Editorial
It arrived with a crash, bang, wallop...
The plummeting value of some of the largest care
businesses seemed to take the market by surprise –
however, it had been predicted. The issue was who
would be first and how deep would be the wounds.
Now we know.
Southern Cross saw its share value plummet by 75%
in a week, there continue to be concerns about it’s
business model which requires quite a lot of short
term capital and an active and acquisitive real-estate
market to which it can off-load property assets of
businesses it buys up – entering into long term
leases.
Over the last few weeks we have seen a growing list
of care businesses around which there have been
concerns.
Is it all gloom?
Not a bit of it. I expect we will see some ‘old, familiar
names’ re-entering the fray. Shrewd businessmen
smelling a bargain with a value that offers real scope
for up-side. I predict that we will see the likes of
Hamilton Ansted – who made a sweet £40m on the
sale of his business five or six years ago. He has not
spent his entire time on beaches and spending his
cash on pina coladas, he has kept in touch with the
market.
Tony Heywood left Four Seasons very swiftly some
six months ago, I don’t know what he is up
to. However, he too will be able to sniff out value.
Then there is Chai Patel. He saw his reputation
traduced over the cash for honours investigations
and his long term loan to the Labour Party. He is
very experienced and knows the sector extremely
well with a number of successes already chalked
up. He has already reemerged with a new entity,
Court Cavendish, using his own money and is doubtless
ready to make his move.
Abuse
1. A new Safeguarding Policy and Dignity
Charter launched in Lancashire
At the Lancashire ‘Learning Together’ Workshop 1st
July for domiciliary care providers the Chairman of
LCA, Sue Lace and the Director of Adult Social Care,
Lancashire County Council, Richard Jones were the
first to sign the Charter, doing so on-line in front of
the audience of mostly domiciliary care providers and
council staff.
To sign the charter on-line:
http://www.lancashirecare.org.uk/
dignity_in_care_charter_sign_up.asp
2. Schwarzenegger Signs Legislation Giving
Elder Abuse Victims Greater Support in
Court
2 July 2008—Imperial Valley News
Governor Arnold Schwarzenegger signed a new law
giving older people and disabled adults the right to
have up to two support persons with them when delivering
difficult testimony in cases of elder abuse.
“By allowing a friend or family member in the courtroom
while giving difficult testimony, elderly and disabled
adults will feel more comfortable coming forward
and pressing charges to allow justice to be
served. This legislation not only protects this vulnerable
community but helps to prevent these types of
crimes from happening again,” Governor Schwarzenegger
said.
Schwarzenegger has previously taken steps to protect
California’s older citizens.
Business News
3. Patel on buying spree
6 July 2008 - The Sunday Times
Chai Patel has come out of the shadows with a new
entity, Court Cavendish, which is expected to announce
the acquisition of Care Management
Group. He has also established a new private equity
vehicle, Elysian with a former partner from Doughty
Hanson, Ken Perry.
4. RBS seeks care merger for Priory and Four
Seasons
6 July 2008 - The Sunday Times
It is reported that Royal Bank of Scotland is discussing
the possibility of merging Priory with Four Seasons.
If it happened it would create a business valued
at £2bn.
5. Craegmoor Sale
5 July 2008 - The Times
It appears that the sale of the Craegmoor group of
companies is about to be completed with Advent International
becoming the new owners.
6. Occupancy fears drive down shares in
Southern Cross
5 July 2008 - The Times
Shares fell a further 14.5% as Southern Cross revealed
lower than expected occupancy of its care
homes – a key indicator of its success. There is
speculation that it may be as low as 80%
7. Southern Cross Healthcare Group PLC
4 July 2008
Board Appointments
Southern Cross Healthcare Group PLC confirmed
Richard Midmer joined the Board of Directors
of the Group, following his appointment as Finance
Director announced on 30 June 2008. Southern
Cross also announced a further strengthening of
the Board through the promotion of Kamma Foulkes
to Executive Director of the Company with responsibility
for Elderly Care. John Murphy, who remains
an Executive Director, will take sole charge of
Acquisitions and Developments and retain responsibility
for the Group's Active Care division and management
of the supply chain.
Richard Midmer was previously Group Finance Director
of NHP plc, the quoted care home company, from
November 2000 until its acquisition
in February 2005. He is a non-executive Director
of CareTech Holdings plc and Rugby Estates Investment
Trust plc.
Kamma Foulkes, currently Managing Director of the
Group's 324 homes in the Southern division, has over
15 years experience in the care sector and joined the
Group in 1998. She is a registered nurse.
Ray Miles, Chairman of Southern Cross,
said: “Richard and Kamma are important additions to
the Board of Directors. Richard is highly experienced
in finance, project management, elderly care and the
PLC environment and he knows our business
well. Kamma currently oversees the operations of the
Group's Southern division and her experience and
knowledge will provide a highly valuable insight to
the Board.”
8. Southern Cross to negotiate new deal with
banks
1 July 2008 - The Times
Southern Cross fails to repay bank debt
1 July 2008 - TimesOnline
City Focus: Collapse at Southern Cross
1 July 2008 - Daily Mail
Shares in Southern Cross, Britain’s biggest care
homes operator, dropped 58% after it failed to make
a debt repayment.
The industry has been hit by local authority budget
constraints and higher costs from a rising minimum
wage. Southern Cross, has operated a business
model under which it will buy a care home then sell
the freehold to a property company paying rent on it.
In relation to recent purchases it has not been able to
sell-on the property and the value has, of course,
now reduced. It has not been able to repay a £46
million loan. The banks have agreed to renegotiation
but the company is bound to have to pay higher interest.
Shares in Care UK, the care home operator, fell by
12% after it announced it was in discussions to buy
the 50% of its joint venture Partnership Health Group
that it does not already own. Care UK’s shares
closed at 375p.
The Daily Mail refers to police investigations last year
into two care homes operated by Southern Cross.
Meanwhile Bill Colvin's credibility as MD has not
been helped by his failure to manage analysts' expectations.
Sebastian Jantet, an analyst at broker
Investec, warns that trying to work out what to do
with Southern Cross is 'a little like catching a falling
knife'. However, he remains a buyer 'we do not believe
that local authorities have many alternatives in
the longer term'.
