5 tips to improving care business profitability

Care Homes are enduring an increasingly tough battle for survival, whether it is inconsistent CQC inspections, the cost of minimum living wage, or hard up local authorities, so it might seem strange to read an article about profit improvement.

However, in my opinion, Profit is a choice, as is the level of the profit.

Briefly – Profits are simple – in theory! – to have a profitable business, you need to be able to charge the “right price” necessary to cover your costs to leave appropriate levels of profit over for you to invest, to repay loans and to reward you with the lifestyle you deserve.

Alas we do not have a “pure market” as such, and a large number of care homes rely on state funded clients for their income. 

However, the same principle applies to these care homes, but only if they can find relatives who are able to contribute additional “top up” funding.

So for my five tips for financial success I have to assume you are ready to take the necessary measures to attract clients who can afford to pay extra or who have relatives who are prepared to contribute extra 

1 – Strong Leadership is vital – and employ the right team members to allow you to create “the right culture” in your home 

2 – Identify small inexpensive ways to stand out from the crowd, and make your residents say “wow” about you and your team

3 – Think menus – give your clients more choice of services for which they might be prepared to pay

4 – Use the power of social media to allow the benefits of your home to be shared “live” with prospects 

And last, but not least, 

5 – Always be proud of your prices – never make the suicidal mistake of trying to compete with competitors on price 

Care Home Resident shares her experience of saving Canton Library from a bomb in WW2

Another fabulous initiative from Hallmark Healthcare. Thanks Avnish Goyal for sharing – this sort of thing makes Care Homes less institutional and more like little communities – I love Hallmark and the way they continue to set higher standards for their homes

Edith Spackman, 93, who lives at Regency House, our care home in Cardiff, South Wales has shared her experience of saving Canton Library from a bomb in WW2.

I started working in Canton Library in Cardiff when I was just sixteen years old. When I applied for the Library Assistant job, they took three people straight away and five went on a waiting list. I was really upset when I was one of the five, but after two short months I got the job! During the war we were always worried about bombs coming down and would have to take extra care walking to and from work. About a year after I had started working in the library, during the Cardiff Blitz in 1941, one of the air raid sirens went off and we had to evacuate everyone from the library. In times such as this, customers would leave but the staff would stay until the library was ready to be re-opened to the public.

I was doing some filing in the back room when an incendiary bomb was dropped through the roof and landed on the filing cabinet. I was in shock, but I can’t say I was scared really as at this point I was used to the raids. The incendiary bombs spat out chemicals designed to start a fire, so my first instinct was to put it out and save myself and the library. I grabbed a bucket from the store room, filled it with water and used the foot pump to squirt water onto the bomb. The library’s caretaker came running to help me and brought a bag full of sand, which he poured over it and the flames soon went out.

Once the fire was completely out and the library’s closing time had passed, I left and walked home to Ely, just as I did every evening. There were a lot of bombs going off that night, especially around the docks and Canton High School had been reduced to a shell.

When I got home, I noticed that there were lots of little holes in my dress, but at the time I didn’t think anything of it. The next morning, I got up for work and got dressed, only to see that I was covered in little red dots. I thought I had chicken pox, so I went straight to the doctors on my way to work to get some cream to sooth it and it turned out they were burns from the chemicals. From the doctors I went straight to work but I was so worried about being late, we didn’t have telephones in those days, so they may have thought I wasn’t coming in. I loved my job working at the library and I didn’t want anything to jeopardise it.

Despite the bombing the library was open as usual the next day. I used the cream the doctor gave me and the burns healed in just a week. I worked in the library until I was called upon to repair aeroplane engines in the war, but I soon returned to the library once the war had finished.

Care home with something to shout about

Alison and her team

The 40-bed family owned home run by Alison Lee and her husband Gabriel celebrated its top rating in November (see EXCLUSIVE: Hampshire care home is ‘outstanding’) along with its 40th anniversary.

“We were celebrating our 40th when we got news of the outstanding so it’s been party after party,” Alison said.

Unlike some other homes we have spoken to, Alison and her team did not prepare for their CQC inspection.

“Nothing is just a tick box exercise it’s all about having a positive outcome and impact on our residents.

“I get really cross when people say you need to do this for the CQC,” Alison added.

“We don’t do anything just for the CQC, we do it for our residents’ benefit and care. It’s us as we are. We couldn’t prepare because we didn’t know they were coming.

“Sometimes we don’t communicate well enough to the CQC what we are doing. I think that’s probably what our biggest weakness has been in the past.”

General manager Jo Grinyer added: “What we are doing is so natural to us that sometimes we can forget that what we are doing really is special.”

