21 April 2023 meeting with PAUL VICKERS of HOME INSTEAD HIGH PEAK.

The UK is one of the most aged societies on the planet.  The number of people aged 65 years and over increased from 9.2 million in 2011 to over 11 million in 2021; the proportion of people aged 65 years and over rose from 16.4% to 18.6%. Here in the Peak District, our older residents make up nearly 30% of the population, amongst the highest in the UK. They don’t all need care, but many will during recovery from illness and surgery. So it’s a surprise that we don’t have more care agencies serving the neighbourhood.

Paul Vickers

Paul Vickers is the local franchise holder for Home Instead Senior Care, which originated in the USA and is now established in a dozen countries including Australia, New Zealand, Canada, Japan and much of Europe.

With family in the Wirral he started in hospitality, running a Llandudno hotel, then moved to airports and airlines, where he was CEO for hospitality at Terminals 1 and 2 at Heathrow and worked with SAS the Swedish airline. Then to the National Trust as national Catering Director for 8 years, with stints at Bournemouth Conference Centre (so I’ve eaten his butties), Warwick University and elsewhere.

When Paul wanted to return to the north of England he was headhunted for Operations Director at Sunrise Senior Living in Knutsford, which he describes as “a 5* hotel with care.” It stemmed from an American idea that residents should arrive in their 50s and 60s, make friends and get settled long before they need looking after, a proposition which leads to huge retirement developments in Florida and other parts of the USA. But it hasn’t taken hold here, not least because when offered accommodation, many older Brits would say, “It’s nice. But I’d rather be at home.” That got him thinking.

He found he had a passion for care and endorsed the adage, “If you don’t care, don’t (get involved in)  care.” Keen by now to own his own business he did his homework and discovered Home Instead Senior Care, set up in 1994 by Paul and Lori Hogan through their experience in providing home care for Mr Hogan’s grandmother Eleanor. He contacted Trevor Brocklebank in Warrington who had obtained the UK franchise, at that time with only a handful of businesses; now it has 250. And he successfully persuaded Christine Blain Hall another Sunrise employee to be his General Manager in the new venture.

We laughed as our speaker remarked that his wife, a chartered accountant, had questioned his ambition to own his own business with: “You’re too old, it’s too much money, it won’t work.” So he went ahead, originally in Marple then providing the service throughout the Peak District.

The advantage of a franchise is that you don’t have to create the infrastructure of training and guidance; that’s provided by HI. But the sales pitch, the networking, was all down to him. The USP was to focus on ways to enhance people’s lives when they’re at home, particularly if they are stuck there by infirmity or isolation. They offer non-medical services, which can be provided alongside the NHS, GPs and local authority services. A minimum of an hour is arranged  – “You can’t do anything much under an hour, it’s too rushed” – in direct contrast to local council caregivers’ arrangements, but the client can have almost any help they need including being taken out for the day, if that’s what they want.

Home Instead High Peak has now been going 14 years, has over 125 caregivers and over 200 clients at any one time, receiving over 80,000 hours of care per annum. That’s a credit to him, and everyone concerned. The office is in High Lane, but the area covered, right across the Peak District including the remotest villages, is split into four, with caregivers routed to be working near to home; they don’t normally have to come into the office. High quality technology (unlike the NHS, still doing a lot on paper) makes the difference here.

The biggest challenge in this industry (as in others) has been staffing, where Paul’s approach has been not to hesitate: in January he increased pay rates for carers well above the local averages, with double rates on Bank Holidays (“We are not shy in what we pay” – a basic of £12.25 ph with travel on top). They advertised through Facebook, the medium he has found most effective. 25 new people applied for jobs within a week, and he took on 15 of them. They do not use agency staff, but will offer both regular contracts and zero hours, which suit many care givers.

That meant increased charges, normally £32 per hour in weekdays and £34 at weekends. “It looks expensive but covers everything and gives great quality of care,” Paul said. In some cases, such as terminal illness, the cost is entirely paid by the Department of Work and Pensions; in most, the client pays direct. The charges compare favourable with residence in a typical private care home – a BUPA home in Cheshire will set you back £1,500 pw or more and you’ll still be sharing a dining room with dozens of other residents.

Covid was a massive challenge, but they had no Covid deaths among clients and a high vaccination rate among staff (unusually in this industry). The office closed for four months in 2020 and twice-daily management calls continued on Teams; the best result of this, said Paul, was an acceleration of technology away from paper. Now records of client visits are entered on smartphones which enable real time alerts (“Joan was not too well today”) to be followed up quickly; the next step is that the client’s family will be able to access this information too.

One obvious challenge is “Trying not to work all hours, but not always succeeding!”  – that brought nods of recognition from our members. Paul gives talks to community groups on subjects like “Dementia Support”, Staying Steady” (on your feet), “Staying Cool in a Heatwave,” – all good advice, and of course good marketing too. The payback for him is “Moments of truth with clients” who often lead very interesting lives – when Paul arrived to assist my late husband, a former police officer, he was greeted with, “Don’t I know you? Have I arrested you somewhere…?” and a knowing wink.

One question was how to cope with impossible clients? We wondered who the questioner had in mind! Paul’s response is that they get the same care as the others, but in truth there is a limit to what HIHP can provide; this is a private business. The agency is under no obligation to attempt the impossible; that’s someone else’s responsibility. I asked about staff welfare, as these are often entry level workers, working alone (mostly) and with sick people, under pressure. Again that’s where the franchise system is helpful. A pension set-up is available; bright ideas are rewarded with points that can be turned into money. Other franchisees have holiday homes which (like Timpsons) can be accessed by staff and their families. Their charitable foundation makes grants, often as recommended by staff. And once an employee gets the ethos, they can earn bonuses by introducing friends and family to be taken on too.

The company has a Five-Year Plan in which the whole team will be involved – like Sir John Timpson, Paul believes in inverting the triangle, so that a wide range of observations and ideas can be considered. The future includes working closely with medical practitioners to provide more complex care at home. Technology is becoming available to do regular full ECG checks at home, or dialysis, which would relieve the burden on both out-patient and ambulance services. It’ll be especially helpful for someone in, say Tideswell, to get dialysis at home, instead of three times a week driving into Stockport. That would be a quiet revolution, and bring a high standard of care to our region, as well as relieving pressure on hospitals and GPs.

A fascinating insight into an important business in a growing industry, where professionalism and quality management go hand in hand.