Ed. In these pages we cast doubt upon the business
model used by Southern Cross, particularly
as the tax position was adversely altered by the
Chancellor of the Exchequer in April. See BHCR
Vol 3, Issue 15, item 9 for an assessment of the
effect of the tax-saving scheme.
9. Claimar Care Group plc
30 June 2008
Claimar Care Group plc (the 'Company'), announced
that it had received notification, that Mark
H a l e s , C h i e f E x e c u t i v e , p u r -
chased 2,950,000 ordinary shares of 10p each in the
Company at 14p per ordinary share on the same
day.
Accordingly, Mr Hales' beneficial interest in the Company
has, as a result, increased
to 8,250,000 ordinary shares, representing
approximately 16.50% of the Company's issued
ordinary share capital
10. CLAIMAR CARE GROUP PLC
UNAUDITED Interim Results
For the six months ended 31 March 2008
HIGHLIGHTS - 2008 - 2007(*)
Turnover— £24.1m - £9.1m
Gross profit - £7.5m—£3.3m
Operating profit before amortisation and acquisition
related costs - £1.6m—£0.8m
(Loss)/profit for the period - £(0.1)m—£0.5m
Basic (loss)/earnings per share - (0.20)p - 2.19p
Fully diluted (loss)/earnings per share - (0.20) -
2.18p
Shareholders' funds - £37.9m—£12.4m
Commenting on the results, John Crabtree, Chairman,
said:
“The first half of this year has been both challenging
and disappointing. We are disappointed that recent
trading has been adversely affected by a shortage of
suitable staff across the group, but more noticeably in
the Complete Care Group, our complex care business,
and our inability to pass on the full charge of
increased staff costs principally arising from the implementation
of the working time directive and rising
fuel claims. Management has set in train a rapid recovery
plan to deal with these issues,”
Whilst the Board believes that turnover and profit will
continue to grow throughout the reminder of the trading
year they will fall short of current market expectations
hence the trading statement announced to the
market on June 23.
On current trading and prospects, Mr Crabtree added:
“Trading since the interim period end has been challenging,
however the Board have introduced a number
of measures to respond to the issues raised in
our trading statement made last week. During the last
12 months the Group has diversified its revenue
streams, by developing new opportunities that offer
the group higher gross margins and other means of
generating revenues from its core activities. Despite
the current setbacks the Board continues to
be optimistic concerning the long term outlook for the
business based upon an ageing population and the
increasing number of people choosing to be cared for
at home.”
11. CLAIMAR CARE GROUP PLC
UNAUDITED Interim Results for the six months
ended 31 March 2008
CHAIRMAN'S STATEMENT
23 June 2008 - Trading statement
Ed. What appears below is my abbreviation of
the statement – for the full version, visit the company’s
website www.claimar.co.uk
Last week the Group issued a trading statement to
the market because it had identified a number of unexpected
factors that had started to impact the
Group materially over recent weeks. In conjunction
with the preparation and independent review by Claimar
Care's auditors of its interim results for the six
months ended 31 March 2008, the Group undertook
a detailed review of current trading and expected
performance for the full year, ending on 30 September
2008.
• Complete Care has experienced a delay in entering
into of a number of new complex care contracts,
and the Board is not confident the recent
shortfall in performance will be recovered by the
financial year end;
• The Group has not yet been able to recover from
local authorities the increased cost of providing its
care services, including in particular the increased
costs of fuel and the costs associated with implementing
the working time directive; and
• The conversion rate of applicants for franchises
from SureCare has fallen away significantly as a
result primarily of the tightening of the credit markets,
which has impacted the ability or willingness
of applicants to meet the upfront franchise payments
and working capital requirements.
Taking into account the above factors, the Board anticipates
that, whilst turnover and pre tax profit will
exceed the equivalent prior year numbers, earnings
per share will fall below those of the prior year and be
materially below current market expectations.
Notwithstanding these issues, the Board continues to
believe, against the background of an ageing population
and the wishes of many elderly people to live in
their own homes, that the Group has good prospects.
Interest costs have risen from £99,000 to £642,000
representing the financing cost of increased borrowing
which was used to partly fund the two acquisitions
in the period plus provide working capital for day to
day operations.
The income statement shows a loss of £148,000 on
the market value of an interest rate hedge. The requirement
to show the fair value of this financial instrument
is a consequence of IFRS reporting the
Board having decided to hedge a large proportion of
the Group's long term borrowings to limit exposure to
future interest rate fluctuations. Were Claimar's accounts
drawn up to today's date the overall fair value
adjustment would now be a credit to income of a few
thousand pounds.
Based upon the matters disclosed above basic earnings
per share have reduced from 2.19 pence to a
loss of 0.20 pence for the period.
Existing Business and the Market.
In our core business Claimar Care Limited. which
provides mostly services to older adults we, together
with the rest of the sector have seen significant
change.
Several new initiatives launched by the government
are starting to create uncertainty regarding the short
term method of procurement. Historically Local Authorities
have either delivered care services themselves,
or increasingly have outsourced to independent
providers. Overall the market continues to grow
with the number of hours commissioned growing by
4% between 2006-2007 to approximately 3.9 million
hours per week. According to data available from the
Department of Health the independent sector now
provides 78% of all homecare in England. Contracts
appear to be getting bigger as local authorities seek
to work with fewer but larger providers, making life for
the small independent provider much harder as they
find it increasingly difficult to bid for, win and then deliver
larger contracts, however in some cases contracts
are either being delayed or shortened as commissioners
seek clarification regarding the impact of
new initiatives such as Person Centered Planning,
Direct Payments and in particular the use of individual
budgets discussed later. All of these initiatives are
designed to give service users more choice and control
over how their service is delivered, and will we
believe lead to a greater number of people choosing
to remain in their own home, rather than be cared for
in a residential home, or nursing home.
One of the most significant initiatives during 2007 was
the pilot within 13 local authority areas of Individual
Budgets. Individual Budgets differ to Direct Payments
in that they bring together a number of income
streams of which Direct Payments are only one.
