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THE BIG INTERVIEW: James Rycroft, Managing Director, Vida Healthcare

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James Rycroft, managing director of Outstanding rated care home designer, developer and operator, Vida Healthcare, talks to CHP.

James set up Vida Healthcare with his father, Chris, in 2010 with a view to developing pioneering care homes for people living with dementia after recognising the care sector was not meeting  increasing demand for specialist dementia facilities.

Since then, Vida Healthcare has gone from strength to strength and now boasts two Outstanding rated care homes – Vida Grange and Vida Hall in Harrogate.

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A third state of the art care home, Vida Court, is due to open this month.

“We have been working on Vida Court for three years since the design stage,” James told us.

“We design, develop and operate. That’s our USP. We only offer care to those people who are living with dementia. We know there are a lot of things we can do, starting from good design, all the way to our ethos of care where we train frontline staff to deliver and interact with the residents.”

James told CHP that, despite COVID-19, the development of Vida Court, which provides 100 beds and features a 12-seater cinema, hair salon, convenience store and coffee shop, had gone very smoothly.

“Right at the start of COVID concrete suppliers were not coming out but we managed to get the last supplies to pour the slab and once that was in we were off, and all the other trades could come in and start building,” James explained.

“Each time you do it you learn more so this time it felt a bit more relaxed. We were a bit more in control of the melee of opening a care home.”

When it opens, Vida Court will take the care provider’s capacity to 300 beds.

“Each of the homes is very large because of economies of scale and the way we designed them,” James said.

Each is split into different houses in order to cater for a range of individual care and personal needs.

“Vida Court is a large building but has eight individual self-contained care homes within it,” James explained.

“That allows us to offer a range of care options as people’s needs change on their journey with dementia.”

Vida Grange
Vida Grange

Each of the houses has the same layout, facilities and artwork in order to minimise any anxiety caused by transfer to another part of the home.

“That has a really positive impact on the health and well-being of everyone, including families,”
James noted.

“We look after the families and acknowledge they are going through a distressing journey of having to make the decision to place their loved one in a care home.

“We have tried, since the start, to change the stereotype of being put into a care home. We build these modern, state-of-the-art buildings that are first and foremost a homely home that offers all the services you would expect, and more. We encourage residents to personalise everything but it just so happens that we also provide care with very different skill sets and levels.”

Vida Healthcare’s houses range in size from 10 to 20 beds across its three care homes. Vida Court and Vida Grange both operate eight houses with four houses provided in Vida Hall.

“You can do a lot with build and design that enhances people’s lifestyle and well-being,” James said.

“The general ethos of our design is to create an environment that allows residents that in other environments may be restricted to have freedom, while staying safe.

“We create a home with lots of destinations for residents to go to that allow them to be fulfilled and stimulated as opposed to creating locked areas.”

Each of the homes is designed with a continuous hallway to allow residents to walk freely and avoid any anxiety caused by feeling closed in.

“You create a circular walkway on which you have your bedrooms and your destinations such as lounges and dining areas and all our sensory pods,” James said. “It keeps people actively distracted.

“The CQC have their minimum standards but we don’t want to build to a minimum standard. We are building homes that are spacious. The bedrooms are large and more like a suite. Every room has an en-suite shower room and toilet. We try and promote independent living for as long as possible.”

In terms of signage, Vida seeks to strike a balance between retaining people’s dignity and making families feel comfortable in homes that are comfortable and not too ‘creche like’.

For example, each toilet door in the homes is painted yellow so that residents find it easy to orientate themselves.

While some design specifications are standard within the homes, James stressed Vida’s care ethos is based on the premise that what works for one person may not work for someone else.

“We need to tailor people’s day-to-day living to what works for them,” James explained.

“We do that on a daily basis because people change as they progress on their journey. That’s when the skills of the staff come in as well as the training that we offer. We need to understand people’s needs and interpret them in the right way to be able to create happiness. It is not an exact science. Our approach and attitude to what we do is without ego.”

James stressed the real personalisation in care comes in a resident’s care plan.

“That is an unbelievably undervalued skill set,” James said.

“Writing an amazing care plan and adapting it on a daily basis is key to that resident having great care. It is all about the care plan. It’s not just about care. It’s not just about their favourite newspaper and when they want it delivered. It’s about lifestyle changes such as what kind of music they like and do they prefer being alone?”

Vida Court's staff room
Vida Court’s staff room

Each of the houses caters for people with different personalities as well as different care needs.

