Brunelcare Strategic Plan 2015 -2020. Brunelcare Strategic plan: 2015 -2020; Our vision, mission and values Brunelcare is a local charity and registered

Brunelcare Strategic Plan2015 -2020

Brunelcare Strategic plan: 2015 -2020; Our vision, mission and valuesBrunelcare is a local charity and registered provider which has been working with, and for, older people in and around

Bristol since the 1940’s.

Our VisionTo be recognised and renowned for “Helping people to make the most of their lives.”

Our MissionOur mission is to listen, learn and improve so that we are able to:

• Deliver great service that meets the needs of our customers.• Enable our staff to be all that they can for our customers.• Make our business stronger for the future.• Create great communities to live, work and be in.

Our values Our values underpin everything that we do at Brunelcare and give an insight into our culture. These are the behaviours that you should expect to see on a daily basis.

• We put the customer’s individual wellbeing at the heart of our entire decision making process. • We are passionate about what we do and strive to make a positive difference to people’s lives. • We are each responsible for delivering great service, first time, to meet each customers unique needs.• We ask “if it isn’t improving service to our customers, then why are we doing it?”• We do all we can to ensure equal opportunities for all. • We encourage everyone to challenge and make suggestions: we are always seeking to improve.• We are one team, working to the same purpose, to develop a strong and efficient business.• We actively listen and go and experience issues raised, then problem solve together.• We make decisions as near to the customer as possible.• We aim to provide a service that is ‘value for money’ without compromising on quality.

This document provides an overview of the organisation’s work and aspirations for the next five years, and is reviewed annually by the Trustees, and updated to provide a rolling five-year strategy.

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Brunelcare Strategic plan 2015 -2020; An overview of current environment

OVERALLBrunelcare operates in three areas, namely: housing (independent living for older people where we offer support as required), community services (providing care in people’s homes and day centres) and care homes (generally very frail older people who are often living with a dementia).

This market remains a very dynamic and difficult one in which to operate. The current economic environment means that many councils are needing to cut funding to vital services and we have experienced a reduction in fee levels, as well as the ending of some services. In addition, the health service is facing many significant challenges varying from older people blocking beds in hospital to a shortage of nurses. All of these issues look likely to continue.

Due to this, we recognise the need to increase the amount of low level health care work we undertake, build on our reablement capabilities and increase the percentage of people who are paying privately for their service. This will be accompanied by a pricing strategy to ensure that all services make a surplus. Our reputation with our customers and commissioners is very high, but we have more work to do to share this with the general public and we shall embark on a branding and marketing programme to raise awareness.

We are a highly regulated organisation, with the Homes and Communities Agency (HCA), the Charity Commission (CC) and the Care Quality Commission (CQC) each having different requirements and approaches. In addition, our care commissioners also audit our services. On the care and support side, we have fully prepared for the new CQC requirements and await our first inspections. From an HCA perspective, we have recently succeeded in gaining our previous high ratings and will need to ensure that we can continue to evidence Value for Money (VfM). Within housing, we will pay particular attention to the way in which we manage our property assets, with particular reference to the recently completed Asset Management Strategy.

We employ circa 1,200 people from a wide variety of backgrounds, with the focus on recruiting people with the right behaviours. Our aim is to nurture all of our staff to ensure that they make the most of their talents to the betterment of the lives of our clients.

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Brunelcare Strategic plan 2015 -2020; High level strategy

THE NEXT FIVE YEARSWhen thinking about our 5 year business strategy, we consider four main areas: compliance, financial sustainability, customer satisfaction and staff satisfaction. Given this approach, many of our objectives each year are to ensure that we improve in all four areas. We currently have no plans for major expansion outside of our geographical area, but, given the dynamics of the marketplace, will not rule this out and will reconsider our strategy every year to recognise the changes taking place. The following highlights our current thinking;

Year 1: Housing: Actions from asset management strategy, decide on housing software.Community services: Pilot undertaking health care work, continue systems review.Care homes: Develop pricing tool and negotiate prices for current block and Continuing Health Care

contracts. Fully recruit nurses across all care homes.Central support: Pricing and marketing strategy, implementation of the Care certificate.Business Development: Identify extra care development opportunities and move into health care

Year 2: Housing: Complete housing software implementation, continue asset and service review. Community services: Build on health care work and increase reablement, move to shift work.Care homes: Consolidation, growth in clinical work.Central support: Continued focus on business efficiency, talent management and new software

implementation.Business Development: Continue building development, health care and partnership opportunities