Other income included within an individual Budget
could include Supported People funding (Money
spent on housing related support, including developing
life skills, such as budgeting and cooking);
Independent Living Fund (this money is used to
help disabled people live in the community);
Integrated Community Equipment Services
(this pays for equipment such as grab rails, or ramps
etc.); Disabled Facilities Grant (his pays for changes
to accommodation such as a stair lift); Council provided
social care for adults (money that Social Services
spend on day centre's, residential care, meals
on wheels and other kinds of social care including
home care.)
Of the 13 Local Authorities chosen to pilot the
scheme most if not all chose different strategies and
service user groups to pilot, in some cases local authorities
chose not to involve older people
focusing instead on younger adults with a learning
disability or physical disability. The outcome of
the pilot is yet to be reported although we expect the
findings to be reported later this year.
We view the implementation of Individual Budgets
positively, it is likely that local authorities whilst allowing
service users more choice will still wish to closely
monitor how the money is spent and the safeguards
that exist to protect them, whilst this will inevitably
lead to new methods of contracting we are confident
that our mix of business and geographical presence
puts us in a very strong position to benefit from these
initiatives.
As mentioned in our trading statement we have
found the recruitment and retention of care staff increasingly
difficult across the group.
The Senior Management team has been restructured
with the creation of a new Operations Director role
for the North, and also the separation of Quality and
Compliance now reporting directly to the Managing
Director.
In SureCare our domiciliary Care franchise business
whilst we have seen a steady increase in the royalties
paid to us by our franchisees we have seen a significant
fall in the number of anticipated franchise
sales. The fall in sales is attributable we believe to
the following factors:
A tightening of the credit market, and a fall in the
value of property (taking equity from the home was
one of the main sources of funding used by prospective
franchisees to purchase the franchise and fund
working capital during the early stages of the businesses
development).
SureCare has also suffered from a delay of approximately
3 months in the production of its new rapid
response alarm aimed at the homecare market. The
device has been specifically designed for the group
and prototypes have undergone a process of robust
testing. We now anticipate the launch of this device
towards the end of this financial year.
In Primary Care Training our training business following
significant contractual delays experienced in the
first half of the year, resulting in a small loss for the
interim period we are now seeing significant
growth. Since April PCT have signed up 300 candidates
and expect to reach 500 by the end of July.
New Business
Since the end of the period we have been awarded
and commenced a number of new contracts. They
are:
Manchester—3500 hours per week (previously
around 1700 per week)
Rotherham—1500 hours per week
Leicester—Emergency Response
Blackburn & Darwen—Renewal and extension of existing
contract.
Lancashire—2 new extra care sites.
We are confident that the strong organic growth
achieved previously will continue.
Acquisitions
Complete Care Group
Ravenscroft
Other acquisitions
There continues to be a strong pipeline of acquisition
opportunities within the sector. The Group has been
in discussions with a number of possible vendors but
in focusing increasingly on the quality of earnings of
the existing businesses and also the need to consolidate
its current position has decided not to pursue
these acquisitions. Aborted bid costs in the sum of
£75,000 have been charged to income as a consequence.
Dividend
The Board does not propose the payment of an interim
dividend (2007 - 0.25p)
Current Trading and Outlook
Following the consolidation of our acquisitions and
the opening of new branches to service significant
new contracts we now operate from 39 branches located
principally throughout the Midlands and the
North of England.
Notwithstanding a number of challenges facing Claimar
and the wider care market, the Board of Claimar
Care believes that the business has good medium
and long term prospects given the population demographics,
industry trends of consolidation, the increasing
barriers to entry and the strong, motivated
and ambitious management team.
and the wider care market, the Board of Claimar
Care believes that the business has good medium
and long term prospects given the population demographics,
industry trends of consolidation, the increasing
barriers to entry and the strong, motivated
and ambitious management team.
Board Changes
David Jackson, who joined the Board as Group Financial
Director and Company Secretary on August
9 2007 resigned on May 8. On June 23 we announced
that Nick Townend, who is currently responsible
for the finance function at Anchor Trust, the
largest not-for-profit provider of housing, support and
care for the elderly in England, with turnover of approximately
£250m and a staff of over 11,000 will join
the Board as Group Finance Director and Company
Secretary on August 11. At Anchor he has responsibility
for all aspects of cash-flow and treasury management,
budgets, financial planning and forecasting,
and statutory and regulatory reporting. He
joined Anchor Trust in 2005 as Head of Finance of its
Care Services division, having previously held senior
positions at Tetra Pak and Royal & Sun Alliance.
12. Southern Cross shares slump after profit
warning
30 June 2008 - ReutersUK
Britain's largest care-home operator Southern Cross
Healthcare Group (SCHE.L: Quote, Profile, Research)
said it expected full-year core earnings to be
below market forecasts, wiping around two thirds off
its stock market value.
In a trading update on Monday, Southern Cross said
occupancy levels at its homes had not grown by as
much as it originally expected and trading was
unlikely to improve sufficiently for it to meet its previous
forecast.
Southern Cross reported that had been given an extension
to July 28 to pursue a sale of property assets
to cover the repayment of one of its banking facilities
of £46m.
13. Southern Cross Healthcare Grp PLC
30 June 2008
Trading Update, Funding Arrangements and Board
Change
“Although the overall occupancy in the Group's
homes has risen since the half year from 32,900 residents
to 33,450 residents (90% of all available beds)
by 27 June, this increase has not happened at the
speed, nor to the absolute number of residents, originally
anticipated by the Company. Central government
funding to Local Authorities for social care has
come through later than in previous years and the
seasonal admissions increase has taken longer to
occur. These factors, when combined with higher
than normal attrition rates of nursing residents, have
resulted in lower than anticipated occupancy levels.
Slightly lower occupancy spread across a large portfolio
offers limited scope to reduce costs and overall
financial performance in the second half has therefore
fallen behind expectations. Our fourth quarter,
which commences on 1 July, is traditionally the
strongest and we expect occupancy to continue to
improve, with a record number of residents currently
in our homes and actual fee levels now averaging in
excess of £530 per resident per week. Nevertheless,
trading is unlikely to improve sufficiently to meet our
original forecast.
In addition, financial performance in the Group's specialist
subsidiary, Active Care, has remained significantly
below forecast, due to lower occupancy levels
and a high fixed cost base. A new management team
has recently been appointed and they are conducting
a full review of the business.
