Brunelcare Strategic Plan 2014 -2017 Brunelcare Strategic plan: 2014 -2017: Our vision, mission and values Brunelcare 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 Vision To be recognised and renowned for “Helping people to make the most of their lives.” Our Mission Our 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. •We are passionate about what we do and strive to make a positive difference to peoples lives. •We are each responsible for delivering great service, 1st time, to meet each customers unique needs •We will 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. . •Everyone is encouraged 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 will actively listen to 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 three years, and is reviewed annually by the Trustees, and updated to provide a rolling three-year strategy. Brunelcare Strategic plan: 2013-2017: An overview of current environment OVERALL Brunelcare operates in three areas, namely: housing (sheltered and extra care), community services (providing care in people’s homes) 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 cuts to fee levels and complete services. This looks likely to continue and we recognise the need to increase the percentage of people who are paying privately for their service in order to maintain the financial viability of many of the services which we provide. This will be accompanied by a pricing strategy to ensure that we recover the full costs of all services, except those which we aim to subsidise as part of our charitable objectives. 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 and the Care Quality Commission each having different requirements and approaches. In addition, our care commissioners also audit our services. On the care and support side, we are fully compliant with all CQC requirements in all services. Whilst we believe that we run a highly efficient organisation, we have yet to convince the HCA that our approach to Value for Money (VFM) is as good as it can be. We shall therefore need to put some effort into ensuring that we have all the evidence required. This will pay particular attention to the way in which we manage our property assets and we shall be reviewing our asset management strategy as part of this programme. Our employees are our most important asset in achieving great service. We employ circa 1,200 people from a wide variety of backgrounds, with the focus on recruiting the people with the right behaviours. Out 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. In addition, we need to develop a learning culture alongside our systems thinking work so that managers, in particular, see their role to problem solve. Brunelcare Strategic plan: 2013-2017: High level strategy THE NEXT THREE YEARS When thinking about our 3 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 reconsider our strategy every year to recognise the changes taking place. The following highlights our current thinking. Year 1: Housing: Roll out of systems thinking with a new asset management strategy planned Community services: several contracts up for retender and some excellent new business development opportunities; growth expected Care homes: Three sites for new care home development available. Finalise Irwin development. Development programme for nurses. Central support: Focus on improved efficiencies with business process reviews, wide area network roll outs and workforce planning implemented Year 2: Housing: year 1 of the Asset Management Strategy, continued tenant scrutiny Community services: a year of consolidation Care homes: Potential opening of new care home(s), clinical governance focus. Consider specialism. Central support: Continued focus on business efficiency, talent management and new software implementation Year 3 Housing: Potential disposal and planning for reprovision of sites Community services: Consider move into other areas (geographical and specialism) Care homes: Consolidation, growth in clinical work Central support: Consideration of shared support services Brunelcare Strategic plan: 2013-2017: Community Services Operations and Plans COMMUNITY 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 personal, innovative and higher-quality services. Our on-going project of redesigning services and staff structures around the customer has brought demonstrable efficiencies. This creates the space to deliver what matters most to our customers, even within tighter budgets. To accommodate income pressures in an already low-margin business 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. Our plan is to optimise the effectiveness of our operations to ensure financial stability during this period of change and to be ready for new business opportunities. Many contracts will be up for renewal in 2014 and there are also new opportunities ranging from domiciliary care to Dementia Care Pathway in Bristol. All shall be considered. In addition we will be increasing the use of telecare, and focussing more on supporting people to engage with their communities and access community resources. Brunelcare Strategic plan: 2013-2017: Care Homes Operations and Plans CARE HOMES Our four care homes (with 250 residents) provide support for older people who have are living with some form of physical or memory impairment through the provision of nursing and residential care (with around 80% of our residents either diagnosed or living with some degree of dementia). All four homes have been recently inspected by CQC and are fully compliant. 