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Fostering a best fit

Finding the right framework when delivering foster care is complex. Can successful models be easily replicated? Eleanore Robinson reports

This summer the government set out its vision for foster care. One of its five over-arching ambitions was that ‘placements are driven by the needs of the child, not availability of a bed, location, provider type or cost’. 

This would involve local authorities spending their budgets on the highest quality and most suitable placements to meet the child’s needs and having a strategic approach to sufficiency planning, which drives commissioning and procurement decisions, based on needs. 

Furthermore, councils should use their knowledge of sufficiency and local demand to work with other local authorities and independent fostering agencies (IFAs) to ensure resources are used in the most effective ways to meet the needs of their children. 

These recommendations came in response to an independent report by Sir Martin Narey and Martin Owers, which found commissioning processes were not being driven by the needs of children. The National Fostering Stocktake stated: ‘We believe that strategic commissioning of IFAs would lower the cost of fostering and improve its quality. But at the moment there is too much buying of placements - in what amounts to large scale spot purchasing - and too little commissioning.’ 

IFA’s also argued that many councils ‘in-house first policy’ contributes to children unnecessarily experiencing multiple placements because ‘first available’ is not always ‘best fit’. 

TACT

The government believes the key to improving commissioning is more effective partnerships, and there are a number of projects to test collective commissioning and service delivery. The Department for Education is also supporting new commissioning models, one of which is TACT Peterborough. 

Peterborough City Council outsourced its fostering and adoption services to not-for-profit fostering agency TACT (The Adolescent and Children’s Trust), which has more than 500 foster carers looking after 600 children, in April 2017. Under the deal, TACT delivers fostering and adoption services on behalf of the council, with the expectation that it would deliver savings of £1m a year once fully established. 

It also boasted that the agreement would ‘reduce the council’s reliance on higher cost independent fostering and residential placements, as well as providing improved training and 24/7 support to all carers, adopters and relatives looking after children who come into care in Peterborough’. 

This would be done by recruiting and retaining more local foster carers through an improved support network that TACT would deliver, cabinet member for Peterborough’s children’s services councillor Sam Smith said at the time, leading to more local longer-term foster placements. 

And this partnership is proving fruitful with Peterborough’s children’s social care services being rated at Good by Ofsted this summer for the first time since becoming a unitary authority in 1998. Ofsted said: ‘Statutory functions in relation to fostering and adoption are delegated 

to a national charity which provides a seamless service model. 

‘Children live in placements that meet their needs, and overall placement stability is good. The majority of children in care live with foster families. Children are matched appropriately to carers, including, where possible, carers willing to commit to the option of Staying Put in the future. 

A small number of children were still privately fostered, however. 

Framework

But could this model be replicated in other areas? 

Attempts to create commissioning consortia or a unified framework for commissioning fostering services have not been met with great success. The complex nature of providing services usually sees social workers or their team leader placing children in foster care, using an existing list of families they use. Furthermore, creating a unified framework for remuneration would be difficult given the personalised nature of each fostering package. 

To complicate things further, social workers have a duty of care to children and the foster parents as well, and to minimise placement breakdown. Principle at consultancy Candesic, Dr Joe Taylor explained that personalisation was not just about the children. It was about creating a temporary family so having a unified framework is partially at odds with this. 

He said: ‘It is a bit of a red herring this talk of unified commissioning. It is more about finding the right framework. 

‘The responsibility of care devolves to the social worker. If they do not find the right placement, they will keep on looking. Social workers are very cautious in making sure they are making the right decision. 

‘At the higher end of the market we are going to see more case referrals that can be facilitated by larger groups.’ 

‘It is older children with complex behaviour who will need a lot of help but people willing to do that are few and far between and sometimes they need to be placed out of area.’ 

In these cases, social workers would contact their colleagues in other local authority areas, but large independent fostering agencies might be more able to facilitate an appropriate placement. Taylor added: ‘Fundamentally there is a growing role for independent fostering agencies to do more. At the moment the system is very old fashioned and inefficient.’ 