As a result, the Board now expects that Adjusted
EBITDA is unlikely to exceed £80 million for the financial
year to 30 September 2008 (2007: £66.8million).
Funding Arrangements
As part of its overall banking arrangements, the Company
has two syndicated credit facilities specifically
for the purpose of funding additional acquisitions.
These facilities are currently drawn as to £82 million
and are secured against a portfolio of 20 recently acquired
and developed homes which are held for resale
and leaseback.
One of these facilities, drawn as to £46 million, was
originally due for repayment on 30 June 2008. It was
intended that the property assets funded by this facility
would have been sold prior to this date and the
loan repaid. While the Company has received indicative
offers in relation to certain of these assets, and is
continuing actively to pursue their sale, they remain
Group assets for the time being. Accordingly, the
Company, which is working closely in partnership with
its banking syndicate, has been granted an extension
to the repayment date and a waiver of an anticipated
non-compliance with a financial covenant until 28 July
2008. This period will allow the Group to pursue the
potential sale of some or all of these assets and/or
suitable amendments to its overall longer term funding
arrangements. A further announcement will be
made in due course.
Board Change
Richard Midmer, previously Finance Director of NHP
plc, is joining the Company as Finance Director. Jason
Lock, the current Finance Director, will leave the
Company with immediate effect.”
14. Qatar calls for help in reviewing ailing
investments
29 June 2008 - Telegraph
Qatar's sovereign wealth fund has appointed Ernst &
Young to restructure its entire debt-laden £3bn
healthcare and property portfolio and put a turnaround
plan in place.
The portfolio, which includes care home operator
Four Seasons which owes £1.4bn and specialist care
businesses Care Principles and Senad, has been hit
by falling property prices and cutbacks in Government
spending, and the Qataris are at risk of loosing
their investments.
The care home chains, which have tens of thousands
of staff, are burdened with debt and lenders to
the 30,000-bed Four Seasons business have threatened
to ‘pull the plug’.
Ed. Expect to see parts of the business being
put up for sale to release cash to repay bankers.
A ‘fire-sale’ may attract a lot of interest, but, only
from those who have cash or access to borrowings
at reasonable rates. Royal Bank of Scotland
already owns considerable assets and businesses
in the health and social care sector – it
might be interested in snapping up a bargain or
two. Alternatively, we may see interest from Russian
oligarchs and Sovereign Wealth Funds.
Care Homes
15. Fire safety in care homes
1 July 2008 - CSCI e-newsletter
It is important for providers to ensure that fire risk
assessments are up to date and regularly reviewed.
CSCI highlights the potential risk of using
manual override buttons at fire escape stairs in
homes for people with dementia.
More information on how to undertake a fire safety risk assessment
16. Ireland - ‘Private-bed’ use for elderly
soars
Use of non-health service beds jumps as average
age of population rises
30 June 2008 - The Times
The health service is renting 66% more beds from
private care homes than it was two years ago, as it
tries to cope with the country’s rapidly ageing population.
The Health Service Executive (HSE) had over 3,000
contract beds in private-care settings last February,
up 1,202 on February 2006. These are used to accommodate
public-nursing home patients when the
state’s facilities are full.
The HSE introduced a delayed-discharge programme
in 2005. The aim was to free up acute hospital beds
by moving long-term elderly patients to private residential
care. This has boosted the private sector,
with some homes now taken over by public patients.
17. ‘A social care system for all’
July 2008 - Caring Business
Minister Ivan Lewis addressed an invited audience of
care home owner/operators and paid tribute to all
those working in the sector. He said that councils
had to get away from the ‘no help here’ culture and
that it was ludicrous for them to keep voluntary and
private providers at arm’s length.
18. Legal challenge over fees for care homes
July 2008 - Caring Business
English Community Care Association is said to be
launching a legal challenge the level of fees paid for
council funded service users.
19. There are no easy answers
July 2008 - Caring Business
A report of a panel debate at the launch of national
care homes week; with some of the questions and
answers.
Case Reports
Law Reports
20. (1) A PRIMARY CARE TRUST (2) P (BY
HIS LITIGATION FRIEND THE OFFICIAL SOLICITOR)
v (1) AH (2) A LOCAL AUTHORITY
(2008)
Balancing conflicting welfare considerations, it had
been in the best interests of an adult male with severe
epilepsy to have his condition assessed at a
residential unit to which he and his mother consented,
which would not have a bed available for up to a
week, even though the medical evidence indicated
that he needed an urgent assessment because of the
risk to his health.
21. Law lords ruling could force change in
discrimination law Legal experts said a Law
Lords ruling in favour of a council which
evicted a schizophrenic man could force the
Government to overhaul discrimination law.
30 June 2008
More information at: http://www.learningdisabilities.org.uk/
information/news?EntryId17=30645
Disciplinary cases
Nothing to report
Cases in the news
22. Paediatricians cleared
5 July 2008 - The Times
Children’s doctor is cleared over tests
5 July 2008 - Daily Mail
Prof David Southall, Dr Martin Samuels and Dr Andrew
Spencer have been cleared of professional
misconduct in relation to tests and research on children
conducted in Staffordshire in the early 1990’s.
23. Judge backs cancer patient’s fight for
vital drug
5 July 2008 - Daily Mail
Jean Murphy, 62, from Salford and who had cancer
of the kidneys, succeeded in satisfying a judge in a
judicial review hearing that the Salford PCT which
distributed the £3,500 a month medication, Sunitinib,
only in exceptional circumstances – even though it is
routinely available in neighbouring trusts.
24. GMC dismisses child doctor case
4 July 2008 – BBC News
The General Medical Council has dismissed the latest
case against paediatrician Dr David Southall.
Southall and two other doctors were accused of not
obtaining the correct consent during a medical trial of
a new type of ventilator for premature babies in the
1990s.
Dr Southall has already been struck off the medical
register over another case, although he is appealing
that ruling.
For full report click here
25. NHS to review cancer drug refusal
4 July 2008 – BBC News
A judge has ordered Salford Primary Care Trust to
review its decision to deny a kidney cancer sufferer a
life-enhancing drug.
Jean Murphy, 63, of Salford, turned to London's High
Court after the Trust refused exceptional funding for
the drug Sutent.
