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THE BIG INTERVIEW: Paavan Popat, CEO, TLC Care

Paavan-Popat-Oct19–9

With all seven of his care homes rated Good, and an eighth home currently being built, CEO Paavan Popat says TLC Care is on a journey to Outstanding at every service.

Building a career in social care has been a family affair for Paavan. The TLC Care CEO grew up in a care environment after his mother bought Clavering care home in Hatch End, Middlesex where she worked at as a manager in the 1980s.

Paavan took over the business from his father in 2009 after studying construction at university and going onto work for a global development consultancy.

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“I had an interest in building care homes,” Paavan told CHP.

“I wanted to look at the position of the business and see where we were and take the homes to the standard I was seeing in the Pinders Awards.

“I started off by looking at the existing buildings and how we could refurbish them and change the position of them and very quickly realised that actually we had some really stunning homes.”

Paavan rebranded the Rockley Dene Homes business he inherited from his father, as TLC Care.

“TLC stands for our company values of Truth, Love and Compassion, which is something everyone in our business knows,” the CEO said.

“We are very much a values led business. Not only are the values relevant to our team’s day to day life, they also see it and feel it when they are at work.”

Following her appointment in 2017, COO Lorna Badrick played a key role in the operational side of the business.

“In that two years we have moved a long way in terms of our journey,” Paavan said.

“Lorna has worked in care previously and comes from an HR background. We are not only caring for people. Person centred care really depends on person centred leadership. Lorna has been extremely instrumental in driving our strategy for people forward. She’s been shortlisted for the Investors in People Award, the Care Leader of the Year award (National Care Awards) and more recently for CHP’s Leaders in Care Awards.”

Operating in an often crowded private pay market in the south east, Paavan said TLC’s focus on its people, continuous improvement and being outstanding made it stand out from the competition.

“Whilst we have systems, structures and processes in place we absolutely encourage people to bring their personalities to work,” he noted.

“We are very keen on getting to know our team members. The more they feel comfortable with an engaging relationship, the easier it is to deliver outstanding care.

“We are in difficult markets in difficult locations but we are very focused on continuous improvement.

“We are always aspiring towards Outstanding. If you get the care and lifestyle services right, then demand should follow.”

TLC Care’s boasts a 95% occupancy rate across five homes, with the other two yet to reach maturity, reflecting its success in being able to cater its homes towards meeting demand in its local area.

“In every home we are very focused on making sure we are catering for the market in that area,” Paavan highlighted.

“We really invest time and energy into getting to know the local market rather than having a one stop approach for every care home.”

Complete with Hindu Temple and fully vegetarian menu, Karuna Manor in Harrow is a prime example of how TLC Care has catered its offering to the local community. The 60-bed home’s 100% occupancy, with a solid waiting list, is a testimony to this.

Camberley Manor in Cambridge provides a further example of how each home is individually targeted at the local market.

“In Cambridge, we needed to cater for members of the academic community,” Paavan explained.

“People’s wellbeing and lifestyle choices change massively, depending on their life history. We have taken a massive step in making sure our whole wellbeing programme within Cambridge is nothing like any of our other homes because it needs to cater for a different audience. We are very good at doing that.”

In Surrey, the provider, meanwhile, has taken pains to cater for the lifestyle interests of the many ex-service men who populate its Camberley Manor home.

TLC offers the full spectrum of care ranging from residential, nursing and dementia, right through to end of
life care.

“We make sure that our teams that are recruited are specialists for those categories of care and actually have the right person fit for what our residents are looking for in those communities,” Paavan explained.

“It has been quite helpful to say people with nursing needs, for example, require a different kind of personality to care for them for their end of life care, compared with someone who is really active and wants to be out and about and wants people to give them that social assimilation. That split in resident group has shaped our operational model.”

All of TLC Care’s homes provide nursing care, excluding its Cuffley Manor home in Potters Bar, which is on the same site as its Cooperscroft nursing home.

Following the launch of TLC Care, Paavan also set up a hotel in Stratford, East London and has a further hotel under construction in Cambridge.

Given the shift towards hotel style design and hospitality services in the private pay market, CHP was interested to learn the ways TLC was utilising synergies between the two businesses.

“Both businesses are shaped very much around the needs of our residents,” Paavan said.

“The hotel is built for a very much more transient market but we have been able to apply our hospitality experience within a care setting and our general view has been that it has been an enhancement and helpful to the lives of our care home residents.”

Paavan pointed out that all TLC Care’s care homes were Hospitality Assured accredited.

“The inspectors are coming in and assessing independently the level of hospitality that they would normally do in the hotel and restaurant sector and we find that helps us in our strategy and approach to person centred care,” he explained.

“It’s helping us with our journey to Outstanding and given us some good foundations.”

Given the well documented strains on the care workforce, being able to call on its hotel workforce is a particular benefit of TLC’s diversification.