Year 3-5: Housing: Complete service redesign, review assets for disposal or refurbishment. Community services: Consider further growth into health as well as other areas geographically.Care homes: All homes to achieve Dementia Care Kite mark and Gold Standards Framework in end of life care. Identify opportunities to manage more care homes.Central support: Continued focus on VfM. Other activities dependent on operational changes Business Development: Continue building development, health care and partnership moves

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Brunelcare Strategic plan 2015 -2020: Community Services Operations and PlansCOMMUNITY SERVICES

Currently we make 18,000 visits per week to over 1,300 people in Bristol, Somerset, North Somerset and South Gloucestershire, including residents of our Extra Care Housing schemes. During these visits we provide assistance with personal care and meet the health and support needs of physically and mentally frail people and their carers. Alongside this we provide reablement services, respite services and day care, all aimed at tackling social isolation, creating meaningful activities and restoring lost independence.

Building a relationship with a regular carer, who has the skills and the time to do an excellent job, at preferred times of the day, is what matters most to our customers. Reconciling this with the volume and logistics of our work, and with the financial viability of the services, is an on-going challenge. In addition, the majority of our services are currently commissioned by local authorities. Budgetary pressures are likely to be translated into frozen or reduced hourly rates, while a wider social agenda will demand more.

The health care sector is also in crisis and there is a need for patients to be discharged from hospital much more quickly. This is compounded by unprecedented demand in GP and community health services. We are actively working with community health providers to explore how we might work together to help solve some of these issues.

Our on-going project of redesigning services will continue and we will seek to launch new services in the same geographical area, to increase the number of customers organically or by acquisition, and to shift the mix of customers towards those that are self-funded, ensuring we are best placed flexibly to support those with personal budgets.

A change in business focus will also help us to achieve our aim of paying all staff in community services by shift (rather than the current hourly rates). Like all other providers, we are unable to guarantee hours to our staff, or pay for “down time” between calls. This leads to a high turnover rate and is the single item of frustration of our staff in the community.

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Brunelcare Strategic plan 2015 -2020: Care Homes Operations and Plans CARE HOMES

Our four care homes (with 296 residents) provide support for older people who are living with some form of physical or memory impairment through the provision of nursing, respite and residential care (with around 80% of our residents either diagnosed or living with some degree of dementia). The homes currently have an occupancy level of over 97% (compared to the UK average of 90%) and we receive referrals from outside the area.

The dependency levels in the care homes continue to increase with a lot more people moving into the homes on a permanent basis with complex health care needs. We are seeing that the need for long term residential care is reducing but there is now a greater demand for respite and short stay care in the local areas.

We recognise that the demand for hospital beds is greater than ever, with many older people taking up hospital beds who are medically fit to go home but not quite ready due to physical or social factors. To assist with this unmet demand we have opened a new reablement centre for older people to help them recuperate and become more independent enabling them to return home safely.

We have already achieved the Gold standards framework for end of life care in one of our care homes, and the Dementia Care Matters kite mark in another. Our intention is that all four of our homes will have achieved these awards over the next few years.

We are conscious that there are continuing financial pressures from our Local Authority commissioners. Although we have a number of block book bed contracts in some of our care homes, we wish to increase the number of private paying residents (where the fee is higher). In order to do this, we shall be focusing on marketing our homes to increase awareness of the services at large in the community.

We know there is a national shortage of nurses taking up positions in care homes as it is seen as a less attractive role than one in hospital. We will be looking at innovative ways of working with local hospitals and nursing colleges to increase the number of nurses working for us and raise the profile of this very important role.

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Brunelcare Strategic plan 2015 -2020: Housing Operations and PlansHOUSING

We provide approximately 1,050 homes in Bristol for 1,300 tenants, ranging from accessible independent bungalows, to sheltered housing with a low level of support, to extra care housing with the potential for high levels of care and support.

Our properties vary from older properties which are not always fully accessible (stairs to the first floor as an example) to brand new properties which lead the way in modern design. Our properties are a mixture of studio, one bedroom and two bedroom properties. We do have high occupancy rates, with each tenancy lasting an average of six and half years. However, over the last five years we do know that the average age of our new tenants has decreased, and that more men are now moving in with us. We have just produced our asset management strategy for 2015 -2020. A key driver of the strategy is the review of our assets to ensure that our buildings and the services that we offer appropriately meet the needs of our current and prospective tenants.

