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Survey moves sector in right direction (article from CMM)

This article appears in the November issue of Care Management Matters

The recently launched care sector survey, Your Care Rating, has attracted positive publicity and received a generally warm welcome from all quarters.  Melville Knight, Chief Executive of Castleoak, the specialist care sector development and construction group, sits on the Board of Your Care Rating and played a pivotal role in its creation.

Here, he takes a look at the genesis of the idea and reveals his hopes for its future.

It might seem unusual to credit a journalist with the impetus for Your Care Rating but that’s exactly what we have to do with David Brindle, the Guardian’s highly respected Public Services Editor.

To explain the connection, you have to go back to April 2011 and a conference we funded for leading figures in the care sector. The question we were posing at our Innovation Exchange event was what could the care sector do to improve its image and to help people see the decision to move into care as a positive one.

The choice of topic could not have been more appropriate, as the event came hot on the heels of the Panorama expose at Winterbourne View.

As anticipated, the conference produced much lively debate and left us with a great deal to think about – but that might have been it without David’s call to arms.  Speaking from the platform, in answer to a question from the audience about what we could do next to take this agenda forward, David was very forthright and practical. His view was that we should resolve not to leave the venue without agreeing that we were going to do something to maintain the momentum.

A number of key figures stepped forward there and then to pick up the gauntlet thrown down and a meeting of what became the Steering Group was convened. At the same time, both the National Care Forum and the English Community Care Association indicated their willingness to throw their collective weight behind this initiative.

Steering Group determines direction
If you had asked most of the Steering Group members what they thought the outcome of our discussions might be, I would hazard a guess that most of us would have anticipated the creation of some sort of wide-ranging PR campaign, designed to redress the balance between negative and positive coverage of the sector.

However, it very quickly became clear that we would be following a different track. The delivery of an annual independently conducted, sector wide survey was seen by all as a means of providing the public with objective data which would allow them to see for themselves what care home residents thought of the care they were receiving.

This was seen as a much more meaningful course of action than an orchestrated PR campaign. Higher risk too? Well yes - because the survey results will be transparent and nobody can guarantee how good they will be - but all the more credible for that.

The organisations represented on the Steering Group led from the front by agreeing to switch from their existing internally organised survey arrangements to a universal and transparent sector wide model.

The fact that these organisations were represented on the Steering Group by Chief Executives or senior directors should not be underestimated. They were able to make on-the-spot commitments that meant the discussions maintained a real momentum.

That fact, coupled with the buy in from NCF and ECCA also made a major difference when we came to talk to other providers about it. If this initiative hadn’t been backed by Steering Group organisations, who could deliver over 30,000 beds between them, it’s unlikely that we could ever have built up such a head of steam.

It also says something about the sector that those on the Steering Group were adamant that they were not seeking to create some self-appointed elite club. There was a fierce determination that, although Your Care Rating should offer a “quality mark”, it should most definitely not be a tool for self promotion.

Nor should it be a “provider league table” by the back door, which is why the results focus on individual homes rather than aggregated scores for providers.

What is the current state of play?
Almost 50,000 residents in 850 homes received the independent survey in the week of 17 September. It is being conducted by leading market research company Ipsos MORI which has researched, designed and implemented the survey.

The survey will be completed annually and will enable participating care providers and customers to compare results from one care home to the next. In this first year, organisations that missed out in the September cohort can form part of an interim study in January 2013.

In the survey, care home residents are being asked to rate factors including activities, privacy, security, food, outdoor areas, staff, whether they are happy at the home and whether they would recommend it. The results will be published in early 2013.

A great deal of care has been taken in the design and piloting of the survey to make sure that the survey is accessible to as many residents as possible; indeed, a group of residents was involved in shaping the approach. The process has been designed to allow relatives, friends and volunteers to assist residents with survey completion, but it is the residents’ views that will be captured.

A total of 13 national and regional organisations have signed up to the initiative, including those from the for-profit and not-for-profit sectors.  They are Anchor, Avante Partnership, Barchester Healthcare, Borough Care, Care UK, Community Integrated Care, Coverage Care, The Fremantle Trust, Greensleeves Homes Trust, Guinness Care and Support, HC-One Limited, Methodist Homes and The Orders of St John Care Trust.

Your Care Rating covers care homes in England, Scotland, Wales and Northern Ireland - primarily serving older people (aged 65+). However, younger adults in such care homes will be included. We hope that many more care providers and care homes will join the year 2 survey that will be conducted in September 2013.

Board Structure and Governance
The Board of Your Care Rating has been established as an independent not-for-profit organisation. This company has been formed to host and promote the survey, provide an authoritative source of information for prospective residents and family members and to champion continuous quality improvement in care services.

The company is a ‘not for profit’ organisation, and any surpluses will be retained and used to further its aims and objectives. To begin with, it made sense for those involved in the Steering Group to form the first Board.

However, our aspiration is that, with time and in the interests of good governance and independence, representatives of the care providers taking part in the survey do not sit on the Board but are part of a representative reference group. Depending on the strength of the finances there may also be a case to look at establishing a simple executive structure.

For the time being, however, apart from me, the other directors are:-

  • Jane Ashcroft, Chief Executive, Anchor Trust
  • Mike Parsons, Chief Executive, Barchester Healthcare
  • Douglas Quinn, Chairman, Castleoak Group
  • Roger Davies, Chief Executive, MHA Care Group
  • Carole Sawyers, Chief Executive, Fremantle Trust
  • Cedric Frederick, Chief Executive, Avante Partnership
  • Belinda Moore, Marketing Director, Care UK
  • Julian Evans, Head of Healthcare, Knight Frank

At the launch of Your Care Rating, Anchor’s Jane Ashcroft chose some very appropriate words to sum up why its introduction should be seen positively.

“People often choose a care home at a time of crisis so it’s crucial they have relevant information at their fingertips and nothing is more important than the views of current residents. This survey will provide that,” she said.

“Crucially, the results will also provide valuable information for providers to help continuously improve their services and the involvement of Ipsos MORI means people can feel comfortable that their feedback is anonymous.”

In conclusion
Your Care Rating is a very positive indicator that collaboration in the care sector is alive and well and that care providers have a genuine desire, matched by a financial commitment, to try to make it easier for the public to get easy access to objective and helpful data that can inform their decisions.

I have personally been delighted that the initiative has been so well received. The wider national press and media have picked up on it – it even enjoyed an airing on BBC’s One Show - and I believe it has helped to reinforce the message that the sector is really serious about delivering the best possible care. We are receiving enquiries about the initiative from providers on an almost daily basis.

Politicians and the Regulator have made encouraging noises and I really hope that we can maintain and build from this very positive start – and we are now exploring ways of rolling it out to embrace those delivering extra care, domiciliary care and, as appropriate, certain forms of specialist care for younger people.

Of course, there is no silver bullet.  The emergence of Your Care Rating won’t eradicate the risks the sector faces from, for example, rogue care workers but it does show that the sector is prepared to be transparent, wants to listen, will take positive action and that it is moving in the right direction. Most importantly, of course, it gives people receiving care a real voice.

This article appears in the November issue of Care Management Matters

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