Keep exploring

David Leatherbarrow, National Fostering Agency chief executive, said that it was right that councils should explore different mechanisms and structures for children’s services, provided there is no compromise or dilution to their corporate parenting responsibilities and statutory obligations. 

He said: ‘I am very open minded and my team will always consider the right opportunities where we believe we, as an organisation, can add value and make a real difference to the service through our management expertise, our emphasis
on quality and, more importantly, to the children and young people reliant on that service. 

‘I would always be supportive of the following three key points: delivery of best value, best quality and child-centric outcomes as the core tenets of
any future consortia or commissioning arrangements being considered for children’s services.’ 

Charlotte Ramsden, chair of the Association of Directors of Children’s Services’ Health, Care and Additional Needs Policy Committee, pointed out that the National Fostering Stocktake conclud-
ed that it was ‘entirely legitimate’ for councils to either provide most of their own foster care or work with independent providers. 

She said: ‘There is no one-size fits all model of delivering foster care, where working in partnership to provide services makes sense and improves outcomes for children and young people in care local authorities will be considering this. 

‘A broad range of high quality provision is necessary to meet the diverse needs of the children and young people in our care to enable us to find the right placement at the right time for every child and young person. As with any partnership arrangement there will be opportunities and challenges - some independent providers specialise in recruiting placements for children with very complex needs which are not always available locally. However, the variability of quality in the system is a challenge as is the cost of some types of placements at a time when local authority budgets have been reduced by half since 2010 and demand is rising. 

‘It is for each council to decide on local arrangements in line with local needs. Ultimately, the biggest concern for local authorities is that the arrangements in place achieve better outcomes for children and young people. If this also helps with reducing costs, so that any savings can be reinvested in services, it’s a bonus as budgets reduce and need increases.’ 

Care Markets: December 2018/January 2019

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The Watford Gap

by Eleanore Robinson

While flourishing in the south east of England, private retirement villages providing care have yet to take off in the north. Apart from a handful located in pockets of affluence, most notably in parts of Yorkshire and Cheshire, where house prices are a similar level to the cost of acquiring a two-bedroom apart- ment in a development, this type of care facility has yet to take off. But demand for these types of services across the country is strong, so could this be an opportunity missed?

Demand and supply?

While there are retirement villages for private clients, where residents buy a property on the development, in the region, few offer care services. Those that do tend to be at the top end of the market. Demand is met at the other end of the spectrum by charities offering extra care housing for the most disadvan- taged older members of society.

There is no doubt that the demand for these services is there. Knight Frank’s recent report UK Retirement Living Comes of Age suggests a need for three million retirement living properties to house the number of people aged over 65 that would consider downsizing. This is based on the assumption that 25% of over-65’s in their existing homes would consider downsizing into some form of specialist retirement living.

Furthermore, the private retirement living market has expanded from 2% of total stock in the 1970s to almost a quarter of retirement stock at present, Knight Frank found. Since 2000, private units have accounted for 54% of all new units delivered annually.

So why is development in the north lagging behind?

Director of healthcare investment (alternatives) at JLL, Phil Schmid, explained that people at both ends of the socio-economic spectrum can afford to have their care needs covered either through paying privately or being supported by the state.

‘In the middle is not covered. There is no option other to remain in your own home until it becomes a burden and you have to move into residential care.’

Success stories

One successful development is Middleton Hall Retirement Village, just outside Darlington, County Durham, which offers apartments and bungalows in its rural scheme, alongside a spa and a residen- tial care home.

Managing director Jeremy Walford said: ‘The issue is not so much the lower property prices, as land is also less expensive, but the lower rates of property price inflation and risk of property prices going down. This makes the ‘event fee’ model (where fees of upwards of 10% are charged on selling the property) less marketable. Consequently, the importance of making an ongoing profit from the retirement village services is key. In the case of Middleton Hall, this means providing high-quality care services.