Manager Vicky Ayling, who has been with the home for 17 years, said “really good team work” and listening to the residents was the home’s winning formula.

Alison and her team spend a lot of time getting to know the life histories of their residents so their care is as personalised as possible.

“We get to know their life histories,” Jo said. “We use that to shape everything we do from the activities to the care.”

Staff training is key for Woodlands and Hill Brow, which achieved Investors in People Gold status in 2013.

“When we are recruiting we are looking for a spark in people and a desire to do this,” Alison said.

“All of our staff from the laundry man to the manager are trained very heavily.”

Staff turnover is low for the group at just under 20% with no agency staff at the homes. The group has signed up to the Living Wage which offers a minimum rate of £8.45 an hour.

Annual bonuses are also provided and staff are further incentivised through a “staff achiever” award with staff nominated each month by residents for a £25 prize.

When hiring, the group looks for the right attitude rather than qualifications.

“We can teach anyone without the qualifications,” Alison said. “All of our senior staff are qualified assessors so they all teach NVQ.”

Jo added: “Sometimes it is easy when people don’t have previous experience so we can train them in our ways.”

The home offers dementia forums to help relatives on what to do when they come in to see their loved ones. It also has a dementia specialist who works alongside the staff.

“While we have a nursing home where we can move people if necessary we are aware that moving people living with dementia can be very distressing. After all this is their home so we support the staff to make sure people can stay here for as long as possible,” Jo said.

“We are trying to lead and shape the future for all care homes by sharing our experiences and knowledge.”

Through her nursing background and experience as a community matron Jo has led the way in minimising hospital admissions for Woodlands’ residents through training staff to recognise the signs of infection and preventing falls.

“Our hospital admissions across our three homes have halved thanks to Jo’s training,” Alison said.

With weekly rates of £840-£1,090 for residential care the group is predominantly made up of private, fee-paying residents.

“We have to make a profit to make sure that we are still running next year as it enables us to invest for the future and in our staff.”


When touring Woodlands, Care Home Professional was struck by the little thoughtful touches that make the home special. A quiet area in one of the home’s corridors is a favourite spot of one resident who simply likes to watch the passing traffic. A TV camera has been set up on a bird box in the home’s garden so residents can watch birds as they feed. In the dining room, a calendar of events provides information on a packed weekly itinerary of activities which include visits from a ‘pat dog’.

Chef Becky Collier offers a  different menu each day catering to the tastes of the residents. Becky’s  ‘booze trolley’ is a big favourite. She also runs a popular cooking club on a Thursday afternoon where residents can cook their own tea.

Students living in nursing homes – a solution to our ageing populations?

In today’s society both young and old increasingly find themselves living in a bubble of like-minded and similar-aged peers. This is especially true of university students who leave home at 18 to live with people of the same age – who have quite often had similar life experiences.

Given this, the report that a Dutch nursing home has established a programme providing free rent to university students in exchange for 30 hours a month of their time “acting as neighbours” with their aged residents is unusual.

The programme has seen students in their early twenties sharing lives with residents in their eighties and nineties. As part of their volunteer agreement, the students also spend time teaching residents new skills – like how to email, use social media, Skype, and even graffiti art.

Reducing loneliness

The incentive behind Humanitas Deventer’s “exchange” programme is the research basethat shows that reducing loneliness and social isolation improves well-being and extends life expectancy in the elderly.

And though research on the impact on students seems yet to be explored, from my own experience of running a similar project at the University of Exeter, I know that it is overwhelmingly positive – giving young people a sense of connection with older generations, and significantly increasing the likelihood that they will continue to volunteer after university.

Since 2011 student volunteers from the university’s Department of English and Film donate their time to bring conversation, literature, and friendship to the residents of over ten residential care homes across the city. And since the project’s inception it is estimated that around 250 active volunteers have reached over 500 elderly residents – at least half of whom have dementia.

Reading between the lines

The Care Homes Reading Project draws upon the natural skill set of its target volunteer community – which includes a love of reading and an understanding of the power of literature to impact lives positively.

Research shows reading poetry with dementia sufferers – many who learned poetry by heart when they were younger – brings comfort and reassurance through hearing and reciting familiar verses.

 Age breakdown of global population by 2100E

Image: Bank of America/Merrill Lynch Global Research

Rhythm and rhyme bring a sense of order and predictability and, as this project has seen first hand, poetry can spark memories previously unknown to carers and even to family members.

Residents regain a sense of themselves as “a whole person, past and present”, as one care home manager put it. And in one brilliant example, a 100-year-old resident found a shared play-reading session with one student volunteer revived long-buried leading-lady speeches once delivered when she was an actress.