She is the only carer of her seriously ill husband - a
factor the judge said the panel had failed to consider.
For full report click here
26. Worker's 'cruel sex act' on OAP
1 July 2008 – BBC News
Cardiff Crown Court has heard how a care worker
begged a colleague to lie on his behalf after he carried
out a sexual assault on an elderly dementia patient
at a home in Powys.
Gareth Jones, 22, is accused of a "shocking, pitiless"
attack on the 77-year-old when he got her ready for
bed at Mountain's Home at Libanus. The elderly
woman needed life-saving surgery after she started
bleeding.
For full report click here
27. Trust fined over man's bath death
30 June 2008 – BBC News
A Birmingham mental health trust has been fined
£25,000 after the death of an elderly man who was
scalded in a bath filled with 95C water at a respite
home.
George Inwood, 68, had Parkinson's disease and
died of a suspected heart attack and scalding at The
Lodge Hostel in Stechford, Birmingham, in 2004. The
inquest heard that a faulty thermostat meant water
was twice the recommended temperature.
For full report click here
Children
28. Court costs 'risk' for children
1 July 2008 – BBC News
The BBC has found out that an increase in court
costs could be putting local authorities off from applying
for protection for vulnerable children.
Fees for care orders in England and Wales have
risen 25-fold since April this year and an increase in
local authority funding is supposed to cover the increase
- but some council officials say it is too low
and has not been allocated properly.
Reports suggest that across England and Wales applications
for care orders have fallen by between 20%
and 60% since the changes.
For full report click here
Conferences & Courses
To follow next week
Consultations
29. Saving Carbon, Improving Health: A Carbon
Reduction Strategy for the NHS in England
Closing Date: 21 August 2008
The consultation document can be found at http://
www.sdu.nhs.uk
30. Towards a Strategy to Support Volunteering
in Health and Social Care: Consultation
Closing Date: 30 September 2008
A consultation seeking views on a proposed volunteering
strategy for health and social care that will
articulate the key actions needed to address the perceived
obstacles to volunteering.
For full consultation click here
31. Consultation on a Statutory Scheme to
Control the Prices of Branded NHS Medicines
Closing Date: 15 July 2008
This consultation seeks views on options for the
Government's use of statutory powers to control the
prices of branded NHS medicines.
For full consultation click here
32. Consultation on Assessment of Adult Social
Care
Closing Date: 8 August 2008
The Commission for Social Care Inspection (CSCI) is
seeking views on its proposed modifications to the
body’s performance assessment of adult services in
2008-09.
For full consultation click here
33. Transforming the Quality of Dementia
Care: Consultation on a national dementia
strategy
Closing Date: 11 September 2008
A consultation seeking views on proposals for a national
dementia strategy. It draws on evidence from a
range of reports and stakeholders, a series of listening
events involving more than 3,000 people and the
recommendations of an external reference group.
For full consultation click here
34. Consultation on the Publication of Children's
Homes Inspection Reports
Closing Date: 16 September 2008
A consultation seeking views on whether or not Ofsted
should publish children's homes inspection reports
on its website.
For full consultation click here
35. Volunteering in health and social care
Closing Date: 30 September 2008
A volunteering strategy for health and social care will
initiate the key actions needed to address the perceived
obstacles to making a refreshed vision for volunteering
in health and social care a reality. The
plan is to publish a final strategy and implementation
plan in early 2009.
For full consultation click here
36. The NHS Resilience and Business Continuity
Management Guidance 2008: Interim
strategic national guidance for NHS organisations
– Consultation
Closing Date: 30 September 2008
A consultation seeking views on a set of general principles
to guide all NHS organisations in developing
business continuity management processes.
For full consultation click here
37. A Consultation on the NHS Constitution
Closing Date: 17 October 2008
This consultation seeks views on a proposed NHS
constitution that aims to empower both staff and patients,
containing clear pledges on the ways in which
the NHS will strive to go beyond the stated rights to
improve the working environment.
For full consultation click here
38. NICE: Current consultations
To browse through consultations go to http://www.nice.org.uk/
page.aspx?o=consultations.current
CSCI/Care Quality Commission
(w.e.f. 2009), CSSIW,
Healthcare Commission &
Scottish Care Commission
39. CQC: Regulator to have social care and
mental health expertise
3 July 2008 – Community Care
The Government has bowed to concerns that the
Care Quality Commission board would be too healthdominated
and has now said it will include people
with experience in social care and compulsory mental
health services.
For full report click here
40. Healthcare Commission Corporate Plan
2008-09
2 July 2008 – Healthcare Commission
The Healthcare Commission’s corporate plan setting
out what the body wants to achieve in 2008-09, highlighting
key activities and how the commission will
measure success and shows the programme of work
and priorities for the year ahead.
For full report go to http://www.healthcarecommission.org.uk/
_db/_documents/1907_HCC_corpplan_tag.pdf
41. Management of controlled drugs in care
homes
1 July 2008 - CSCI e-newsletter
Last year, the Government passed legislation that
affects the way care homes store controlled drugs.
Nursing homes always had to comply with this legislation.
In 2007 the term ‘nursing home’ was changed
to care home and since then every care home must
comply. This brings legislation into harmony with the
National Minimum Standards.
Every care home needs to read this guidance:
Read our written guidance on the safe management of controlled
drugs in care homes
42. Food safety measures in care homes
1 July 2008 - CSCI e-newsletter
The Food Standards Agency has published a supplement
to the Safer Food, Better Business pack, which
was launched earlier this year. The Food Standards
Agency also revised its 2006 guidance for caterers,
on food served to older people in residential care.
Find out more about the new Food Standards Agency guidance
43. Campaign to raise the awareness of National
Care Standards
30 June 2008 – SCRC
A campaign to raise awareness of Scotland's National
Care Standards has been launched today and
will include a television advert and a touring theatre
production which will visit day centres and care
homes throughout Scotland.
For SCRC report click here
For full Scottish Government report click here
44. CSCI: Proposed regulatory regime is
‘backward’ step
30 June 2008 – Community Care
The Commission for Social Care Inspection has criticised
the Government’s new proposed regulatory
regime and warned that adult care providers will be
insufficiently challenged, especially in improving service
users’ quality of life.