‘We funded most of our development through bank debt as we had an existing care business to generate profit. In our model, we also made a development profit for the leasehold developments that reassured the bank that we could comfortably repay the debt.

‘There are advantages of operating in the north in terms of employment – Middleton Hall benefits from having charming, enthusiastic and friendly staff, all locally recruited. We also operate a wide range of services – in effect we offer a US style CCRC (Continuing Care Retirement Community) model that I believe is key. I cannot overemphasise the importance of quality though – it is critical for housing with care (ARCO regis- tered schemes) to differentiate ourselves from standalone retirement housing and care homes.’

Walford added that, while there was an advantage in being relatively unique and without true competition, the lack of awareness of retirement villages does provide a marketing challenge, as the number of self-funding clients was far smaller in its catchment area. But, he argued, with the right business model there was an opportunity for growth.

High-end offerings

Audley Villages operates two villages in Harrogate and Ilkley and is developing a further site in Scarcroft, all within reach of Yorkshire’s most affluent areas. Also catering for people at the highest end of the socio-economic spectrum in the re- gion, these developments boast access to fine dining, swimming pools as well as on-site care services.

Chief executive Nick Sanderson explained: ‘They are all in what is called the Golden Triangle where affluence levels and therefore property prices are much higher than average. However, that does not discount going into new areas in the north.’

Audley is currently in negotiations to develop sites in the north under its new mid-market brand Mayfield, with an announcement expected next year.

Sanderson said: ‘Our Mayfield develop- ments will be more city centre and more urban. We can make them work in the north where house prices are lower.

‘Housing with care relies on home ownership and 77% of over 65s are home owners. In 90% of these cases, they are debt free so they have sole control of their homes. If they are in a low value area, the costs of a retirement village will need to be less. But in the north land costs are cheaper and building costs slightly less and, taking into account minimum wage, services cost less.

‘If you make it bigger with 250 apart- ments, it brings down the costs. I think it is a massive opportunity.’

Straddling two sectors

So why are not more providers doing the same? Sanderson explained that housing with care ‘falls in a hole’ between housebuilders and care providers, with the former wanting to construct a village and then walk away and the latter not interested in getting involved in the development side.

‘Another thing is we need customers to demand services’, he added. ‘That will be the biggest driver. Once we start and we make it successful, then other people will follow.’

Unlocking the future

Executive director of ARCO, the representative body for housing with care providers, Michael Voges, agreed that mid-market schemes could be a potential solution to unlock the housing with care market in the north.

He said: ‘Larger scale building brings down the initial costs. It is probably going to be six months to a year before we see this model becoming increasingly popular.’

Development vs operational

Voges argued that another factor that could drive the development of retirement villages in the north is the current shift among operators from a development model, where residents pay the costs up front, to more of an operational income model, whereby costs are recouped at the end of life through event fees. This means older people who are asset rich but cash poor can be offered fixed prices for services while they are resident in the village, without having to worry about future hikes in the cost which they may not have the disposable income to afford.

‘It is not about affordability, it is a liquidity issue’, he explained. ‘It is about how to operate incomes that will unlock the property market in the north.’

Schmid, went further saying a greater reliance on shared ownership as well as event fees could unlock the market.

He said: ‘It is tough when sales are reliant on property prices. But longer-term money is moving into the sector driven by income. People are starting to look at the sector.’

He said more clarification around event fees could attract new investors. ‘The beauty of the sector is there is a demand all over the country.

‘Because there are still risks in the space, they need to see high levels of returns. If they [the risks] are removed, it will allow them to grow more. It is not just the preserve of the South East.’

Care Markets: october 2018

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CHARGING AFTER DEATH: The CMA sets out its proposals

Following publication of the findings from it’s inquiry into UK care homes at the end of last year, the Competition and Markets Authority (CMA) published guidance last month on charging ‘after death fees’.

