So we’re thinking about care homes

From George Coxon, care home owner and lead for the Devon Care Kite Mark

Whether through media perceptions, personal or professional experience, everyone has an opinion about care homes — and they are not always good. I’m determined to try to change that. I run two well regarded care homes in south Devon, and am passionate about creating positive experiences for people living and working in them.

I also believe every care home — including my own — can improve and I believe that the best way to do this is by constantly learning from others, drawing on the knowledge and experience of those who work in and run care homes, and spreading it around. There is nothing that is wrong with care homes that can’t be fixed by learning from what is right in the best care homes. Our focus is about instilling a positive culture of enthusiasm and kindness in our ethos.

These beliefs — in the value of practice-based knowledge embedded within care homes, and the importance of sharing this knowledge — are obvious to me. But they are counterintuitive to many. Too often those sent to advise care homes on improvement have never worked in one and their focus is solely on clinical, not practice-based, knowledge and skills. Equally, the competitive markets we operate in make people reluctant to share the secrets of their success with others, their competition.

The reason I hold to my beliefs is because I have seen the difference they have made to care homes in Devon over the last seven years. Back in 2012 a group of care home owners set up a provider-led learning collective, we called the Devon Care Kite Mark (DCKM). Through this group we have shared the secrets of our practice: in peer reviews conducted under the principles of appreciative inquiry; through masterclasses for owners and managers; and through learning events and conferences. It might have seemed like a gamble, but we soon realised we had more to gain from sharing our practice with each other, from collaborating rather than competing.

We have achieved a lot in the last seven years. It’s a unique model that really works. I can’t claim it is all the result of DCKM, but Devon now has more CQC rated ‘outstanding’ care homes than any other local authority area. Competition combined with the fragmented nature of the care home market means it is a service area where it is difficult to spread innovation and improve practice. We have found a way.

The South West Academic Health and Science Network — which aims to improve the health and care of people in the South West by spreading innovation — were interested in what we were up to, and the broader lessons that could be learned from it for those interested in systemic improvement. They commissioned Collaborate to investigate what was special or interesting about DCKM, for care homes but also for improvements in other health and care contexts. That was great for us: as a group, we are always trying to learn and improve.

Collaborate’s report gave us two things:

• affirmation about what we were doing and the impact we have had; and
• ideas and recommendations for how we could develop in the future (while retaining what makes us unique), expanding our impact and becoming more sustainable and inclusive.

As a result of the report we are evolving. We are changing our name to the South West Care Collaborative to better capture what we are (a ‘collaborative’ more than a ‘kite mark’), and to reflect our intention to extend the geographical impact of what we do (the South West, not just Devon). The core of our approach — dynamic, provider-led content in immersive masterclasses, and themed peer reviews — has not changed. But we are raising our ambitions and broadening our activities so we can have a wider impact. As part of this year of transition we have done three new things:

• First, supported by the SWAHSN, we have told our story in our own words through the TED inspired event in front of a sizeable ‘live’ audience, and filmed and streamed to hundreds more around the country. Social media coverage used #irresistiblecare with national, multi-professional and DCKM lead activists sharing inspiring and memorable thoughts and ideas about the ‘new narrative’ we are creating for care homes. I was one of 10 speakers who each gave 11 minute talks. I asked the group what were the most important words to them when thinking about care homes. I shared my top contenders — KIND, KEEN, FRESH, CURIOUS, PROUD, SAFE, and FUN — before I expanded on my chosen word, TIME and how we use it in care homes. I said we should ban the ‘B’-word — not BREXIT but BUSY — because making time to chat is just as vital as chores and checks. You can see my talk and all the others from the day here.
• Second, we have sought to embed what we do and the way we work within the wider system of health and care. It is one thing to improve the care homes we own and run: the bigger prize is systemic improvements in the quality of care, and true integration with health. So we are taking a more active role in our local health and social care Sustainability and Transformation Partnership, where I have joined the Board. In addition, we are engaging actively with primary care (as part of the new Primary Care Network developments), with acute and community services such as local hospitals and locality services, and working with specialist providers like mental health trusts and hospices.
• Third, we are developing our connection with SWAHSN. AHSNs like ours in the South West are hot beds of energy and ideas, and care homes have a lot to contribute to (as well as gain from) the cross-fertilization of ideas across health and care. We are promoting the need for a ‘first stage connection’ with care homes when innovation and improvement plans are being developed, so that insights from the care home perspective are fully embedded from the start. This will allow us to contribute fully to the co-design and co-production of solutions. We all have so much to gain from creative improvement work, and efforts to increase the adoption and spread of innovative ideas and practices.

I love what I do. Care homes, like the infographic storyboard we produced says, ‘touch every base’ and unquestionably I say with absolute sincerity work in progressive energised care homes provide a special kind of buzz and thrill to those associated with them. We are as interested in medication as we are in foot care, in the quality of medical care as well as fostering rich social relations, from Beatles days to conker tournaments and all the other things that enhance the lives of our residents.

There really is nothing like the feeling of satisfaction you get from life in a great care home — as a resident, as a worker, or as an owner. That’s why I’m so passionate about what I do and so proud of what we have achieved through the DCKM. I’ve seen what we can do when we come together, open ourselves up to the scrutiny of our peers, and share the best of what we know. It’s the power of collaboration in action. And we are only just getting started.

George Coxon

Owner/ Director — Pottles Court and Summercourt Care Homes

Independent Health & Social Care Consultant inc Network Associate SW AHSN

Chair of Devon Care Kite Mark

Member of the Mental Health Nurse Association National Professional Committee

If you want to know more about the DCKM go to http://devoncarekitemark.co.uk/ or contact George

For more information on Collaborate CIC, please email enquiries@collaboratecic.com

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