For full report click here
Education
Nothing to report
Ireland, Scotland & Wales
Ireland
Nothing to report
Scotland
45. Health bosses order data amnesty
4 July 2008 – BBC News
NHS Lothian has ordered a data amnesty after an
employee lost personal information of 137 patients.
The campaign has been launched to ensure all
28,000 staff understand the rules on storing sensitive
data - and to own up if they lost files themselves.
For full report click here
46. Call For Crackdown After NHS Worker
Loses Patients' Files
4 July 2008 – The Herald
More concerns about how the NHS treats personal
information were raised again after files relating to up
to 137 Scottish patients went missing.
Copies of letters and memos containing medical details
were stored on a USB memory stick by a health
worker in NHS Lothian. This was in clear breach of
data protection rules and the device has since been
mislaid. The files contain sensitive medical details.
For full report go to http://www.theherald.co.uk/
display.var.2378808.0.0.php?utag=28804
47. Care roll-out report is published
4 July 2008 – BBC News
Fife Council has revealed details in an interim report
of 350 assessments of whether people can afford to
pay for their home-care services.
The pressure group CAC (Campaign against
Charges) had staged a protest inside the headquarters
of Fife Council demanding to know what was
happening. A full report on care-charges will go before
councillors in September.
For full report click here
48. Record Number Of Pensioners Are Diagnosed
With C Diff Bug
3 July 2008 – The Herald
A report has revealed that a record number of Scottish
pensioners have been diagnosed with the bug
C.diff.
The figures show 1861 cases of C Diff among the
over-65s between January and March this year
which is a 16% increase from 1608 in the last three
months of 2007.
Health professionals said the rise could be linked to
the changing seasons but warned as rates have
been monitored for less than two years, it is too early
to draw definite conclusions.
For full report go to http://www.theherald.co.uk/
display.var.2376473.0.0.php?utag=28804
49. GP contracts in £160m overspend
2 July 2008 – BBC News
An Audit Scotland report has found that the new GP
contract, that allowed most doctors to stop doing out
of hours calls, has cost more than £160m than had
been allocated for its first three years.
The report did point out, however, that early signs
showed that patients benefited in areas such as
monitoring and flexibility.
For full report click here
50. 'Mixed reports' on hospital bugs
2 July 2008 – BBC News
A survey by the NHS agency Health Protection Scotland
has shown that the rates of infection from the
bugs C.diff has risen, whilst those from MRSA has
fallen.
Figures showed that 1,861 people were diagnosed
with C.diff in the first three months of 2008 which is
an increase of 16% on the previous quarter.
Over the same three months, the number of people
diagnosed with the superbug MRSA fell to 193.
For full report click here
50. Vetting and Barring consultation report
2 July 2008 – Scottish Care
Update from Protection of vulnerable groups implementation
team on vetting & barring consultation exercise.
For full report click here
52. Stage set for care standard drive
30 June 2008 – BBC News
Dundee has seen the launch of a campaign aimed to
raise awareness of Scottish national care standards.
The standards set out what people can expect from
each type of service including childminding, personal
care and homes for the elderly.
For full report click here
Wales
53. Care homes and hospices could face
regular inspections
2 July 2008 – Community Care
A new inspectorate for palliative care providers in
Wales may be established in Wales following a review
by the All-Wales Palliative Care Planning
Group.
For full report click here
54. Welsh nursing homes inspected
1 July 2008 - COI
The Health and Safety Executive (HSE) has released
the results of a series of inspections carried out to
look at the management of some specific health and
safety risks at nursing homes across Wales during
March and April.
Of 28 homes inspected, 75% were issued with at
least one enforcement notice, and a total of 31 enforcement
notices were issued. The management of
legionella risk and the correct use of bedrails were
the main recurring areas of concern.
As a result of the findings, HSE will be contacting
nursing homes in Wales to remind them of their duties
to manage health and safety, and will be providing
training resources to help homes improve standards.
HSE Inspector Steve Scott, who led the initiative,
said: "The sample is a small percentage of the total
number of nursing homes in Wales, and we must
stress that not every nursing home we visited was
issued with an enforcement notice.
"Those who did receive an enforcement notice were
extremely keen to address shortcomings when they
were raised. These homes were given a specified
period of time to put matters highlighted right, and we
are carrying out follow up visits to all of these premises
to ensure that remedial action has been carried
out."
"The inspections found that management of other
risks such as slips and trips and manual handling
were generally being addressed but the use of bed
rails, and legionella risk, was an issue at many of the
homes we visited."
The HSE has been working with other organisations
such as the Care and Social Services Inspectorate
Wales (CSSIW), Care Forum Wales and Association
of Directors of Social Services Cymru to raise the profile
of safety at such care settings. Close working
with Local Health Boards (LHBs) and private providers
of care will continue, and HSE with its partners is
planning to hold safety seminars for nursing home
managers in the coming months. A number of interactive
tools are being made available online which
will provide further guidance.
HSE hopes to run seminars in September / October
2008 on the issues arising but homes requiring advice
and guidance in the meantime can contact HSE
Infoline on 0845 345 0055 .
Ed. First, I have seen the DVD produced by HSE &
BUPA, it is simple, direct and clear. I recommend
that all staff in care homes, especially managers and
maintenance staff upon whom, for the most part, the
burden of bedrails falls should view it.
We hope that you will soon be able to download
the DVD FREE OF CHARGE from our website.
Look out for future announcements.
During a five year period to March 2005, the Reporting
of Injuries, Diseases and Dangerous Occurrences
(RIDDOR) statistics identified at least 10 fatal
accidents and a number of major injury incidents in
which the use of bed rails was implicated. (Source:
http://www.hse.gov.uk/lau/lacs/79-8.htm)
Ed. I have spoken to the lead HSE inspector responsible
for this work, Steve Scott who told me
that it is clear that the level of knowledge of Legionella
risk is worryingly low. Advice and information
on controlling Legionella can be found at
http://www.hse.gov.uk/legionnaires/index.htm
Legionella is a bacteria commonly found in natural
and artificial water systems, and can thrive at
temperatures between 20 Degrees C and 45 Degrees
C. The main method of controlling them is
to ensure water is hot, and that hot and cold water
systems remain separate. There is a duty on
care homes under the Health and Safety at Work
etc Act 1974 to consider risks from legionella
that may affect their employees, and people in
their care.