“We have houses that are more social,” James explained.

“We have houses where people like to be quieter. When we admit people to our care home we will assess their needs and decide which house their personality will be suitable for. If it doesn’t work then we will liaise with the families and look at moving them.”

The care home provider is currently conducting research with University College London in monitoring people’s brain activity to measure their responses while listening to music.

“It’s really exciting research because we have a lot of residents who struggle to communicate so when families come in they don’t know if they are doing the right or the wrong thing but we can start to tell whether that’s the case,” James told us.

“We try to be innovative and creative and challenge what we do all the time. Our homes are Outstanding really because of that.”

Vida uses Amazon Alexa across its homes to offer residents instant access to music of their choice.

“We are in a time now where we are blessed with technology that can help people and everything is so immediate,” James said.

“If someone is presenting with complex behaviours we need fast resolutions. If we know someone likes jazz we can put that on immediately and see how it works.”

Vida’s household model is also able to cater for varying levels of care needs.

Vida Grange, for example, has two houses for people under 65 who are living with dementia.

“We found that some younger people living with dementia are really active and others are quite serene so we opened up two houses and split those so that they can offer similar types of care to people whose personalities are very different,” James told CHP.

Additionally, Vida Grange operates six nurse led houses where people can be placed in terms of their personality and environment, as well as two residential care houses.

Care is provided generally on a 2:1 or 3:1 basis with 1:1 care also offered on a temporary basis for people needing more focused attention.

Vida Healthcare operates on a flat fee basis for both private and publicly funded residents.

“I have a policy where it doesn’t matter who funds the resident, the price is the same,” James stressed.

“The cost of care is the cost of care. What I don’t accept is private fee payers effectively subsidising local authority fee payers.”

Having initially operated with a 25:75 public: private fee payer mix, Vida Healthcare has managed to buck the overall sector trend by increasing its proportion of publicly funded fee payers to 55%.

“The reason for that is because the acute sector in particular has recognised that we will look after people that need to leave them because the way they present with their dementia is so complex a standard care home cannot accommodate their needs,” James explained.

“People have recognised that we are providing a niche service for complex dementia needs.

“I am really proud of taking young people who are supposedly complex and putting them in the right environment with the right care package that they deserve, so that all of a sudden they are not complex anymore.”

With Vida Healthcare charging fees of between £1,500 and £2,000 per week, CHP asked James how willing local authorities are to pay fees at this level.

“They have to pay them,” James answered.

“They have to go to panel to ask for the authority but it’s very rare that we get declined. We don’t break even until 75-80% occupancy. It’s not easy.

“There’s sometimes an attitude from commissioners that our fee levels are outrageous. They ask ‘how can you charge that?’ I am very happy for them to come around and look at the finances with me.

“There is a real misunderstanding between the perception of social care and how much it will cost. That’s why the government funding announced in September is very welcome although it’s unfortunate that social care will receive very little of it for the first three years with the NHS taking precedence.

“The government prioritises the NHS way above us. We have been lobbying for years for extra financing. Take aside all of the NI and the tax increase issues and whether you agree with that, we now have up to £12bn a year into the sector which is a result. It’s just a bit depressing that it is going towards unblocking the backlog at the NHS over the next three years.”

Vida Court's coffee bar
Vida Court’s coffee bar

James highlighted that the NI hike on businesses would mean he would be paying an extra £70,000 in tax for little in return. “It’s like a hidden tax that we are not benefiting from at this moment in time so that’s what I would like to fight for a little bit more,” he told us.

The MD said that while the government had made mistakes during the pandemic, the extra funding it had provided was “very welcome”.

“Of course we can criticise their response at the start but this pandemic took the world by surprise and it is very easy to criticise and politicise this process,” James said.

“I would challenge any government to not struggle in that environment.”

The managing director said Vida Healthcare’s bank partner, Yorkshire Bank, had been “nothing but supportive” throughout the pandemic, adding care home development activity had remained healthy in the North Yorkshire area.

James highlighted recruitment as the “biggest test” for the sector going forward.

“Recruitment was previously about managing natural churn of staff but what we are seeing now is the replacement of staff becoming more difficult,” James said.

The care home provider has launched its own training platform, Vida Academy, to support its workforce.

The Academy supports all staff, from new starters right through to senior managers, to learn and develop in their role.

Starting with an induction programme for new starters, the programme works through the Care Certificate and mandatory modules to provide specialist training courses and apprenticeships from Level 2 to Level 6.