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. This is especially affected by hospitals wishing to avoid death in hospital (leading to very short end of life stays) to individuals delaying their admission for as long as possible. We are conscious that there are increasing financial pressures from our Local Authority commissioners. We have managed to secure block book bed contracts in some of our care homes, but wish to increase the number of private paying residents (where the fee is higher). In order to do this, we shall need to increase awareness of the services at large in the community. We know that we could manage at least one further care home without any increase in overheads. Bristol City Council is currently looking for partners to build two new care homes. We have identified potential partners for this who would put up the funding required. Current proposals are to have 70% nominations to the care home; this will be open to negotiation. In addition, we need to satisfy ourselves that the business will be able to repay the loans. The clinical manager in each home will be ensuring that all nurses continue their professional development. Our specialists in nutrition and wound management will continue and we shall be developing the role of the nurse (to include the administration of IV antibiotics) in order to reduce hospital admission .Our reputation for end of life care has grown and we shall be continuing our training in this specialised area. Brunelcare Strategic plan: 2013-2017: Housing Operations and Plans HOUSING 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. Despite this, we have high occupancy rates and, when we last reviewed our assets in 2010, we felt that there were many years life in all our properties. We shall be conducting a detailed Asset Management Strategy in the coming year in order to develop our plans for the coming years. In the meantime, we shall continue to maintain our properties to a high standard and improve energy efficiency. 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. As a result we know that repairs and maintenance and the management of anti-social behaviour are of the utmost importance to our tenants and will continue to focus on these in the short term. A tenant scrutiny panel has just been launched at the end of 2013 and we (together with the Tenants’ Participation Advisory Service: TPAS) shall be supporting them in their investigations. Bristol City Council face many financial challenges. It’s recent considerations to cut 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 tenant (which represented around 10% of the total responses from the population of Bristol), these cuts will no longer happen. Overall the focus in housing is on meeting the demand of customers and looking at ways to continually improve our services. Brunelcare Strategic plan: 2013-2017: Central Support operations and plans CENTRAL SUPPORT OFFICE Our central support office employs 35 people who are responsible for business development, HR, finance and IT. Our challenges for the coming year are: • There are many opportunities to expand 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. •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, 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 the Wide Area Network (WAN) network, ensuring improved speed and reliability. In addition, we shall be reviewing our major applications with the aim of removing complexities, improving the user experience and upgrading to supportable levels. •The agenda for the HR Team involves achieving a closer alignment of HR activities to business requirements with a particular focus on workforce planning and development, fit for purpose HR operational policies and processes that attract good quality employees and retain essential skills within the business. Brunelcare Strategic plan: 2014-2017: Overarching objectives and goals 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 CUSTOMERS 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 BUSINESS 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 the 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 Objective 1: Deliver great service that meets the needs of our customers Goal 1 Achieved in 2013/4 In CS, customers told us they would like visits at their preferred time from a carer they can get to know and relate to. In CS customers tell us about their goals and we support them to achieve Improved communication regarding changes Improved customer satisfaction and reduced complaints 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 Long Term Objective To be viewed by all stakeholders to be a provider of choice evidenced by high satisfaction and growth Proposed Actions • Better tailoring of our services to meet customer priorities ECH schemes renowned for a personalised, flexible service within a thriving community setting which is operationally efficient • Clients able to influence priorities and scrutinise performance Rollout a new way of working across community