Bristol City Council (BCC) face many financial challenges and recently proposed cutting funding for older persons’ services, (which would have meant that our alarm service, and many of our Supporting People services would have been cut). Following responses from 500 of our tenants (which represented around 10% of the total responses from the population of Bristol), these cuts did not happen in 2014, however these services will be reviewed during 2015/16. We undertake to work with BCC and our tenants to be able to provide a high quality proactive service that appropriately supports those living with us.

We have many mechanisms in place to work with our tenants to help us shape our services and Tenants Voice (formed in February 2009) is growing in confidence. Their focus has matured to cover policy work, service standards, annual reports, event planning, involvement in staff interviews, writing corporate objectives and carrying out site inspections, to name but a few. We have also introduced a question of the month in addition to our site meetings and have a mystery shopping scheme in place. A tenant scrutiny panel was launched at the end of 2013 and we (together with the Tenants’ Participation Advisory Service: TPAS) have been supporting them in their investigations. They will be reporting their first findings in 2015.

Overall the focus in housing is on meeting the demand of current and future customers and looking at ways to continually improve our services for those who live or want to live with us.

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Brunelcare Strategic plan 2015 -2020: Central Support Operations and Plans

CENTRAL SUPPORT OFFICE

Our central support office employs 35 people who are responsible for business development, Human Resources (HR), Finance and Information Systems (IS). Our challenges for the coming year are:

• There are many opportunities to expand our business, both from a service and capital investment perspective. The business development team will continue to focus on building its’ network and assessing all business opportunities to ensure that we invest our time in those areas which match our strengths and are financially viable. In addition, it will implement a marketing strategy in order to raise awareness and increase our self funded customers.

• From a finance perspective, we shall develop a pricing strategy to inform all new contracts, ensure that we monitor all Value for Money (VfM) savings, maintain good control of arrears, review our internal audit strategy to ensure that it covers regulatory areas and continue to review our treasury management strategy and maintain our current levels of financial control.

• The focus for Information Systems will be to implement a new housing system and also review all other applications with the aim of improving the user experience and upgrading to supportable levels.

• The agenda for the HR Team involves working with the operations to decrease turnover of staff and improve the recruitment. The new Care Certificate in 2015 will be a major area of focus. Other areas of focus will include workforce planning and development as well as fit for purpose HR operational policies and processes that attract good quality employees and retain essential skills within the business.

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Brunelcare Strategic plan 2015 -2020: Overarching objectives and goals

CUSTOMERS

STA

FF

CO

MM

UN

ITIES

BUSINESS

Objective 1: Deliver great service that meets the needs of our customers

Goal 1: A range of methods in place to find out what our customers want and a system to use findings to drive business improvement

Goal 2: Housing Services which are highly regarded by tenants, leaseholders, local authorities and regulators

Goal 3: Care services in our care homes and the community which are recognised by clients, relatives, commissioners and employees as being innovative and sustainable

Objective 2: Enable our staff to be all that they can for customers

Goal 4: The ability to attract the right people to work for us

Goal 5: Develop staff to have the right skills and behaviour

Goal 6: Manage staff in a way which keeps the right staff

Objective 3: Make our business stronger for the future

Goal 7: Improve the efficiency of the organisation and create more funds for future business development

Goal 8: Business processes and information systems which are capable of actively supporting our employees to meet the needs of customers

Goal 9: Maximise the opportunities in the market to develop and grow sustainable business

Objective 4: Create great communities to live work and be in

Goal 10: Improve our properties in order to increase their sustainability

Goal 11: Build all new properties to a high standard which meets the needs of the customer

Goal 12: Make our communities great places to be

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Objective 1: Deliver great service that meets the needs of our customers

Long Term Objective

To be viewed by all stakeholders to be a provider of choice evidenced by high

satisfaction and growth

Goal 1 Desired Outcomes Proposed Actions

A range of methods in place to find out what our customers want and a system to use findings to drive business improvement

• Better tailoring of our services to meet customer priorities

• Clients able to influence priorities and scrutinise performance

• Improving satisfaction with how they are informed

• A provider of choice for commissioners and individuals

Research into experience for families after someone has passed away

Survey Somerset customers to see the impact of the new way of working

Gain feedback from customers on other low level services they might need


Housing Services which are highly regarded by tenants, leaseholders and regulators

• High levels of customer satisfaction

• Low levels of voids with high satisfaction of new tenants

• Clients say that it is easier to get hold of people

• All regulatory standards met

Retender “out of hours” call system

Goal 1 Achieved in 2014/5

Monthly coffee mornings set up in Care Homes with all relativesPositive feedback from all commissioners


Tenant Scrutiny panel established and investigating communicationsSuccessfully negotiated continuation of Supporting People funding

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Objective 1:Deliver great service that meets the needs of our customers (cont.)

