The CMG Choir provided excellent entertainment during the event as well

For those that read my blog regularly, you will know that I am particularly fussy about the way that CMG services keep their gardens, so I was thrilled to see so many excellent entries into our annual CMG In Bloom competition, which gives services the chance to demonstrate how they have made improvements in their gardens, especially where there has been any particular involvement of people we support. We have received some splendid entries so I don’t envy the judging panel in their decision making, but well done to all those who have taken part.

We are going through an important process at the moment in CMG around staff consultation on our sick pay policy linked to proposed pay rises. We want to give staff pay rises but we are in a challenging financial climate with virtually no fee increases from Local Authorities and some Local Authorities wanting to reduce fees they pay us. We have undergone a really good participative process with our staff representatives and our Head of HR and myself have attended over 10 consultation meetings and had some lively debates. We are now changing the proposals based on the feedback we have received and we will be releasing new proposals this week. We hope to conclude the process by the end of this month.

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Driving up quality, rewarding long service and our annual staff awards

26th August 2015  Add comments

I visited 17 services last week and was particularly impressed when I went to our Willesden Lane service in Brent. Staff were about to take all of the people they support, who are wheelchair users with profound and multiple learning disabilities, onto London Underground and up the Shard, one of Europe’s tallest buildings. I’ve since heard that they all had a great time so well done to all.

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We have prepared a report on our Driving up Quality self assessment day which took place a few weeks ago and we will be circulating it next week. One of the key themes that came up is that CMG doesn’t do enough to recognise and appreciate long service by staff members. We have discussed this with our staff representatives and as a result will be introducing a new scheme in January 2016 where we will write to each person when they reach 5, 10 and 15 years service thanking them and giving them a gift voucher. The value of the gift voucher will increase with length of service. Unfortunately, an added complication is that our friends at the Inland Revenue treat this as a taxable benefit which seems rather mean spirited. However we will be paying for these gift vouchers/tax by cancelling a staff discount card which virtually no-one in CMG has taken advantage of because the process for using it was too time consuming.

We are also in the process of planning our Annual Staff Awards which will take place in a prestigious hotel in London Kensington in November. This is an annual event where we recognise staff who have made outstanding achievements in any of the following categories:

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
Best contribution from head office
Outstanding contribution to CMG

All winners and runners up will be treated to an evening of celebration with a 3 course meal, disco and trophy to recognise their achievements and will be able to bring a CMG colleague with them to the event. Staff, people we support, families and external professionals can nominate a staff member. If you would like to submit a nomination, please email sue.pym@cmg.co.uk for a nomination form.

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Transforming Care, NHS and austerity measures in local authorities

18th August 2015 1 Comments

I visited 15 services this week and was really pleased to see a significant number of our staff who have been promoted internally. I am very keen that people join CMG not just for a job but to make a career with us and a number of people have progressed from being support workers to managing residential homes and supported living services. The majority of Regional Directors have also been promoted internally. We are hoping to develop a ‘Next Steps’ programme in a few months to give a more structured development path for people with potential who want to be promoted and develop their career with us.

I have talked before in my blog about the Winterbourne View programme, now called ‘Transforming Care’. I have two frustrations: the lack of progress since the awful abuse at Winterbourne View took place about four years ago and the lack of involvement of community based providers who have the expertise in how to support people with complex and challenging behaviour in the community. I am pleased to say that following a discussion with NHS England’s Director of Transformation, she has agreed that it will be helpful if the provider sector in England could come up with a proposal as to how we could provide greater leadership and input into the process of designing new services as a replacement for assessment and treatment units. A workshop will be taking place in early September, attended by representatives of all the major provider representative bodies in the sector following which there will be a report which will be considered at the Transforming Care Provider Forum which I will be going to for the first time at the end of September.

Michael Fullerton, our Clinical Director and I, also had a meeting with a specialist NHS Trust last week to discuss the idea of setting up a community based crisis team. I think it is essential that we have effective crisis services in place otherwise people will continue to be inappropriately admitted to assessment and treatment units and we won’t see the number of in-patient beds reduced to the level required. Following that discussion, we are now proposing to establish a national pilot site in London for Transforming Care. If this gets off the ground, it will provide us with an opportunity to explore new service models that more effectively support people in the community and prevent inappropriate hospital admissions. There are several other pilot sites in the country but surprisingly given its particular population and characteristics, not one in London at the moment. I am very keen for CMG and other competent social care providers to be involved in looking at how we can re-shape our services so that we aren’t overly reliant on institutional hospital settings.