After it found that some care home operators were still charging relatives up to a month after the death of a resident, CMA suggests that payments should end within three days or the point the room is cleared of deceased’s possessions and reoccupied (if earlier). Care home operators should not pass on the costs of preparing the room for the next resident or the loss in income caused by a void in occupancy, and should not be still charging the deceased’s estate once the room has been reoccupied.

As care home fees are usually paid in advance, CMA states care homes should refund any advance payments covering the remainder of the period beyond the three days covering the residents death. ‘Such refunds should be timely’, it adds.

However, CMA acknowledges there will be circumstances where relatives may need access to the room for longer than three days.

The consultation document states: ‘It may therefore be appropriate for contracts to make provision for these circumstances, by setting out a longer stop date beyond the initial three days, during which payment must be made if the room remains uncleared. After this longer period, it would be appropriate for the care home to reserve the right to take reasonable steps to mitigate their loss, such as by removing the deceased’s possessions themselves from the room, storing them safely and charging a reasonable storage fee. This would allow the home to get on with the process of preparing the room for the next resident.’

Furthermore, CMA says that operators should not ask for top-up payment to continue after local authority funding is no longer available. In order to be fair under consumer law, top-up payments must be paid for the same period as local authority fees.

Following cases of relatives not just being charged extended top-up fees, but the shortfall in local authority fees once they have stopped, CMA states this is not fair under consumer law, along with charging for the shortfall in FNC payments once NHS funding have ceased.

The consultation document states: ‘The CMA is already taking forward action against certain care home providers that it considers are unfairly charging fees for extended periods after a resident has died, asking them not to enforce their terms. It may also decide to open further investigations against other providers before the publication of its final advice, if it identifies serious concerns about potential breaches of consumer law. In relation to the issues covered in the draft advice, once it is finalised we will expect all other care home providers to review immediately and, where necessary, change their contract terms and practices or risk action.’

Clare Auty, partner in the commercial health team at Browne Jacobson said the guidance was based upon the Consumer Rights Act 2015 (CRA) and Consumer Protection for Unfair Trading Regulations 2008 (CPRs).

She explained: ‘Prior to the CMA investigation, few operators considered the applicability of consumer laws to residents and patients rarely viewing them as ‘consumers’.

‘Furthermore, many advisors who were aware of the CRA would have relied on the CRA exemption that the fairness test does not apply to the main subject matter of the agreement which they believed included price/fees. The CMA believes this exemption cannot be relied upon as fees after death are not the main subject matter and are contingent on the death of the resident. They are therefore not concerned with the level of fees, which is outside the advice, but the period of time for fees to continue to be paid.

‘The CRA applies a test of fairness to terms in a consumer contract, even where those terms are negotiated. A term is unfair if contrary to the requirement of good faith it causes a significant imbalance in the parties’ right and obligations to the detriment of the consumer. Unfair terms or notices are not legally binding and enforcement action can be taken. Where a consumer has paid money, this money is recoverable and orders can be made to refund such sums. The CRA also requires contract terms to be “transparent”.’

‘The CRA also contains a Grey List of terms which may be unfair and therefore are not subject to the exemption. Terms requiring a consumer to pay fees for services not provided are fully subject to the fairness test – for this reason the CMA believe that top up and FNC payments should not be payable post death as they represent fees for clinical services which are not being provided.’

Executive director of the National Care Forum Vic Rayner added that, while the report acknowledges the existing anomaly between local authority contractual practice in this area and that applied to self-funded contracts, it does nothing to address it going forward, instead suggesting that the local authority contractual practice is based on ‘local authorities being well informed, and with equal bargaining power to the care provider’.

She said: ‘This is not only far removed from many of the NCF members’ experience, but is in contrast to the CMA’s own report, which recognised very starkly the underfunding of care provision by local authorities. This does not sound to me like a contractual relationship based on an equal footing, and we hope that the CMA will be looking at challenging local authority contractual practice to bring it in line with it’s proposed consumer law advice to be applied to care home contracts with individual residents.’

