The Associated Retirement Community Operators (ARCO) – Consumer Code

ARCO aims to set and maintain high standards for operators of
retirement communities in the UK. The ARCO Consumer Code was launched in
2015 to provide a benchmark for good practice within the
housing-with-care sector. The Code applies to retirement communities in
the UK that have been registered with ARCO by Approved Subscribers to the ARCO Code.

Operators who signed up to the Code will ensure that prospective
residents are given clear and transparent information about fees and
service charges well before they decide to move in. Retirement community
operators will also need to provide core levels of services in
retirement communities, and must maintain a fair and consultative
relationship with residents.

The introduction of the Code marks the culmination of two years of
work to agree a common set of high standards for the sector, which go
above and beyond statutory duties. To ensure that standards are met, the
Code is supported by a robust standards and compliance framework.
External assessors conduct independent reviews of services against the
Consumer Code on ARCO’s behalf. These assessors monitor Subscribers’
compliance with the Code, and ARCO will take action as necessary when
standards are not met. Please read the FAQs or email for more information.

Please note that ARCO does not provide a dispute resolution service,
and we encourage residents to follow their operator’s complaints
procedure. If residents have gone through this procedure and are not
satisfied with the result, they can take complaints to the relevant
Ombudsman service, which ARCO members must be signed up to. However,
ARCO’s Standards Committee will consider external evidence in cases of
allegations of an infringement to the Code.


Download the Code here

Making healthy normal in Oaklands Park


Southern Cross Care (SA&NT) has opened it’s seventh Health and
Wellness Centre at Oaklands Park Lodge this week, continuing our quest
to “make healthy normal”, as Jo Boylan, Director Operations said at the launch event.

Designed to promote active ageing among our residents, the centres
support our residential care customers to improve their overall
mobility and strength, while helping increase their skills and maintain

The Health and Wellness Centres are led by a team of Southern
Cross Care Lifestyle Coordinators who have each completed their
Certificate III in Fitness through the Australian Institute of Fitness.

Residents seek GP clearances so they can take part and we are seeing
overall mobility improvements in residents including increased physical
fitness, strength, balance, flexibility and endurance.

Each Centre is fitted with a range of specialised exercise and
rehabilitation equipment including recumbent bikes, seated elliptical
trainers, handheld and strap on weights, balance boards, parallel bars
and chi balls. The early intervention trial program, has received
positive response from residents and already shown strong improvements
in their physical and mental health.

It has been encouraging to witness the positive social culture among
residents, including many who have claimed to have formed new
friendships as a result.

Making healthy normal in Oaklands Park

Chair of the Residential Care Leadership Board – Centre for Public Appointments

The DfE is setting up the Residential Care Leadership Board (RCLB) to drive improvements in the residential care system in England, as recommended in Sir Martin Narey’s independent review of residential care (July 2016). The board will have an initial focus on Sir Martin’s recommendations for commissioning and Staying Close pilots, with scope to extend this remit by agreement with the DfE.

The DfE is seeking to recruit an independent Chair, for an initial period of two years, to provide strong leadership to the RCLB. Further details are available below.

Chair of the Residential Care Leadership Board – Centre for Public Appointments

Children’s Homes by Peter Higginbotham

Children’s Homes surveys the wide range of institutions that, over the centuries, were used as a substitute for children’s ‘natural’ homes. This includes not only orphanages but a wide range of other establishments run by particular bodies (charities, religious groups, workhouse authorities, occupational groups, local councils, single individuals etc.) or which served particular purposes (penal confinement, moral protection, special training etc). Now, there is much evidence that some children’s institutions were indeed fearful places where children were, at least by present-day standards, badly treated, even if it was often with the best of intentions by those who ran those establishments.

From the Tudor times to the present day, this fascinating book answers questions such as: Who founded and ran all these institutions? Who paid for them? Where have they all gone? What was life like for their inmates? And where can their records be found? Illustrated throughout, Children’s Homes provides an essential account of the previously neglected history of these British institutions.

Published July 2017 by Pen and Sword. ISBN 978-1526701350

Children’s Homes by Peter Higginbotham

(via Therapeutic approaches to residential child care in Northern Ireland)

What is the video about?