55. New rules 'risk carers shortage'
30 June 2008 – BBC News
An investigation by the BBC has found that many
foreign staff working in care homes in Wales are uncertain
about their futures because of new work permit
guidance.
Some are leaving Wales to work in English care
homes where wages are higher ahead of the introduction
of new immigration rules.
For full report click here
Learning Disabilities
56. Fair Price, Fair Care: Care Funding Calculator
4 July 2008
The English Community Care Association noted the
launch of a National Care Funding Calculator to identify
the needs and costs of care for people with learning
disabilities living in residential settings.
ECCA believes that state funding for residential
placements should be based on a local negotiation
using all available evidence, which results in individuals
receiving high quality care and support. This
should represent value for money for commissioners
and a fair price for providers.
ECCA intends to monitor the use of this new national
calculator, alongside other local costing tools, to ensure
its Learning Disability (LD) members are treated
fairly. Costing models should be applied consistently,
recognising that as a result of the use of such models,
fees paid may need to change. There should be
no assumption that a wholesale fall in fees will result
from the use of this new calculator or, indeed artificial
targets for cost reduction set. The calculator should
be seen as a basic information resource and used
constructively in any negotiations, together with other
relevant information, by both parties to ensure best
quality personalised care.
It was sometime after the commencement of the work
to develop the calculator that providers from ECCA
were able to comment and input their views. ECCA
would have preferred an approach that saw providers
working on the calculator from the beginning with
commissioners in an open and transparent
way. Whilst some changes have been made as a
consequence of eventual dialogue between ECCA
members and the RIEP leading on the calculator,
more still needs to be done and ECCA will continue to
press nationally for adjustments to the calculator to
properly reflect property costs and investment returns.
ECCA will use its network of LD provider members
to monitor how the calculator is used locally and
also press further for any changes it feels need to be
made as a result of the experience of providers in
using the calculator.
As such, ECCA believes the new calculator launched
this month is the start of a process that is organic in
nature and that ECCA, and its members, will want to
see further iterations of the calculator in the future
based on local feedback.
Finally, ECCA believes that the regional RIEPs who
will promote use of the calculator within councils and
train councils in its use, should ensure that the training
involves providers. In rolling out use of the calculator,
bringing providers and commissioners together
at the initial stage, will allow a proper exchange of
views and concerns before the calculator is used locally.
We will encourage ECCA members to give feedback
to ECCA on how the calculator is used and to share
this with other ECCA members to ensure all members
are well informed on how the calculator is being
used. We will also aim to help and support providers,
wherever possible, where we feel councils are
using the calculator inappropriately.
57. Learning Disabilities Care Funding Calculator
Launched
4 July 2008
The English Community Care Association has responded
to the launch of the Care Funding Calculator.
Martin Green, Chief Executive of ECCA, said:
“ECCA believes that state funding for residential
placements should be based on a local negotiation
using all available evidence, which results in individuals
receiving high quality care and support.
“Costing models should be applied consistently, recognising
that as a result of the use of such models,
fees paid may need to change. There should be no
assumption that a wholesale fall in fees will result
from the use of this new calculator or, indeed artificial
targets for cost reduction set. The calculator should
be seen as a basic information resource and used
constructively in any negotiations, together with other
relevant information, by both parties to ensure best
quality personalised care.”
58. New report from the Learning Disability
Coalition highlights cuts
3 July 2008 – NCF
A report published by the Learning Disability Coalition
shows that 34% of people with a learning disability
have reported that their day time activities have
been cut. The report ‘Tell it like it is’ was the result of
a survey undertaken of people with a learning disability
and their carers.
The survey also reveals that 37% of people whose
college courses were cut were forced by lack of provision
to stay at home and 77% of people who commented
on their transport services had a negative
experience of them.
For full report click here
Legislation Update
59. No. 260 The Protection of Children
(Scotland) Act 2003 (Amendment of the Definition
of Child Care Position) Order 2008
1 July 2008 – OPSI
For full legislation click here
Mental Health
60. DH-funded study: £2bn to eliminate ageism
in mental health
3 July 2008 – Community Care
The Department of Health has funded study which
estimates it would cost £2bn to eliminate age discrimination
in mental health services in England.
For full report click here
61. DH: Pandemic influenza: guidance on
preparing mental health services in England
2 July 2008 – DoH
A document designed to assist mental health trusts
and other specialist mental health service providers in
developing their plans for responding to an influenza
pandemic.
For full report click here
62. Key bodies call for urgent action on mental
health in later life
30 June 2008 – NCF
Key organisations are calling for action from the Government
to address a full range of ‘later life’ mental
health problems as its formal consultation on the National
Dementia Strategy for England begins.
For full report click here
Miscellaneous
63. Polyclinics 'not a threat' to GPs
6 July 2008 – BBC News
Lord Darzi, Health Minister, has insisted that no GP
surgeries will be closing due to the introduction of
polyclinics.
He said no practices would be forced to shut due to
the 150 new centres which will house doctors alongside
other medical staff.
For full report click here
64. From Bucharest...
5 July 2008
A Romanian surgeon must pay a man £400,000 for
accidentally chopping off his penis during an operation.
It seems that it was not re-attached and that an
‘aesthetic organ’ was made from muscle – the man is
said not to have a ‘good state of mind’.
65. Expatriates win healthcare battle
5 July 2008 - The Times
Britons living in the Spanish Region of Valencia have
secured the right to public healthcare at ‘affordable
prices’.
66. Charging for Residential Accommodation
Guide 2008
4 July 2008 – DoH
This is the latest draft of the 2008 charging for residential
accommodation guide. It covers charges for
residential medical accommodation.
For full report click here
67. Whistleblowing Arrangements Code of
Practice
4 July 2008 – NCF
The PAS 1998:2008 Whistleblowing Arrangements
Code of Practice is now Available to download.
This document sets out good practice for the introduction,
revision, operation and review of effective
whistleblowing arrangements.
For full report click here
68. Health Scrutiny
Health Scrutiny in the North West Conference:
Facing the Challenge Together
With both Health and Social Care undergoing significant
change and development, Health Scrutiny is
entering into a period of both challenge and opportunity.