“We’ve got a range of trainers that work with us to develop people’s skill sets,” James explained.

“We are a specialist dementia care provider so we should have specialist training and that’s what we do.

“We look after our people and have so many examples of people who are developing really good careers with us. It’s something I’m really proud of because care should be classed as a career and hopefully that will entice people to come and work with us.”

The MD said Vida was thinking of creative ways of enticing staff through incentive packages as well as creating career paths.

“People go into care for all the right reasons but we want to develop those people,” James said. “It’s really important for us to have a longevity of staff staying with us because it’s good for residents and their familiarity, and we don’t want a high turnover.

“My goal is to employ 15 more staff than we actually need on a day-to-day basis to create a comfort blanket.”

The care home provider’s turnover is well below the industry average currently at around 10%.

“When people leave us it tends to be because they’re starting a family or their family dynamics have changed,” James noted.

James said being a family business that paid well made Vida an attractive employer.

“We’re not a big corporate machine and therefore there’s very little bureaucracy so things happen and we react and we listen to staff,” James explained. “We’ve always said if staff can put recommendations forward that will help and assist the residents’ lives and if they can justify it both in terms of need and financially then we’ll do it.”

Being renowned for providing Outstanding care and offering state-of-the-art facilities proves a strong draw to the local workforce. James is also fiercely proud of Vida being a values driven business. “Our values are very important for people and that refers to staff, residents and families, and everyone involved,” James said. “How we operate is all about kindness.”

The provider pays its staff well above the Real Living Wage as well as offering weekend and other enhancements, including a 20% overtime bonus. Vida also operates a bus pick-up and drop-off service for staff to access its new home, Vida Court, which is located in a two-mile radius of its other homes. As we approached the deadline for mandatory COVID vaccination this month, CHP was keen to hear the MD’s views on the issue.

“We started off with probably around a 30% refusal rate so what we decided to do over the period was to inform and educate people and try and do that in different ways,” James noted.

The care home provider held webinars led by experts and a Q&A session designed to address staff’s concerns.

The business has also developed an in-house staff app called ‘Team Talk’ as a way of communicating with the staff in the most effective way.

As a result, Vida has seen take up of the vaccine move from 70% to 96%.

“I’ve no idea why they did not mandate it for the NHS as well at the same time and we have lost a few people because of that,” James said.

“It’s been quite an emotional journey. We are left now with those people that are very genuinely scared or concerned or have genuine issues and as a result of that they’re going to lose their career, now that’s tough.

“Then we’ve got to protect our residents so it’s a tough decision to have to make. Overall I do agree with it. If you’re working in frontline healthcare you should have the vaccine. The staff have been amazing throughout the pandemic. I’ve had the easy bit which is trying to run the business in the background but the frontline carers, I can’t imagine what they have gone through.”

A bedroom in Vida Court
A bedroom in Vida Court

The care home provider has introduced counselling and group sessions to support staff who have been suffering from burnout.

“I think certain people may still be suffering from the negative effects of the pandemic,” James said.

Looking ahead, James said his vision was to take Vida’s unique and innovative model and scale it up to reach a larger geographic area.

“At the moment we’re clustered into a two mile radius with 300 beds but we have a proven model that is scalable and we’re looking at opportunities to expand nationally,” James explained.

“As a national centre of excellence for dementia care and one of the UK’s leading providers, we’re committed to supporting research and development in order to continually improve dementia care in the UK.

“This comes in many forms from new thinking and ideas from staff, partnering with universities to coordinate student placements, and participating in research programmes.

“We’re currently working with UCL on some really exciting research which could have significant impacts on dementia care. We are also continuing to invest in our training platform, Vida Academy, to ensure its ongoing expansion so that we can support staff and carers with career development and progression opportunities, and our residents through outstanding care provision.

“This supports our goal of changing the perception and stereotype of care homes from a place where you end up, to a home with specialist care and facilities.”

Vida Healthcare achieved BILD-ACT accreditation in September 2021 to deliver Positive Intervention In Dementia Care (PIDC) to all its staff. This training promotes best practice using de-escalation techniques and safe interventions during periods of behavioural and psychological symptoms of dementia in a dignified and respectful way.

James concluded: “Social care is an essential part of our society and has gained traction in terms of recognition by the government and general public, particularly during the pandemic.

“At Vida we’re planning to capitalise on this momentum to ensure our sector is seen to be on a par with the NHS, and receives the support and recognition it requires to continue protecting vulnerable people successfully.”

 

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The author Lee Peart

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