Responses to the consultation should be submitted by post or email by no later than 5pm on 16 February 2018.

Providers' post-death policies
The CMA’s investigation found that out of 32 of the largest UK care home providers, 15 charged no fee, or charged no fee once the room is cleared of possessions, or only charge fees for three days and 10 charged for periods ranging from five to seven days.

In addition 69 out of 120 care home providers who responded to a CMA online survey said that they do not charge fees following the death of a self-funded resident, only charge for a period of up to three days, or only charge fees until the room is cleared of possessions.

As a result of CMA intervention Maria Mallaband Care Group (MMCG) and its sister company Countrywide Care Homes voluntarily amended its contract terms in December for self-funded residents so that fees will only be charged up to the date of death. Up till then it had a clause in its contracts charging this type of resident up to a month of fees.

MMCG said: ‘The clause upon which they have focussed was, in any event, frequently not applied by us. The CMA are looking into many issues in our sector and we believe their findings will help towards a much needed common understanding of fairness, whether that be in relation to specific terms of business or the chronic underfunding by local authorities of much needed care services.’

Barchester Healthcare told CM: ‘We are actively participating in the CMA consultation. Supported by regulatory guidelines we feel it is appropriate to charge for a period of one week after death for those in long-term residential care. This period allows family members to say goodbye to their loved one in their place of passing, and the dignity and respect to remove personal items during what is a very sad and difficult time.’

A spokesman for Four Seasons said, around 85% of its clients are local authority-funded and council contracts usually terminate within three days or less. Its self-paying residents would be usually be aligned with this policy but it is reviewing the terms and conditions for all its homes with new contracts coming into effect this month.

HC-One added: ‘HC-One’s standard notice period is up to seven days for self-funding residents. This helps to ensure families have enough time to make any arrangements. We always seek to be flexible and will consider individual circumstances and each family’s needs where possible.’

Bupa’s standard approach is 14 days for long term residents and three days for short term residents (who have been at the home for 31 days or less). A spokeswoman added that they do look at the issue ‘case by case’.

Care Markets: February 2018

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CM MEETS..ANDREA SUTCLIFFE: THE CHIEF INSPECTOR OF ADULT SOCIAL CARE TALKS ABOUT WHAT GOOD QUALITY LOOKS LIKE AND CAN PROVIDERS IMPROVE IN THE CURRENT CLIMATE?

CM What are your inspectors reporting back are in main issues among providers who are failing to meet the standards?

AS We ask five questions when we go into care services, if they are safe, caring, effective, responsive to people’s needs and is it well-led.
The two questions that are the most problematic are ‘Is it safe?’ and ‘Is it well-led?’. What we are seeing is on the safety side of things is do we have sufficient numbers of capable and competent staff to deliver care in a safe way, are the processes and procedures embedded within services so that people are able to be safe, to be supported to have independent and meaningful lives in terms of what they can do?
The other side is around leadership and we can see how important leadership is in establishing the right culture – a person-centred culture which is transparent and inclusive. If that leadership isn’t there, services can quickly deteriorate, staff are not supported so you have higher levels of turnover so are more reliant on agency staff which means that people don’t get continuity of care.
I think the role of the registered manager is one of the most important jobs that anyone can do. It’s a job that has to cross a whole range of different capabilities and skills.
They are managing a staff team, they are managing the environment, they are looking after people and they are setting the tone and the culture of the organisation.
If they have got it right and they are really caring about the people who are using the services, doing the right things for them, enthusing their staff, providing the right training and support, and working positively with the people who use their services and their families, we can absolutely see that makes a difference.

CM How is the implementation of the market oversight regime going? Are you satisfied that the market is stable?