services including reablement • Improving satisfaction with how they are informed •A provider of choice for commissioners and individuals Goal 2 Achieved in 2013/4 Tenant scrutiny panel developed: 7 on the panel. Tenants Voice continues with a strong membership Desired Outcomes Goal 2 Housing Services which are highly regarded by tenants, leaseholders and regulators Desired Outcomes • 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 Proposed Actions Tenant scrutiny and self assessment in place Retender “out of hours” call system Objective 1: Deliver great service that meets the needs of our customers Goal 3 Achieved in 2013/4 Settling in period for residents much improved; each allocated an individual to care for them. Few admissions on a Friday. All care services CQC compliant Increased levels of satisfaction in CS due to service redesign and focusing on goals rather than task Long Term Objective To be viewed by all stakeholders to be a provider of choice evidenced by high satisfaction and growth Goal 3 Care services which are recognised by clients, relatives, commissioners and employees as being innovative and sustainable Desired Outcomes • 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” Proposed Actions Mandatory training review conducted to ensure that we are compliant with our regulatory responsibilities Objective 2: Enable our staff to be all that they can for customers Goal 4 Achieved in 2013/4 New Finance Director appointed Improved nurse recruitment through sponsorship and reputation Goal 4 The ability to attract the right people to work for us Desired Outcomes • High quality appointments •. Become an employer of choice Goal 5 Achieved in 2013/4 Business partners in the HR department assisting with more added value work Improved clinical governance: falls, pressure sores, end of life care. Nurses trained to give IV antibiotics Training on welfare reform complete; all tenants supported Staff trained in power of attorney matters Goal 5 Develop staff to have the right skills and behaviour Proposed Actions Enhance the learning opportunities for nurses in the organisation by offering nationally recognised qualifications as part of their development plan. Develop a resourcing solution including workforce planning and improved value for money from recruitment suppliers Desired Outcomes • Demonstrable value for money of training Proposed Actions Develop the skills of our staff to ensure they make the most of their talents. For managers this will enable them to improve decision making, inspire their teams and manage business and individual performance. Improve the settling in period for staff in care homes. •Staff turnover rates reduce • Continuous improvement in staff satisfaction •. Change in staff culture from task to outcome focus • Evidence of person centred services Long Term Objective •All staff are coached and mentored To be rated as an extraordinary company to work for by our employees •Empowered staff to be more accountable for their own team’s performance • Improved staff performance; more accountability Objective 2: Enable our staff to be all that they can for customers Goal 6 Achieved in 2013/4 Auto-enrollment of staff completed in January; less than 10% opted out to date. New disciplinary process developed Improved TUPE knowledge with Care UK handover Maintenance team terms and conditions completed Head of Staff Council appointed; admin support given. Staff more supported in new ways of working Long Term Objective To be rated as an extraordinary company to work for by our employees Goal 6 Manage staff in a way which keeps the right staff Desired Outcomes • 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 Proposed Actions Develop a learning culture so that managers, in particular, see their role to problem solve and improve their operations on a continual basis Objective 3: Make our business stronger for the future Goal 7 Achieved in 2012 Residential beds reduced in Glastonbury; very few left and fully staffed for nursing. New ways of working rolled out in Somerset Acquisition of Care UK with no addition to overhead cost Acquisition of Woodland Court Successful tender for reablement service Goal 7 Improve the efficiency of the organisation and create more funds for future business development Desired Outcomes • Successfully manage the business through the current economic crisis •Clear evidence of savings • Funds available for future developments Long Term Objective To have a reputation with our customers, staff and commissioners for efficiency and financial strength Increase brand awareness through a promotional and marketing campaign with the intention of attracting good quality staff and volunteers as well as more private customers Implement a range of measures which provide easy-to-understand information for managers and trustees and which enables them to understand the issues as well as key areas for improvement Ensure that we comply with all regulatory requirement and that we maintain our reputation with the regulators Increase the percentage of private paying customers in order to improve the financial viability of the services Develop a pricing strategy so that all new services, which we tender for, cover the full costs of services Increase the number of private