Long Term Objective

To be viewed by all stakeholders to be a provider of choice evidenced by high

satisfaction and growth


Care services which are recognised by clients, relatives, commissioners and employees as being innovative and sustainable

• Reputation for excellent personal and dementia care

• Ensure CQC rating remains good/excellent

• New services being designed and implemented

• Preserve the personhood, liberty, freedom and independence of all our clients

• Enable our customers to direct their care and support and be involved in decisions about the service they receive”

All care homes to have progress in their plan for achieving the Gold Standards Framework (GSF) standard in End of life care and the Dementia Care Matters Kite mark

Understand any change in regulation and adjust work and audits accordingly


Designed and opened a reablement centre for older people coming out of hospital.

Achieved GSF ‘beacon’ status for end of life care in Glastonbury

Achieved level 2 Kite mark in dementia care in Deerhurst.

Orchard Court redevelopment completed improving the living and working environment

Respite and day centre's running sustainably without grant

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Objective 2: Enable our staff to be all that they can for customers

Long Term Objective

To be rated as an extraordinary company to work for by our employees


The ability to attract the right people to work for us

New recruitment process to be implemented

Pay review for certain staff groups

Enhance learning opportunities for Nurses by offering nationally recognised qualifications as part of development plan.

Undertake a marketing campaign to attract Nurses to the organisation.

Recruit new Chief ExecutiveGoal 5 Desired Outcomes Proposed Actions

Develop staff to have the right skills and behaviour

• Demonstrable value for money of training

•Staff turnover rates reduce

• Continuous improvement in staff satisfaction

• Change in staff culture from task to outcome focus

• Evidence of person centred services

•All staff are coached and mentored

•Empowered staff to be more accountable for their own team’s performance

• Improved staff performance; more accountability

Implementation of training for The Care Certificate to include revised induction and mentoring program

Implement our new induction programme for Nurses using the RCN principles of Nursing practice.

Improve the settling in period for staff in care homes to include thorough induction mentoring and coaching.

Involve staff in continuing efforts with regards to Value for Money (VfM) in order to maintain G1 and V1 status

• High quality appointments

• Become an employer of choice

Goal 4 Achieved in 2014/5Sponsorship of foreign Nurses in placeSuccessful Apprentice scheme in place including Care, Housing, Finance and Admin

Goal 5 Achieved in 2014/5Key management training improved to manage staff effectively.Advanced clinical training for NursesReduced number of hospital admissions in care homes. 40 care staff undertaking the Diploma in dementia care with Dementia Care Matters. New contracts providing opportunities for skills development.

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Objective 2: Enable our staff to be all that they can for customers (Cont.)

Long Term Objective

To be rated as an extraordinary company to work for by our employees


Manage staff in a way which keeps the right staff

• Good performance recognised and seen to be the way we do things

• Staffing rotas meet demand/reduce dependency on Agency

•Staff consultation to be meaningful and productive

•Reduction in sickness/absence

•Poor performance managed quickly and appropriately

Redesign of work for Community Services staff

Retention project to be completed

Undertake a survey for difficult to attract staff establishing why they choose to work for us, what is important for them for their career progression.

Spoken to and established links with University of the West of England (UWE) to introduce new Nurses to the organisation.

Redesign management information systems and reports including effective external benchmarking

Goal 6 Achieved in 2014/5Review of absence policy to aid the management of absence.All sites have received coaching and training to deal with absence.Disciplinary and performance management processes have been improved to be more user friendly.Process for investigations and disciplinary hearings given more structure.Increased focus on causes of poor performance and misconduct and tackling underlying causes2 new managers started in the homes, 1 manager transferred.Pensions auto-enrollment implemented on time

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Objective 3: Make our business stronger for the future

Long Term Objective

To have a reputation with our customers, staff and

commissioners for efficiency and financial

strength


Improve the efficiency of the organisation and create more funds for future business development

Renegotiate our Block and CHC contracts in each home.

Developed and test a pricing tool appropriate to each home that clearly reflects the cost of care.

Increased the number of private fee payers by 10% across all homes.