The introduction of Local Involvement Networks
(LINks) providing communities with a stronger 'voice'
in local Health & Social Care services; the potential
of joint-commissioning for service improvement and
responsive delivery; the growth of NHS Foundation
Trusts and merger of Health and Social Care regulation
- all mark the shift towards greater partnership
working as the vehicle for change and progress.
'Facing the Challenge Together' was the second Annual
North West Health Scrutiny Conference and
took place on Thursday, 26 June with nearly 100
delegates. It was sponsored by the Centre for Public
Scrutiny and NHS North West, and supported by
North West Employers and the North West Overview
and Scrutiny Officers’ Network.
The Conference is part of a wider regional strategy to
develop the North West Health Scrutiny Network. The
network seeks to support strong, impact driven scrutiny
by working together and sharing information,
knowledge and expertise, and the context for improving
the health of the region was outlined by Mike
Farrar, Chief Executive of NHS North West, and was
set on ‘Healthier Horizons’, a ten year vision for the
North West.
Healthier Horizons for the North West
The conference was chaired by Liz McQue, Chief
Executive of North West Employers, and the speakers
are listed below. Click the links for the presentations
from the day.
Keynote Speakers
Colin Douglas, NHS Director of Communications
Jessica Crowe, Executive Director, CfPS
Liam Hughes, National Advisor of Healthy Communities,
IDeA
Mike Farrar, Chief Executive NHS North West
Masterclass Seminars
Colin McKinless, NHS North West
Dr Alison Rylands, North West Specialised Commissioning
Team
Dr Ruth Hussey, NHS North West
Stephanie Varah, LINks Implementation Co-ordinator
On the day, we ran an interactive session around
some of the challenges and visions in the Healthier
Horizons document. The results are neither right nor
wrong: they represent views of those participating on
the day.
69. More support to deliver affordable housing-
announces Flint
3 July 2008 - COI
New immediate measures designed to respond to the
impact of the credit crunch on the housing market and
maintain the delivery of new affordable housing, were
announced by Housing Minister Caroline Flint.
The measures are the first part of a wider package of
action the Government will be announcing this month
to increase confidence and help ensure stability and
fairness in the housing market.
Announcements include:
* A further £270 million is today being allocated
through the Housing Corporation to deliver an additional
3,800 homes for social rent and 1,500 shared
ownership homes over the next three years. This will
help to stimulate wider market activity and brings the
total now allocated over the next three years to £3.6
billion out of the £8.4 billion total budget. This will
drive forward delivery of our overall target of 180,000
affordable homes over the period.
* A new national clearing house is being set up
where house builders can approach the Housing
Corporation with robust proposals to sell their unsold
stock for affordable housing. The Government has
committed £200 million so far for affordable housing
providers to purchase unsold stock from house builders,
which can then be used for social or affordable
housing. The clearing house will enable this resource
to be invested as quickly as soon as possible, by
giving developers greater certainty and an early steer
on their chances of success.
* Increasing flexibility around when providers can bid
for funding from the Government's £8.4 billion affordable
housing programme. Providers will now be able
to come forward with proposals for the Housing Corporation
at any time, rather than waiting for the quarterly
bidding round. This will enable the Corporation
to increase the pace of approvals, to deliver desperately
needed affordable housing, while also supporting
developers.
* Increased funding flexibility so that the Housing
Corporation will now have the option to offer more of
the payment to housing associations and other developers
delivering affordable and social housing at
the start of schemes, helping to improve providers'
cash flow, encourage new starts and stimulate wider
market activity.
* The Government is today announcing the sixth
round of the Housing Private Finance Initiative.
Councils will be able to bid for a share of up to £1.87
billion to build new homes or refurbish existing
houses and estates. The Government will be looking
for bids that aim to shape strong and dynamic communities,
not just build estates, and which make a
real contribution to increasing local housing supply.
Ed. I wonder how much thought has been given
to housing for those with disabilities trying to get
on the housing ladder.
70. NHS Identity Scheme For Dental Practices:
Summary of responses
3 July 2008 – DoH
This document summarises responses to a consultation
on the NHS identity scheme for dental practices.
For full report click here
71. Dental patients should register, says
committee
2 July 2008 – HSJ
MPs on the Health Select Committee are calling for a
return to a registration scheme for dental patients,
they say the move would help ensure more effective
dental care.
72. Q&A: Dental reforms
2 July 2008 – BBC News
Article looking at how reforms has changed dentistry.
For full report click here
73. The man who gives lessons in death to
people who have lost the will to live
2 July 2008 - The Times
A German politician, Roger Kusch, has been promoting
Germany as a destination for assisted suicides.
The case of Bettina S, a 79 year old lady
whose death he assisted, is summarised. Ms S contacted
Roger Kusch because “she was afraid that she
might have to move into a care home”.
Kusch is a former judge, adviser to Helmut Kohl and
Gerhard Schroder and justice minister of Hamburg.
74. Britain’s Missing Top Model
1 July 2008 - BBC Three TV
A version of America’s Next Top Model with a twist;
the twist being that each of the contestants was disabled,
mostly had a limb or part missing. The judges
began to look at what each contestant had rather
than what they were missing. A shame then that one
contestant, Lillie, was ejected not for her looks but
because she didn’t look disabled enough – she is
deaf.
75. NHS dentistry reforms 'failing'
1 July 2008 – BBC News
A report by MPs has revealed that changes initiated
to improve NHS dental services in England have not
succeeded.
The new contract was introduced in 2006 aimed at
simplifying charges and make it easier to locate an
NHS dentist.
For full report click here
76. GSCC to consult on Personal Assistant
Registration
1 July 2008 – NCF
The General Social Care Council (GSCC) has declared
its intention to consult on a system of regulation
for personal assistants at the launch of a new
study looking at the impact of direct payments on the
people who receive them and the personal assistants
they employ.
For full report click here
77. Smokefree England: One year on
1 July 2008 - COI
More people are trying to quit smoking, the air in
pubs and bars is cleaner and rates of compliance
with smokefree laws remain high, according to a new
survey looking at the first year of Smokefree England.
Smokefree law has created a more supportive environment
to help smokers quit t