Shared passions

Our experience in Exeter has shown that students can help to supplement the quality of care in homes by providing relief for overstretched staff. And residents typically respond with enthusiasm to the novelty of younger visitors and to the creativity students bring to their sessions.

Residents are also encouraged to be creative by writing their own poetry. And English students offer expertise in selecting and discussing appropriate literature, and show sensitivity to the emotional response that language can have.

Many students find the visits often evolve into wider-ranging conversations and discoveries of other activities that bring happiness and interest to the residents. One student now not only visits a care home to read but also to hold ballet classes. And in the same home other residents have made use of students’ language skills, holding French and German conversation sessions.

Volunteer students look forward to their weekly visits. They find it is a space they can share poetry and stories – away from the demands of assessments. And many have said that it reminds them why they chose to study English literature in the first place.

Students also learn how past generations read the very same poems in surprisingly different ways. They see first hand how literature stays with us throughout life. And how the experience of shared reading helps to overcome the social and ideological disconnect between generations that plagues contemporary society.

Breaking boundaries

The moral health of a society is plainly visible in the way it treats its most vulnerable members, especially the aged. The government recently announcedthat universities will be required to demonstrate their commitment to enhancing social mobility by establishing or supporting schools, so why not also mobilise the resources universities offer to enhance opportunity and well-being at the other end of life’s spectrum?

The largest resource universities possess is the student body – a force with time, energy, few domestic responsibilities, and a desire to use their developing skills to make a positive difference in the local community.

Our reading project in care homes shows how both young and old can benefit from this type of arrangement. So just like the Dutch, it would be great if Universities in the UK could also look to reduce the cost of tuition fees or accommodation in exchange for meaningful social investment to get more people young and old spending time together.

Written by
Johanna Harris Senior Lecturer in English, University of Exeter
Wednesday 30 November 2016

Sexual healing? Sex robots should be put in OLD PEOPLE’S homes, says expert

SEX ROBOTS should be put into elderly care homes to help residents who still want to fulfil certain needs, a leading expert has stated.

Sex robots are just around the corner with many believing that the first commercially available ones could be available as early as next year.However the ways in which they are introduced to society is something of a hot topic at the moment, with experts discussing whether their availability should be limited or free for anyone to purchase.

Another talking point is whether they can be used for therapeutic reasons.Kate Devlin, a Senior Lecturer in the Department of Computing at Goldsmiths University, who organised the recent ‘Love and Sex with Robots’ congress at the university, says that sex robots purpose should extend beyond simply helping people to get their rocks off.

Instead, Dr Devlin proposes that sex robots could be used to help people therapeutically.

She told Express.co.uk: “The thing that interests me is the use of sex tech for the elderly in care homes because when we say to old people ‘we’re going to put you in a care home’, it really infantilises them but these are still grown adults with the same amount of desire for intimacy but it is incredibly taboo to say.“You could be talking about someone who has lost a husband or a wife and they’re feeling alone and perhaps that is one thing that we could offer.”

Dr Devlin also suggests using them to help people with learning difficulties – potentially helping them to normalise the idea of sex or to help cure loneliness.
She added: “We could actually take a different approach from the porn approach and look at it from a therapeutic way for people who have perhaps limited ability, where they have a virtual sex life.
“You could provide one to somebody who, perhaps for one reason or the other, can’t get out into society to meet people and perhaps that is an alternative to them, perhaps they have physical disabilities, perhaps they have learning difficulties, so it gives these people a new way to connect.”One topic that many experts are considering at the moment is the possibility of using the robots to help prevent sex offending.

However, Dr Devlin is unsure whether it would deter sex offenders or encourage them.The computer scientist said: “We have two attitudes towards this and the first is that if a sex offender had access to a sex robot, perhaps that would be enough of a proxy to stop any abuse of humans, the other argument could be that that could be an escalation.

“Would having that kind of access would mean that they are more likely to go out and abuse humans – we don’t know, we haven’t studied it well enough.“Is it something that could be used as an outlet or is it something that would lead to more offending?”

‘Magic Table’ game helps dementia patients relax and reminisce

A new interactive light game for people with mid- to late-stage dementia is being trialled in UK care homes

Lights are projected on to a table as two people with dementia use Tovertafel (Magic Table).

Tovertafel (Magic Table) consists of a projector that displays interactive images on to any surface below. Photograph: Job Jansweijer/Tovertafel

This is significant. All four are “difficult” or “withdrawn” residents with dementia at Care UK’s Oak House care home in Slough, Berkshire. They are playing with a Tovertafel (Magic Table), a series of interactive light games specifically designed for people with mid- to late-stage dementia, which has newly arrived in the UK.

