“The Granny Crisis, and How to Solve it.” With Ivan White of Kingswood Services and Ivonbrook Care Homes.
Another well-attended meeting, with people ranging from wealth planners to bottle makers wrestling over their coffee with one of today’s great problems.
Andy Nevett, Ivan White, ECJ, Aaron Liston AIMA Group
So here was the brief. We face rapidly rising millions of old people, many of whom will need care. Saga have made a fortune providing them with holidays – but what happens after that? Surely this is a golden business opportunity, which should be done ethically and well despite rising costs and expectations. Damian Green MP has suggested that a new tax be imposed on the over 40s to pay for future care – let me guess: that’ll go down like a lead balloon. The near-collapse of the Four Seasons chain (17,000 residents) just before Christmas shows that size alone is not the answer. So could a small team succeed, where others fail?
In 2014 regulations changed and the Care Quality Commission (CQC) began to inspect nursing and care homes. Not before time, some would say. Soon two homes in Darley Dale, Ivonbrook and Darley Hall, which were in a “very sorry state” faced closure. Derbyshire businessman Ivan White took them over in 2016; since then he’s been working to turn them around. All this while the national minimum wage is rising, auto-enrolment means more contributions for pensions, and “everyone expects five- or six-star standards for three-star prices,” said Ivan. What a nightmare.
He’s lucky in that his backers are able to invest considerable capital sums with no immediate prospect of return. There’s no mortgage or rent to pay – that’s unusual. Deep pockets, and (it appears) infinite patience are needed here: it was short term gain and neglect of the basic fabric which caused the issues previously. On the other hand, who is going to invest in residential homes, if it’s a bottomless pit?
Some changes, Ivan said, were inevitable. The buildings weren’t up to nursing home standards, so those needing nursing csre had to be removed, and the nurses went too. That brought an unexpected challenge: training up care staff, who had been accustomed to taking orders, to step up and take responsibility, and to fulfil the CQC’s stern commands to record (all the time) exactly what residents are doing.
Ivan introduced his senior manager, Neil Hare. They work as a team, but Ivan is an engineer and former estates manager who understands buildings, while Ivan was a senior carer and former NVQ inspector. They did give the impression of being slightly shell-shocked at what they had taken on; Ivan sighed that the CQC still make umpteen unannounced visits because of the past history of the homes, nit-picking almost, when so much progress has been made.
Derbyshire County Council has just announced a 4.99% hike in our council tax bills, taking full advantage of the relaxed cap as long as the extra goes to social care. Their standard rate for residential care (means tested of course) is £490 pw, with a “Dementia Premium Payment” another £40.95 pw. That does not translate into a field-day for private providers. “The basic fee ought to be about £600 per week to cover costs,” said Ivan. Others present thought the real figure is nearer £800 pw – in London you’d be way over £1,000. That includes 24/7 staff, kitchen, laundry, insurance, constant repairs, furnishings, bathrooms, hoists, lifts, utilities, gardening, training, management…
The danger is that self-funding residents may find themselves paying over the odds, which hardly seems fair, while respite or emergency care can be hard to find, especially for anyone with challenging behaviour. Perhaps self-funders are more realistic: Ivan has several who willingly pay £675 per week for a room with en-suite services. The wealth managers present nodded, and took copious notes.
“Team work involves the residents,” Ivan said, and it was clear that the families of residents mattered a lot too. He is pleased when local GPs recognise that they are doing a good job. They’re just about at break-even now, and when the homes get back up to full numbers (about 60) they will be in the black. “My objective is to get these places to the standard where I would want to live.” As a template for tackling the Granny Crisis, that sounds right to me.
One Business Club member pointed out that care home providers are dealing with “a monopsony – a dominant purchaser.” (We are all familiar with a “monopoly” – a dominant supplier. This is the other way round). A fragmented care sector really ought to get together and negotiate better with both CQC and the County Councils. Perhaps one outcome of this fascinating and thought-provoking meeting is that some local care homes may do just that; it would be a great improvement on the current state, where individual proprietors act in isolation, each trying desperately to fit their costs under an imposed price.