fee payers in the care homes Improve financial understanding of the care home managers Ensure that Value for Money becomes embedded as a concept and objective throughout Brunelcare Compete systems thinking review in Saffron Gardens and implement changes •Maintain quality of services delivered •A range of measures in place to assist managers and trustees in their decision making Proposed Actions Objective 3: Make our business stronger for the future Goal 8 Achieved in 2013/4 Replaced payment system in care homes Significant improvements in the IT network. IT strategy approved and 1st year plan implemented Several policies reviewed and implemented including family friendly and acceptable behaviour. Systems thinking complete in Somerset, beginning in housing, care homes and North Somerset Goal 8 Business processes and information systems which are capable of actively supporting our employees to meet the needs of customers Desired Outcomes Proposed Actions •Processes used to ensure staff are in the right place at the right time to satisfy customer needs Roll out and continue to develop systems to reassure the quality of service we provide ensuring they meet our purpose 'helping people make the most of their lives'. •Applications for scheduling and invoicing care, support and rent as well as arrears management is fit for purpose Complete a roll out of consistent, appropriate and proportionate systems in community services and housing Streamline the income collection and arrears process to reduce waste, ensure clean set up for all new clients and reduce overall arrears Establish DD as preferred payment method for all customers Conduct a HR/Payroll/Business review looking at improving processes for starters, leavers and recording of absence Review of HR measures so that they help the business make appropriate decisions •Applications for collection of data on working hours and the paying of staff is fit for purpose •Website and intranet used for all information Long Term Objective To have a reputation with our customers, staff and commissioners for efficiency and financial strength Objective 3: Make our business stronger for the future (cont.) Goal 9 Achieved in 2013/4 Won the reablement bid in South Gloucestershire. Tendered for the dementia pathway work; currently awaiting result. Took over Care UK operations in N Somerset Woodland Court acquired; sales of empty apartments on track (over one a month) Goal 9 Maximise the opportunities in the market to develop and grow the business Desired Outcomes • Commissioners satisfaction and repeat business Secure a sustainable contract to grow the turnover of the business by 5-10% • Maintain contracts in VSH and community where desired All flats in Saffron Gardens in use within a financial model acceptable to the organisation • Grow community services by 30%?? Achieve a positive contribution from the acquisition of Woodland Court •Increase in the number of private customers purchasing support and care in their own homes Retender all current contracts and any new suitable business opportunities Review the lessons learnt from the Saffron Court opening to plan and deliver the development and opening of Irwin Wing • Reduction in empty properties and care home rooms •Maintain occupancy of 95% in care homes Long Term Objective To have a reputation with our customers, staff and commissioners for efficiency and financial strength Proposed Actions •Increase the number of private care, support and CLS services in housing Objective 4: Create great communities to live, work and be in Goal 10 Achieved in 2013/4 Orchard Court to complete in April 2014. Emmanuel Court in progress Wide range of adaptations implemented Goal 10 Improve our properties in order to increase their sustainability Desired Outcomes •Fully accessible buildings • More attractive properties to let • Improved use of assistive technology to assist independence • Reduced energy usage • Reduced void levels Long Term Objective Our communities to be places that people enjoy being part of Proposed Actions New Asset Management strategy in place Complete the refurbishment of Irwin Wing Complete the refurbishment of Emmanuel Court Objective 4: Create great communities to live, work and be in Goal 11 Achieved in 2013/4 No new buildings in 2013/14 Goal 12 Achieved in 2012 600 hours of volunteers time achieved. Satisfactory audit of Health and Safety Goal 11 Build all new properties to a high standard which meets the needs of the customer Desired Outcomes • All new housing to be built to Level 4 of the Code for Sustainable Homes all other buildings to BREEAM Eco Homes Excellent Goal 12 Desired Outcomes Proposed Actions • Minimal antisocial behaviour •Care home take on role as a hub facility for services 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 • Zero tolerance to unacceptable behaviour Our communities to be places that people enjoy being part of No new buildings planned for 2014/15 • A world class development of housing, care home and administrative offices: 1 site Make our communities great places to be Long Term Objective Proposed Actions •Create sustainable and cohesive communities • Older people in our local neighbourhood to join activities/ receive services from our sites Brunelcare Strategic Plan 2014-2017