CEO Jane Townson explains how leading South-West provider Somerset Care remains at the cutting edge of care innovation.
Somerset Care has been breaking new ground since its launch in 1991 when it became one of the first providers to be formed from the outsourcing of adult social care services by local authorities.
The provider, which included Somerset County Council’s care home and home care services, was formed as a not-for-profit social enterprise with any surpluses reinvested into its operations.
Over the years, Somerset Care’s reach has expanded to cover Dorset, Devon, Bath and North East Somerset, Wiltshire, Hampshire, Surrey and the Isle of Wight.
Led by Jane since 2015, Somerset Care has continued to pioneer new models of care and innovation.
With an eye firmly on the future of care provision, Somerset Care has formed an assisted living partnership with leading retirement living developer McCarthy & Stone. Spanning 60 developments nationwide the joint venture is set for huge growth in the years to come.
Jane told us: “McCarthy & Stone realised there was a market beyond their retirement living model where people could receive care and support when they needed it. They are expert property developers and needed a care partner.”
After winning the tender for the southern part of the business, McCarthy & Stone asked Somerset Care to look after its national portfolio.
The joint venture partnership between Somerset Care and McCarthy & Stone – YourLife – manages the care provided in each development, which typically has about 60 apartments.
Each YourLife Estate Manager is registered with the CQC to provide domiciliary care, along with a team of 12-20 staff, depending on the size of the development.
Home owners qualify for an hour of support and/or care per week as part of their management charge and pay for hourly care as and when they need it on top of this.
“Our relationship with McCarthy & Stone is very positive indeed and we have been talking over the last year about how we can extend our partnership,” Jane said.
The JV operates from Aberdeen in the north to the Isle of Wight in the south and from Wales in the west to Suffolk in the east.
Jane said the venture may in future include the building of Somerset Care managed care homes adjacent to McCarthy & Stone retirement living sites.
“Growth is huge,” Jane said. “We are increasingly seeing a blurring of the lines between retirement and assisted living, which we now call Retirement Living Plus, because the people who have bought into retirement living are now ageing, some need care, and we want to support people to remain in their homes where possible.
“At the moment, home owners in McCarthy & Stone retirement living developments are purchasing care from local agencies but our goal is to expand our own home care offering alongside their services nationally.”
In total, there are 267 retirement living and retirement living plus developments nationally and this is set to increase to 451 by the end of August 2019.
“On the retirement living plus side we are opening around 18 new developments a year for the next five years,” Jane added.
“McCarthy & Stone are building as fast as they can,” Jane said. “If they could build homes three times as fast they would still be able to sell them.”
The JV is the perfect fit for Somerset Care’s ethos of enhancing quality and promoting independence for the elderly.
Digital technology is another area where Somerset Care has always taken a lead in the sector.
The social enterprise introduced its first digital care planning systems more than 20 years ago.
Under Jane, the provider is focusing on research, innovation and the development of evidence based data.
“We need evidence to show that what we are doing in some areas is more cost effective than traditional NHS-led approaches,” Jane said.
“That’s also partly why we put such emphasis on digital systems so we have a means of collecting data that we can then use to drive improvements in quality and efficiency, and evidence improvements in practice and cost savings.”
The provider has a number of research partnerships with universities in dementia care; use of digital technology to promote health and well being of older and disabled people; and valuing the social care workforce.
Digital data collection also chimes with Somerset Care’s ethos of promoting candour and transparency. Modern IT systems provide detailed visibility of health and care records, which with secure encryption and appropriate permissions, can be made available to the person receiving support; their next of kin; other professionals involved in that person’s care, commissioners and regulators
Somerset Care was the first independent care provider to take part in Local Government Ombudsman run complaints handling training.
Somerset Care currently uses Caresys care planning management software and is planning to roll out a mobile care management system with another provider.
As well as adopting acoustic monitoring systems in its newest homes, Jane is also a big advocate of e-med digital management systems.
“Our Well Care Plus e-meds system is ground breaking,” Jane told us.
“It’s not just a gadget in a care home, it’s an entire system of governance, with daily input from a team of pharmacists who support our care homes.”
The Well Pad is a portable device, which matches the right medicine with the right resident using advanced barcode technology.
A bar code traffic lights system advises carers on whether they can administer medication as well as the right time and dosage.
Medication administration can be reviewed in real time by managers to see if there are any issues which need to be addressed.
Any safety issues are alerted in real time to managers and to a team of Well Care Plus pharmacists, who are on hand to provide advice and guidance as required. The system also manages stock control, to minimise wastage of drugs.
Use of the system frees up the carers to spend more time with their residents.
“The system provides priceless global data,” Jane said. “Most care home operators would not have a clue about what is going on with regard to medication management as most are still using paper records.