On a final note, we had a very clear reminder last week that austerity is still very much here. A Local Authority contacted us to say they had reviewed the fees for two of the people we support and that they both need to be reduced by over 40%. I know both individuals concerned and that is complete nonsense. It is disappointing that the Local Authority didn’t have the courtesy of looking at the individual’s needs with us as the provider who knows them best. We will be doing our own assessment using the ‘care funding calculator’ which is a recognised tool for identifying how much money should be spent on an individual and we will be responding robustly. The last time a Local Authority told me our fees should be cut by 40% it was for a group of people with profound and multiple learning disabilities. I said to the Local Authority that the only way the fees could be cut to that extent was by stopping all meaningful activities, not taking people out, leaving them in their chair and just providing basic personal care and that if that was what they wanted, they should find a different provider. Interestingly, nearly two years later, those two service users are still with us on the same fees. Whilst it is really important that we work in partnership with our Local Authority partners, there are occasions where we need to stand up for vulnerable people we support and we will not accept fee cuts that are detrimental to them.

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CQC ratings, Deer Lodge and new development

11th August 2015  Add comments

Congratulations to Kim Long and her staff team at Masons Hill’s supported living service in Bromley which received an extremely good CQC report last week. Her service was judged as ‘outstanding’ for ‘well-led’ and ‘good’ on all four other areas. We believe that one of the other four areas should also be an outstanding and are putting together a factual accuracy challenge. If we are successful, this would make this our third outstanding rated service. We have checked the list of 27 current outstanding services across England and we are the only learning disability provider in the country to have two services meeting the outstanding service. This is something we are very proud of, but we are not complacent and are hoping to get several more.

Just on CQC, generally I think the new rating service works very well and is much better than the previous arrangement of having either compliant or non-compliant services which didn’t motivate managers and staff to continuously improve. My one criticism is that the ‘good’ category seems too broad. I think we have now got 18 services rated as good since the new system came in. At the bottom end, we have had a couple of services that have scraped over the threshold, but a lot of our services which are extremely good, have had fantastic reports which must be close to an outstanding. I have suggested to CQC that they consider adding an additional category of ‘very good’ for those services which are doing really well but don’t quite meet the criteria of good.

I had a constructive discussion with our CQC provider Relationship Manager on Friday and he gave me the following up to date statistics on the numbers of services inspected in England so far in the different categories:

Outstanding 27
Good 3,651
Requires improvement 2,147
Inadequate 455

I would like to say a big well done to Leigh Iliffe, Karla AlHassan and all the team at our Deer Lodge resource centre in Brighton. They arranged a fantastic opening ceremony for Deer Lodge which was recently built on Dyke Road in Brighton with a fully re-furbished hydro therapy pool next door. It was a super event and it was great to see families attending. They put on some lovely food and there was a marvellous dance routine by people we support who live in our Brighton services. I would also like to say a big thank you to the worshipful Lady Mayor of Brighton who took the time to come and officially open the service. We want to get the best use out of our hydrotherapy pool and are marketing it to members of the public, as well as people with disabilities.

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I’ll end this blog with another piece of positive news from Brighton. For a number of months now, we have been chasing a planning application with Brighton and Hove City Council to purpose build two eight-bed residential homes on the site of our former Brelade Centre just off the A23. The reason for this, is that we accommodate a number of people with learning disabilities in services in the city, whose needs are changing as they get older with some people finding it difficult to get up and down the stairs. We heard this week that our planning application was successful which means that in the next year, we can build two new services to the highest possible standard which will be fully wheelchair accessible and much better quality accommodation for the people concerned. It also means that we will provide valuable infrastructure for Brighton and Hove to use in the long term as they struggle to find appropriate accommodation for people with learning disabilities. Apparently it was a lively debate at the planning committee and we won by seven votes to five.

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The potential benefit of having ‘mature conversations’ with Local Authorities

4th August 2015 3 Comments

I attended a meeting with Skills for Care last week where we had a discussion about the importance of having ‘mature conversations’ with Local Authorities. This means having sensible conversations with people at a senior level in the Local Authority about the real issues providers face, but also what we can do to help Local Authorities struggling with financial pressures. I strongly advocate ‘mature conversations’, but rarely see them happening in practice. To give one example, I am aware of a Local Authority in huge financial difficulty that has a large in-house service for people with learning disabilities. If that service was outsourced, it would require political support from councillors and would involve the transfer of current staff on their existing terms and conditions. However, given that I believe some of the accommodation is sub-standard, it would be perfectly possible to put together a plan that would enable people living in those services to be re-located to new accommodation designed specifically around their needs with support provided by a high quality provider like CMG or one of our competitors that would enable significant cost savings to be made. The chance of me having that ‘mature conversation’ is virtually zero.