The staff are smiling too. “It’s nice to see engagement and eyes lighting up,” says care home manager Julie Bignell. “Doris can be very difficult and she’s having a lovely time. And it’s hard to persuade Don to sit down. Now he is, and he is really animated playing with that ball.”

“William gets very angry and aggressive,” says his care worker, “so to get him to sit calmly for this long is great.”

The game changes, bringing flowers floating across the table. Lily strokes one of them and it grows into a huge bright bloom. She starts talking about flowers. Then goldfish come swimming along and Lily makes them appear to swim up her arm. “My mother would love this,” she says. “Where can I get one? Can I put down a deposit?”

Tovertafel was developed in the Netherlands and has taken the region by storm. Launched only in March 2015, there are already 500 Tovertafels installed in care homes in the Benelux countries. It got its name from someone with dementia who announced when trying it that “this is a magic table”.

The game has been brought to the UK by John Ramsay, who gave up his job as a corporate lawyer to do this. His father was diagnosed with early-onset dementia when he was 12. “Towards the end,” Ramsay says, “there was nothing I could do to engage him – nothing. Having Tovertafel, something we could do together, would have made such a difference to me as well as to him. It gives me goosebumps when I see residents with grandchildren they’ve been unable to communicate with playing together.”

A group of women enjoy creating a blooming flower on the Tovertafel
 A group of women create a blooming flower on the Tovertafel. Photograph: Job Jansweijer/Tovertafel

Tovertafel was developed by PhD student Hester Le Riche, who wanted to create something to stimulate activity – physical, mental and social – in people with later stage dementia. Few products are designed for them and they mostly become very passive. Some care homes do have sensory rooms but they require one-on-one supervision, and many residents find them too much and won’t go in.

Le Riche wanted to make something that would be in the care home’s main area, that could be done in groups and that required no special supervision. She soon settled on light as the perfect medium: energising, attention-grabbing, clean and completely safe.

After spending many months in care homes (“which sometimes almost made me cry”), following overworked staff (“who often didn’t even have time to talk to residents”), and sitting for hours beside people with dementia, Le Riche tried out all sorts of different images and activities. “The residents designed the games in the end,” she says, “we just watched, listened and laughed with them.”

Tovertafel now consists of a portable white box hung from a hook in the ceiling projecting interactive images on to any surface below. “It does not require initiative,” she says. “It invites reaction.”

Le Riche read the literature on the neuropathology of dementia and on the science of play, establishing that people in the later stages of the disease can still experience three primary outcomes of play: sensation, relaxation and reminiscence. Tovertafel’s eight different games (with more on the way) are specifically designed to elicit all three.

“You can’t go wrong,” Le Riche says. “If nobody touches the beach ball, it bounces off the edge of the projection area. If minds wander, there is always something to come back to. When you have dementia, you are constantly losing abilities, so it is important to be proud of what you can do.”

Tovertafel got its name from someone with dementia who announced that “this is a magic table”.
 Tovertafel got its name from someone with dementia who announced that ‘this is a magic table’. Photograph: Job Jansweijer/Tovertafel

Le Riche and Ramsay have recently launched a version of Tovertafel for people with learning disabilities. The hardware is identical but the games are different – more intense, more directly educational. And from next spring there will be a set of games, also expertly designed, for children with autism. Le Riche is excited about this. At one test session, she says, there was a child who was never able to play with other kids because, “whatever he got hold of he threw. You can’t throw light so Tovertafel allowed him to play with other children for the first time.”

“Everyone has a right to play,” Ramsay adds, “we all need a bit of fun.”

Article from The Guardian by Juliet Rix – 20 Dec 2016

  • Residents’ names have been changed

The Heart of Care by Amanda Waring

A great book for carers – Amanda Waring is a lovely lady with an important message


Passionately written by  Amanda Waring

amanda-waring-bookFrom the first page Amanda inspires us to work together to transform the care of older people.  She describes true person-centred care that enables people to retain their personhood and maintain their dignity.

Amanda has learned much from her personal experiences and from others that she has worked with, such as David Sheard (Dementia Care Matters), Dadi Janki (The Janki Foundation) and Rosemary Hurtley (Consultant Occupational Therapist and Author) and she passes on lots of useful and interesting information to her readers.

The HEART of CARE is also jam packed with activity ideas and is bound to become a firm favourite with Activity Coordinators and Carers

You can purchase the book through Amazon here 

You can find out more about Amanda Waring here

Focus on the People – not the Premises

I love it when I see Care Homes focus on their people and the lives they lead rather than their premises. Love this from Hallmark Healthcare at Maycroft Manor in Brighton