“We can monitor the prescription of antipsychotics for dementia in all of our homes. Where it is rising, we can go back to our GPs to see if we can reduce it.”
Under Jane, Somerset Care also continues to lead the way in the development of integrated health and social care services.
The provider offered the use of the top floor of its Lavender Court home in Taunton to the local hospital for rehabilitation services.
While the plans were eventually dropped when the hospital’s Director of Nursing left their post, the idea was picked up by neighbouring Yeovil District Hospital in June 2015.
A partnership began with the hospital in November of that year at a newly built home in Yeovil, Cookson’s Court.
Jane continues to work to persuade other CCGs and local authorities to adopt the model having made her way onto the A&E Delivery Board of the Sustainability & Transformation Board.
“We have lots of ideas, we have great facilities and we have data and experience that can help, so why would they not want to talk to us?” Jane said.
“It costs almost £3,000 a week to care for someone in an acute hospital and £2,000 a week to keep someone in a community hospital; we can do it for less than half that in more homely, purpose built environments. We have some way to go but the principle has been established.
“The goal is to get people out of hospital quicker, get them back on their feet quicker and to reduce the costs of care.”
Somerset Care has already had 500 admissions under the programme at the 18-bed wing of its Yeovil home.
Patients under the scheme are seen by NHS physios and occupational therapist seven days a week.
“When they come to us their confidence comes back quite quickly because we encourage them to do things and they’re more likely to give things a go than they would at home because they know they have the support,” Jane said.
The average length of stay is about 11 days with 98% of people returning home.
“It costs about £1m a year to run that service but we have saved the local authority about £1.6m in downstream costs in terms of further care,” Jane said.
Yeovil Hospital calculates that a further £1.9m in elective surgery income has been protected by maintaining the flow of patients and ensuring hospital beds are available.
As ever, the issue has been who pays for the scheme.
Yeovil Hospital originally used some of its winter pressure money to pay for a block of beds at a rate of around £200 less than the actual cost of care per bed.
In a further development, the orthopaedic department of a local hospital has approached Somerset Care about the use of its Somerton care home for rehabilitation care.
“Because we have built new care homes we have capacity to offer these services to the NHS,” Jane said.
Going forward, Somerset Care will continue to invest in refurbishment and new developments in order to maintain its cutting edge position.
Over the last 26 years, the provider has invested £75m in its care homes. Its latest Stockmoor Lodge home, which opened in March, is its most expensive yet, costing £7m.
The 90-bed home has been designed in 15-bed households. Each household has its own kitchen, dining and living areas and is like a mini care home to give more of a homely feel.
Somerset Care’s new homes boast most of the standard facilities in modern developments with one notable exception.
“We are not really into this whole cinema thing,” Jane said.
“We have found that most people don’t really spend their time in cinemas. We have large screen Smart TVs and iPads in the lounges and Activity Rooms and we organise film nights with popcorn, as you might do at home. If people want to go to the cinema, we’d rather take them out.”
Somerset Care’s multi-million pound investment programme includes the development of Rowden House in Frome.
Plans include a new entrance area, with communal facilities including a bar/café, hairdressing salon and gym and adjoining assisted living apartments.
The final development is expected to have around 70 beds with fees ranging from £750-1,000, dependent on care needs.
The building is also expected to act as a base for Somerset Care’s home care team.
While Somerset Care has been expanding its operations across the South West and, indeed nationally with McCarthy & Stone, the Isle of Wight is one area where the provider has been reducing its activities.
Somerset Care originally held four homes on the island in converted heritage buildings.
Three of these have now been closed due to a combination of high maintenance costs and the limitations of providing modern care in an ageing building, low LA fees, a lack of affluence in the local population and rising costs, including the National Living Wage, pensions, insurances, regulations fees, inflation and the Apprenticeship Levy.
The first home to close was Osborne Cottage, which was originally built by Queen Victoria for her daughter Beatrice.
“We could have spent £1m on it but we wouldn’t have achieved a return on our investment,” Jane said.
We tried for two years to sell Steephill, our home in Ventnor, as a Going Concern but after the second purchaser withdrew, we were advised to give up and sell it with vacant possession.
Sadly, we have also recently closed Polars care home in Newport, which was built over 100 years ago as a home for blind people, as it was operating at a loss for a long period.
We plan to keep our remaining home on the Isle of Wight, Inver House at Bembridge, as we have invested over £5 million in creating specialist dementia care facilities there, and it is rated as Good by CQC.
In 2016, Somerset Care also closed its home in Gloucestershire, The Prior at Tetbury.
“We were renting the building from the National Benevolent Charity. It was another listed building. It only had 28 beds and it was nursing. Nowadays, it’s difficult to run nursing homes outside substantial population centres, as you can’t recruit the workforce,” Jane said.
“The layout of the building was not suitable for dementia care. We also had high agency costs because we couldn’t find local nurses.”