Breakfast seminar

 

“In the context of the market we’re in, every good operator is doing OK,” Peter Calveley told Care Conversation delegates.

 

This was despite the obvious challenges, he pointed out. As CEO of the UK’s largest care home group, he had overseen the acquisition of 140 homes from controversial provider Southern Cross last year. “How on earth were those homes allowed by commissioners and regulators to get into that state?” he said. “They were a disgrace.”

 

As a consequence, however, CQC and other regulators had experienced “a real kicking” and he was confident that such a situation would never be allowed to happen again. Taking on the homes had involved significant reputational risk for Four Seasons, he told the event, “and we took a lot of flak for it”, swiftly followed by “an intense period of inspection” by regulators who “had not been in those homes for a year”. Only around 30 original managers now remained from all 140 homes, and with some homes having up to 20 staff suspended on full pay, staff agency fees were “huge”, he said. Occupancy rates, however, were now growing. “The question is, what does all of this mean for operators and investors?”

 

The recent Cabinet reshuffle had been a “real shock”, he told delegates. “With a couple of exceptions, we don’t know what the new ministers’ policies are, and in terms what the consequences will be for the implementation of the Health Act, no one knows.”

 

The Caring for our future White Paper, however, did include government support for a cap on personal contributions to care, and October would see a new consultation on economic regulation of the social care sector, partly as a result of the Southern Cross controversy. “It’s quite clear that what they want is better surveillance – information that a lot of us have already said they can have. They want 360 degree surveillance, and I think there will be statutory powers to get that.”

 

This would need to be carried out by a new team, however, as it was not a skill set that currently existed in CQC or Monitor. The most likely scenario would see a group of providers under surveillance, he said, with two phases of triggered intervention – supervisory, or because of transfer of responsibility – and he stressed that it was vital that everyone in the sector made their voice heard in the consultation process.

 

He remained optimistic, he told the seminar. “At a time when there’s a new commissioning framework, it’s a real opportunity for the sector to demonstrate our capability and capacity. Thousands of our clients require 24-hour care –they’re a highly dependent group. For everyone who’s admitted to our homes it’s been decided that this client can’t be looked after at home safely or cost-effectively.”

 

This meant that the skill set in the sector was growing all the time, he pointed out, and highly specialised, innovative services could be provided at a lower cost than NHS provision. Many private sector facilities already had medical and nursing staff on hand to dispense drugs and other tasks, and these facilities could easily be equipped with things such as x-ray facilities and evolve into “genuine community care facilities”, he said.

 

“If you unlock that, it’s a remarkable opportunity. All it takes is more proactive, strategic engagement from commissioners and politicians, and genuine ‘world class commissioning’.” However, the sector needed to act together, and work closely with the community, GPs and others to develop a robust and effective out-of-hospital framework, he said. “You can’t just go to the government on your own and say, ‘We can do X, Y and Z’.”

 

While the sector would undoubtedly go through consolidation and a period of reflection, the key for any operator was to “enhance your service, and get over to commissioners why your proposition is the best”, he stressed. “You need to set the standards for your staff, and get the capability and quality right. There is undoubtedly going to be a differentiation between those providers who are capable of delivering what commissioners want and those who are not. If you’ve got a skill set across a lot of facilities – and evidence of what commissioners think of that – then you’ve got a track record. And you can then offer that to new commissioners.”