Ensure we comply with all regulatory requirements and maintain our reputation with regulators

Complete review of pricing in community services

Review referral process into Extra Care Housing (ECH)

Pilot with partner undertaking more health care work

Review membership of procurement consortia

Review property standard

Reduce proportion of response repairs by 10%

Deliver a flexible “basket” purchasing approach to energy procurement

Perform a detailed Defined Benefit pension review with recommendations and implement agreed strategy

• Successfully manage the business through the current economic crisis

• Clear evidence of savings

• Funds available for future developments

• Maintain quality of services delivered

• A range of measures in place to assist managers and trustees in their decision making


Undertaken some systems thinking in the care homes.

Home managers have a better understanding of their budgets

Renegotiated block contracts with Local Authorities at higher rates

Secured additional respite beds with local CCS’s

Reablement beds opened at Deerhurst

Staff efficiencies in Housing; 5 staff left but not replaced

Successful restructure of Finance Team

Delivered reliable, positive financial results

Achieved G1 and V1 ratings with HCA

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Objective 3: Make our business stronger for the future (Cont.)

Long Term Objective



strength


Business processes and information systems which are capable of actively supporting our employees to meet the needs of customers

• Processes used to ensure staff are in the right place at the right time to satisfy customer needs

• Applications for scheduling and invoicing care, support and rent as well as arrears management is fit for purpose

• Applications for collection of data on working hours and the paying of staff is fit for purpose

• Website and intranet used for all information

Replace Housing software

Ensure FRS102 compliance on schedule

Implement Direct Debit as a payment mechanism


New performance measures agreed with Board across the businessConsidered four alternative housing systemsEstablished effective Wide Area NetworkCare home arrears process improved - debt reduced by £1M

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Objective 3: Make our business stronger for the future (cont.)Goal 9 Desired Outcomes Proposed Actions

Maximise the opportunities in the market to develop and grow sustainable business

• Commissioners satisfaction and repeat business

• Maintain contracts in VSH and community where desired

• Increase the % of community work involved in delivering health care

• Increase in the number of private customers purchasing support and care in their own homes

• Reduction in empty properties and care home rooms

• Maintain occupancy of >95% in care homes

• Increase the number of private care, support and CLS services in housing

Long Term Objective



strength


New Reablement Centre opened and successfully implemented in Orchard Grove, both on time and within budget Majority of Saffron flats occupiedSuccessful bid with Avon and Wiltshire Mental Health PartnershipReablement now fully operationalImplementation of care contract at ABC Centre

Focus on increasing the number of private fee payers in care homes.

Renegotiation of existing block contracts using robust pricing tool.

Review all tender opportunities with a focus on health related work

Marketing strategy to increase private payers and difficult to recruit staff groups

Develop new website

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Objective 4: Create great communities to live, work and be in

Long Term Objective

Our communities to be places that people enjoy

being part of


Improve our properties in order to increase their sustainability

• Fully accessible buildings

• More attractive properties to let

• Improved use of assistive technology to assist independence

• Reduced energy usage

• Reduced void levels


Orchard Court and Orchard Grove refurbishments completedEmmanuel Court refurbishment 80% completeWoodland Court properties selling wellAsset Management Strategy completed

Options appraisal for 5 schemes

Ensure 100% accuracy of property surveys

Ensure that all properties achieve a targeted rate of return and make a positive financial contribution

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Objective 4: Create great communities to live, work and be in (Cont.)

Long Term Objective

Our communities to be places that people enjoy

being part of

Build all new properties to a high standard which meets the needs of the customer

• All new housing to be built to Level 4 of the Code for Sustainable Homes all other buildings to BREEAM Eco Homes Excellent

• A world class development of housing, care home and administrative offices: 1 site

Make our communities great places to be

• Minimal antisocial behaviour

• Care home take on role as a hub facility for services

• Zero tolerance to unacceptable behaviour

• Create sustainable and cohesive communities

• Older people in our local neighbourhood to join activities/ receive services from our sites


No new buildings in 2013/14; refurbishments to care home complete


Reduction in reported number of incidents and accidentsCompleted post occupancy review of Saffron



No new buildings planned for 2014/15

Develop a programme to attain and retain volunteers that adds value to our community offer

Improve the Health and Safety of our residents and staff

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Brunelcare

Strategic Plan 2015-2020

Documents

Brunelcare Strategic Plan 2015 -2020. Brunelcare Strategic plan: 2015 -2020; Our vision, mission and values Brunelcare is a local charity and registered