“We have quite a few people at the hotel who have come into the care business,” Paavan highlighted.

“That’s included operational people from our hotel front desk who have been able to provide training on hospitality to the care home front desk staff and a model for customer service on how we can better ourselves every day.”

As well as encouraging the sharing of staff resources across the business, Paavan pointed out how TLC promotes staff movement across its care homes in order to develop skills, experience and job satisfaction.

“We have team members within the care business who move from one home to another quite a lot,” Paavan explained.

“That’s proved to be really successful. Our care services manager here was a nurse in another home and a unit manager in another home. He’s been employed in three of our homes in completely different roles and it’s worked really well for his growth to learn different ways of working.”

Offering varied and satisfying roles is a key part of TLC Care’s recruitment strategy in a difficult market.

“The recruitment challenge for our industry is very difficult,” Paavan stressed.

“You can earn more money stacking shelves than delivering care sometimes. There is a massive funding crisis and the divide between private pay and local authority pay is so great. There’s only so much you can do before more money is made available.

“We are an agency free business partly because we are able to pay above the National Living Wage and because of our culture and our training and engagement.”

Paavan said word of mouth and refer a friend schemes had proved particularly effective in attracting new staff.

He conceded that even private pay biased providers found it difficult to be competitive in salary terms, however.

“We are not able to offer a lot of money to pay people for the work they do,” he said.

“They have such a huge impact on people’s lives. I would like to think they could be paid better than we do.

“Currently private pay is compensating for low pay local authority funding as the cost of care is still going up. The needs of residents are increasing and our lifestyle offering is much higher than most other operators I have come across.”

As with every other aspect of the business, the provider’s recruitment strategy is executed on a home by home basis.

The CEO conceded it was inevitable that TLC Care had to offer higher salaries in more affluent areas with higher costs of living.

“Their cost of getting to work is higher as there is often no bus route in place so you have to find people who can be creative with car-pooling and so forth to get to work,” he added.

The group’s recruitment challenges reflect the varied demographics of its care home footprint.

While Karuna Manor in Harrow has no shortage of people looking for work, the story in its more affluently located homes in Surrey and Potters Bar offers a stark contrast. The prevailing affluence of both areas means staff have to be recruited from other areas while the homes also have to compete for staff with the plethora of neighbouring care homes.

The offer of in-house accommodation for staff in each of the homes has been key to helping TLC Care offset workforce pressures.

The high quality apartments ensure staff are available on site to fill in gaps in shifts when needed.

“Providing quality accommodation is definitely a helpful way of reducing the recruitment burden,” Paavan said.

“It opens up your staff pool, meaning we are able to recruit from different parts of the country.”

Each apartment, which is typically occupied from three months to up to a year, offers the full range of facilities, including lounge, bedroom, bathroom, kitchen and wardrobe space.

Over the past 10 years, Paavan has focused on repositioning TLC towards the private pay market.

“We had some really stunning homes in prime locations but hadn’t understood the private market as well as we could have so we started looking at that,” he noted.

Paavan has taken TLC’s level of private funding clients from 10% to 65% currently, with the remaining residents CCG commissioned.

“We had four homes when I took on the business in 2009,” Paavan said.

“We still have people funded by the local authority who have lived with us for many years. We made the decision that we never wanted to move people on but we also decided we were going to very gradually transition into the private market.

“I think 65% private pay is a great level to be at. People aspire for that but it’s got to be done in the right way. You can increase the private pay element quite quickly but I am not sure the ethics of that fits with our values.”

The TLC boss has overseen the closure of two homes and the building of three new properties, with a fourth currently under construction.

“We have stuck to our existing geographic footprint and stayed in areas we were comfortable with and where we knew we could meet the needs of that local community,” Paavan noted.

As well as its Karuna Manor home in Harrow, north London, the new builds included two new properties in Potters Bar, Hertfordshire, and the Camberley Manor care home in Surrey.

Two further homes in north London in Golders Green and Hatch End are on the way with the provider looking at a further site in Bushey Heath, Hertfordshire.

“We are working on a number of schemes but are very focused on staying local in the markets that we are already in,” Paavan stressed.

“We are not focused on becoming the biggest regional operator. We are focused on being a regional operator that can grow in the right way. We are happy with our strategy of not taking on more than we can handle and taking qualitative decisions on whether to go into a market or not.”

The CEO said he saw around 12 homes as the optimum size for the business.

“We have been able to meet the needs of the current market and future generations with our new builds,” Paavan said. “We have been able to future proof our homes as much as possible.

“Two of my projects were homes that I had already closed down to demolish and rebuild. One of our homes wasn’t purpose-built. One of them was very early 90s purpose-built and we have taken that to the 21st century.”

With his construction background, the TLC boss takes a hands-on approach with new builds and is equally hands on with his approach to the operational side of the business.