AS What we are seeing across the board is a number of indicators which are worrying us about the resilience of the market.
When we rate services as Inadequate, three quarters of them improve, which is positive but that means that a quarter of them are not improving.
And when we rate services as Requires Improvement, only half of them improve.
The two aspects of that, the ones that don’t improve, that really worries me because I think that is demonstrating a lack of resilience amongst the social care providers to actually be able to improve what they are doing and move into being a good quality service.
The market oversight team is up and running having good and constructive relationships with the providers that are within the scheme. I think it is working well.

CM What is the biggest challenge CQC is facing?

AS The biggest challenge for us is making sure that we are responding appropriately to risk. So that we are using the information and insight that we are getting from services, from healthcare professionals and other professionals who are on the ground and may be aware of things that are going on.
So we can get that information and respond appropriately to risk so that we are protecting people. Just making sure we are constantly on top of that, we are able to respond to that and demonstrate to people that we are taking the action that’s required.
That is really important that people see that happening.

CM This summer CQC carried out its first successful prosecution of a care provider (St Anne’s Community Services). Does CQC plan to use the full extent of its powers against providers who fail to offer the required standard of care?

AS The health and safety prosecution powers are specifically concerned with what the Health and Safety Executive did before.
We’ve had two successful prosecutions and it is likely there will be more as we go forward, sadly. It is happening when someone has been seriously harmed or we think there is a potential for that.
In terms of our other enforcement powers, when providers are not able to improve, we will be using those. I would much rather that we were going into services finding that they were good, telling people that that was the case, and we were going into services that were not good but they were able to improve.
But if they can’t or won’t then we will use our powers that will either force them to do so or may mean that they will no longer operate.

CM In your opinion has government austerity measures impacted on the quality of care some providers offer?

AS We haven’t been able to demonstrate that correlation, partly because our assessment of quality started in October 2014.
To be fair over 70% of services that we are rating are Good and another 1% is Outstanding so there is still quite a lot of good quality care out there which I think we should be very positive about.
We are concerned about is there are certain signs, for example, those services that are not improving and the fact some providers are handing back contracts to local authorities because they don’t think they can deliver a good quality of care on the basis of the resources that are available.
I am worrying as that goes on, we may see providers tempted to cut corners in terms of quality, which would obviously have a devastating impact on the people using services and we all need to make sure we are avoiding this.


CM How are some providers managing to achieve ‘Outstanding’ status in the face of local authority cuts?

AS There are a number of characteristics that are features of an Outstanding service. They absolutely focus on the people who are using the service. They are not providing a great service because they want to get an Outstanding rating from CQC. They are doing it because they know it’s the right thing and they are doing it for the people using the service.
It is the cultural thing of that dripping out of the DNA of the people who are running the service and working there to do that.
The other thing is the outstanding services I’ve seen, spoken to and some of them I’ve visited, is they are not standing still. They all want to continuously improve. So, although we’ve said they are outstanding, they are still looking at ‘What more can we do?’ and ‘How can we improve what we do for the benefit of the people who are using the service?’
I think that is just fantastic.

CM You have just launched your second consultation proposing a further rise in the fees providers pay?

AS The expectation that we move towards full funding through fees is an expectation which is set by HM Treasury and we consulted on that over a year ago in terms of moving towards that in these two years.
I can understand the concerns of people within the sector but at the end of the day it is government policy that the budget that funds what we do comes from fees from providers.

CM If you could change one thing in care, what would it be?

AS I would say that for everybody involved in adult social care, that they focus on the needs of people, their carers and families. If we all start from that premise, we won’t go far wrong.

CARE MARKETS: NOVEMBER 2016

 

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The height of luxury in the heart of London: CCMn gets an exclusive tour of Battersea Place, LifeCare Residences’ new extra-care scheme

There are high-end retirement villages and then there is Battersea Place. Developed by LifeCare Residences in the heart of west London, a penthouse flat with one of the best views in the capital costs a cool £2.9m. Alongside its other apartments, which start at £600,000, it boasts a large indoor swimming pool, cinema room, billiard room, in fact all the facilities you would expect in a five star hotel.