Just to give one other example, I attended a provider forum a few months ago with a Local Authority that has to make £6million of cuts in its learning disability provision. The purpose of the session was to ask providers for their view as to how the money could be saved. I was on a table with some very nice representatives of small not-for-profit organisations. They came up with the idea of supporting service users to go on a camping trip in the summer which would enable the day centre to close and save some money. Whilst this was a great idea, it would clearly go nowhere near saving the £6million required. The commissioner from the Local Authority was involved in that discussion and during the coffee break, I had a chat with him about other ways in which he could save the necessary amount. Having been a commissioner myself in the past, I knew the areas to look at where sizeable savings can be made, including outsourcing in-house services and bringing people back to borough who are in very expensive poor quality placements. I offered to look at his Authority’s expenditure on out of area placements to see the potential for saving money as I’ve got a pretty good idea what fee levels represent value for money. Effectively I was offering him free consultancy. He thanked me and told me my ideas were very interesting and went back to discussing the camping trip.

One of the challenges working with Local Authorities is being able to meet people who are sufficiently senior that you can have these types of ‘mature conversations’ with. Sometimes you can talk with commissioners, but quite often they are inexperienced or frightened of saying something that will get them in trouble with their procurement colleagues. Ideally, you want to have this sort of conversation with Directors of Adult Services. In my experience however, that virtually never happens. I can’t remember any occasion in the last 8 years where a Director of Adult Services has asked to have a chat with me about how we can work together to jointly achieve savings whilst improving services.

The Chief Executives who run the major learning disability provider organisations in this country are by in large a very able, experienced group and Directors of Adult Services would find it a pleasant and refreshing experience to speak to them. I think they need to see the CEO’s as their peers and start having these ‘mature conversations’ so that we find our way through the current difficult environment without simply chipping away at services until they become non-viable.

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Service user conference, services requiring improvements and recognising long service

21st July 2015 1 Comments

We had another really successful Service User Conference last Thursday with over 320 staff and people we support in attendance and as usual there was a real buzz in the air. What I particularly love to see is just how much everyone enjoys the day and how much laughter there is. The day comprises of a talent show where individuals we support can get up on stage and sing or dance to a song of their choice. We have an ‘X-Factor’ type judging panel, comprising of two people we support and Rachel Dodgson, our Operations Director for England. We also have an ‘open mic’ session where people we support can go up on stage and offer any comment they like about anything they wish. This is always very popular! This year we also had a performance by ‘Fan Dance’ – a theatre group made up of individuals with PMLD and learning disabilities. Aside from this, we have a cake and art competition, make up and tattoos and other activities for the people we support to participate in.

I do believe that CMG hold some of the best events in the industry and people who attend are always surprised by just how good they are and what a great atmosphere there is. Our next big event is our Athletics Day which will be held in August and I would like to add that families of people who take part are also invited to attend this event.

I managed to visit 14 services this week including two which are rated as ‘requires improvement’ by CQC. I was glad to see progress in both services and hopefully they will be re-inspected soon and can go up to a ‘good’ rating. I am very unhappy when any CMG service falls below a ‘good’ and I hope that all our services will be rated ‘good’ or ‘outstanding’ in England very soon. Congratulations to the team at Honeywood whose inspection report arrived last week and was rated as ‘good’. Congratulations also to the Trebanos House staff in Wales who had a good inspection report from CSSIW.

As I may have mentioned previously in my blog, the inspection system is different in England compared to Wales. In Wales the only way we have of assessing the overall quality of inspection reports, apart from comments made by the Inspector, is to count the number of ‘requirements’ in each report. Currently we have no requirements in any of our welsh services.

We have been reflecting on the feedback from people we support, families, staff and external stakeholders at our recent Driving Up Quality self assessment day. One of themes was around valuing staff who have given long service to CMG. We are giving some thought as to the best way of doing this. One idea which we would like to pilot is establishing an ‘immediate recognition board’ which would involve an area on our intranet and website where we celebrate the achievements of specific staff members who have particular milestones of 5 and 10 years service. We are planning to call this ‘CMG Heroes’. We are also looking at presenting staff who have achieved long service with monetary vouchers. I would appreciate your feedback on both these ideas.

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