“I look to be involved as and when required and when it’s appropriate,” Paavan told us.

The CEO said TLC Care was “very proud” of the two Pinders design awards it had won.

“The Pinders Awards was my aspiration when I first came into the business,” Paavan said.

“The Pinders Awards plays a great part in shaping our industry and giving new entrants a sense of direction. Once you have that award people living in the home feel that it is the best place to live in.”

Paavan pointed out that all TLC’s homes were designed very differently.

“We don’t have a standard model,” he added.

“The consistent approach is understanding your local community and designing for people who are going to move into your home and the attention to detail that should be given for the people of that local community and to really understand what’s important for the history of the local area.”

The CEO added that quality outdoor space was critical to successful care home design, including offering garden space as well as access to outdoor space on every floor, as well as encouraging independence to avoid people feeling isolated.

Paavan said care home interiors needed to support people’s care needs as well as offering something people can relate to for their whole life history.

“Sometimes when you go into homes they look like the inside of a spaceship,” Paavan said.

“We work with multiple designers and make sure we are actively involved in the design ourselves. When an operational person gets involved in development and vice versa, you end up bridging a lot of gaps.”

The CEO takes an equally hands on approach in the operational side of the business.

“I like to meet with all of my managers at least once a month,” Paavan stressed.

“We do a lot of engagement forums and focus group meetings. We get all of our chefs and maintenance people in special focus groups. I like to go to those meetings to be able to listen to what is happening in those homes and talk about what we are looking at as a business and share best practice.”

The CEO described TLC Care as “very pro technology”.

The provider uses Access Group’s iCareHealth digital care planning system.

“We have definitely benefited massively from having an electronic care planning system at point of care service,” Paavan said.

“Every carer, nurse and team member has a tablet or a touch screen smart phone. We have substantially reduced repetitive paperwork. The information is only as good as what the people put in but it has massively taken out the competition. It’s helped people to complete their paperwork at the point of care without having a negative impact but at the same time it means its real time reporting.”

iCareHealth’s care plans have been integrated with Access Group’s eMAR system.

“We have our own internal pharmacist consultant who supports our home and our nurses with training on medication areas,” Paavan added.

Further care technology innovations include the ENS nurse call system. The provider has implemented a pingu system at Karuna Manor that enables anyone at a nurse station to see where team members are at any time so that they know who they can call on in an emergency.

“It’s been a massive investment but really helpful,” Paavan said.

More controversially, TLC Care took part in a 12-week trial last year of the Pepper robot in partnership with Advinia Healthcare.

“It was really successful with the residents and their family members,” the CEO said.

“People in the home loved it. It was very popular. It doesn’t replace care delivery but it does enable the residents to feel they are being listened to.”

The robots were able to answer simple resident questions such as telling the time to free up care staff to help other residents.

“I don’t think technology is ever going to take away humans so you have to apply its use in a way that people feel positive about,” Paavan said.

“As long as you can do that, I think there is a right place for it. Our experience at Karuna Manor was that more residents and family members wanted to get involved with the robots than we could do trials with.”

While Paavan is ensuring new homes are able to support Amazon Alex, he remains less convinced about this technology in a care setting,

“Where we trialled it very informally in one home for a resident we found it to be confusing because Alexa didn’t always understand what was being asked and it’s answer was different to the question being asked so it ended up leaving the resident more confused than they were in the first place,” Paavan explained.

“It has its place but I’m not sure it’s ready for the care market. It might be more suitable for the domestic market.”

Looking ahead, Paavan said TLC Care remained on a journey to CQC Outstanding with its seven care homes all rated Good.

“We are on a journey to Outstanding at every home,” he noted.

“The first thing is that every home’s journey to Outstanding is unique to that home.”

For quality control, the provider has created a system in partnership with iCare Health for the auditing and monitoring of care planning.

It also boasts its own Quality Assurance framework, including specific clinical areas, dining experience, resident experience, activities and wellbeing.

“We are very keen on our homes using and updating our improvement plan on a daily basis,” Paavan said.

“We are continuously encouraging improvement.”

The provider carries out quarterly independent mock inspections to help homes understand where they are against regulations.

“In addition to that, we really use our residents and team’s life stories to enhance the care we deliver,” Paavan said.

“We are keen to make sure it’s not just process and system driven but people driven and make the care delivery driven by people. Our view is our journey to Outstanding is robust because of our focus on our people.”

When asked by CHP if the CQC was too restrictive in its parameters of Outstanding care, Paavan said keeping the highest rating achievable with hard work was the right approach.

“The journey to Outstanding from Good is more difficult than the journey to Good from Requires Improvement and I think that’s right,” Paavan added.

The CEO said the CQC was in a much better place than three years ago but had a shortage of senior inspectors.

“Just like us, the CQC is on a journey of continuous improvement,” Paavan concluded.

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The author Lee Peart

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