But these aren’t just luxury flats for the older generation. On the first floor is a separate care home for use by residents and other self-paying service users. All the care staff are registered nurses and fees are fixed from the day the resident moves in.

Chief executive Richard Davis told CCMn: ‘Literally this is the only one of its kind in London. There is other retirement housing and other versions of it but it is literally the only one of its kind. We look at the population numbers and if you compare it to the take up rate in somewhere like New Zealand where the market is more established you would need at least 250 places to meet that demand so there is ample room for lots of different providers. The key is as a city and as a country we clearly need more of this. We are determined to do more in London as we see a real need and we think we are pretty good at it.’

Unlike many other high-end retirement developments, the average age of residents at Battersea Place in 79. Around 75% of them come from the local neighbourhood (Kensington & Chelsea is just across the River Thames) with a large portion of the remainder returning to the capital to live or to be near their family.

Mr Davis said getting the project, which is located on prime London real estate across the road from Battersea Park, off the ground was the hardest part. He said: ‘It was nerve-wracking getting started but we knew once we had started that it would work. It was convincing the funders that was difficult as the first question they ask is “show me another one that is working in London” and we are the first and so there is an immediate suspicion that, because there aren’t anymore, that they don’t work. It took some work to get to that point. We pulled our funders back in here as soon as we were open to show them and they were pleased it was what we said it was going to be.’

He added possibly other extra-care operators were not doing this due to the challenge of finding the capital to buy in London. He said you needed a long-term business model as it took eight years to make Battersea Place become a reality.

‘We have a different approach because in the end we are operators and we have to develop because no-one else is going to build what we want to operate’, he said. ‘If you did this with a development hat on you would do it totally differently. But we are an operator and that is where the value of our business is. We deliver a service and we charge a deferred membership fee. We make a profit and we are financially secure to offer that service forever for our residents.

‘There is always a development risk if you are developing a retirement community but you’re prepared to take that risk if there is an operating business that’s of value at the end. I think it is fair to say that there are still many operators that don’t have a great business model that justifies the development risk, as they are really only thinking about getting their money back and making a profit. Whereas, for us, we still want to do that but it’s not where the journey ends, it’s the start.’

Another concern was being able to recruit the right staff, particularly registered nurses. Mr Davis said the industry is quite attractive, particularly to registered nurses, because of the way the care is delivered and ‘the choice we get in our residents’. Recruiting in London meant there is a wide range of people with different experiences and backgrounds that have filled the roles at Battersea Place.

The general manager was appointed 14 months before opening so that she had that time to build up ‘a really good team’. Mr Davis said this had resulted in a good team spirit and a culture around the service quality. ‘We are very pleased with the way people have come together and feedback we’ve had from not just the residents who are moving in but people who are involved in the project, the funders, advisors, the professionals. It’s the first in London so it is quite a milestone.’

LifeCare Residences, which also has developments in Hampshire and Dorset, now plans to concentrate future development within the capital. It has acquired in affluent West Hampstead and it is currently in the design and planning stage.

‘We have actually decided that we are going to focus on London and we want to do more like this’, Mr Davis added: ‘We are relatively conservative, we want to grow sensibly. If you had unlimited capital you could grow rapidly but that’s not our style. We’ll move at a steady pace and other providers will come in, which is fine as there is lots of space for different models and different options, so we won’t be growing at a great rate.’

He said if you grew too quickly you would not get in right. ‘If you expand too much you will slip up on the quality so you have got to remain focused. We see there is a high-end where we are, a mid-market and then affordable housing. I know the one thing this country excels at is the affordable end. I have never seen anywhere else in the world the volume and quality that is here.’

And the feedback from residents had been ‘heartwarming’ he said. ‘I’ve known some of these residents a long time - I’ve met them through functions - and to actually hear from them first hand their experiences, they are just so pleased to be in here and its finally real. I talked to one couple and he said all they did for the first week was sit and look at the view.’

Community Care Market News: June 2016