Children and young people looked after in residential
settings have some of the highest levels of need. It is therefore
crucial that staff have the right skills and support available to them.
This film shows how children’s homes in Northern Ireland have introduced
training in ‘therapeutic approaches’ for their residential child care
staff. The approaches help staff to have a better understanding of how
children’s experiences affect them, to consider their emotional needs
and foster resilience. It focuses on the experience of staff and young
people at the Lakewood Secure Unit.

Messages for practice

  1. ‘Therapeutic approaches’ can help
    residential childcare staff to use a therapeutic perspective in their
    day-to-day social work with children and young people
  2. Staff in
    Northern Ireland reported that it had enhanced their practice,
    particularly their relationships with young people and the consistency
    of approach taken by staff.
  3. Young people also reported improved
    relationships and a better atmosphere in the homes. In the case study
    shown in the film, the young people felt that the therapeutic approaches
    had helped them to talk about their feelings, and for their behaviour
    to be understood.
  4. Implementation is helped by providing training
    and supporting materials, and wider systems working in a supportive
    manner, for example careful planning when a young person is first
    admitted to a home

Who will find this useful?

Staff and managers working in children’s homes and
secure units, and those commissioning residential services for looked
after children.

Using comprehensive geriatric assessment for quality improvements in healthcare of older people in UK care homes: protocol for realist review within Proactive hEAlthcare of older people in Care Homes (PEACH) study

Qualitative evaluation of museum resources for care home residents with dementia

Chadborn, Elaine Argyle, Jonathan Coope and Louise Thomson

A new reminiscence
programme for care home residents with dementia consisted of training for staff and a series of museum resource
boxes. We evaluated the intervention using Dementia Care Mapping (DCM)
of facilitated sessions in five care homes. Here we present qualitative
observations of residents and staff. Furthermore we interviewed staff to
explore their views and practices.

Here we describe the qualitative observations within DCM. During
activity sessions, residents were engaged and interested in the resources. We
observed a variety of responses of residents to the objects, which may have
been associated with different stages of dementia. During a Royalty themed
session, one lady complained that it was ‘bad manners’ to be passing around and
looking into someone’s handbag (supposedly belonging to the Queen). Other
residents were observed waving flags, wearing a crown and reading books.
Residents engaged with each other and with the staff who facilitated the
session, for example joining in singing. Observations of staff behaviours were
reported within categories of DCM; occupation, inclusion, comfort and identity.
Many of these were noted as enhancers of person-centred care, although some
actions were noted as detractors. The latter were mainly due to constraints of
the space or time available.

Interviews with staff indicated that the intervention was an
improvement on previous activities. The historical themes prompted staff to
engage with personal history of residents and enabled a closer rapport, which
may facilitate person-centred care. The training appeared to support the staff,
and gave them confidence and ideas.

Demand in the Residential Care Market – a personal perspective


Brendan Johnston, the Retired
Chief Executive at Northern Ireland Social Care Council and Residential Forum
member asks some questions about the supply and demand for residential care.

At the Residential Forum in May 2017,
we were looking at how we get the best and most appropriate residential care
using the market.  Markets are shaped by
supply and demand, so let’s look at the demand side.

Who shapes demand?

If I buy anything on any type of
market, I am the person who decides on the detail, the quality and the price of
what I’m buying.  The person who uses the
product or service is the person who pays for it.

However, often, this is not the case
in the residential care market.  The vast
majority of residential care beds are paid for by local authorities or, in
Northern Ireland, HSC Trusts.  Deciding
the nature, quality and price of the service (the demand side of the equation),
is therefore split between a number of parties, each of whom may have very
different priorities and concerns.

Specifying the demand involves among


services user and, to a greater or lesser extent, their family; and

care manager or other professional negotiating the placement.

Of course, not all these players have
equal power.  But who should have
sovereignty in the relationship. Putting the user at the centre would certainly
imply that power should be tilted in that direction – that the service user
should be given the money and make the choice.
This, however, is very rarely the case and can produce its own

Informed Demand

Effective markets depend on a well-informed
purchaser.  The service user and their family
may have clear ideas on what they want, but have limited information on the
range of suppliers, the alternatives and what to look for in terms of indicators
of real quality.  How do we ensure that
users are protected from making poor or even risky choices?  

There’s a real challenge here.  We can’t patronise people or treat people as
infants –  incapable of knowing what they
want – we all have the right to make poor choices.  But we need to acknowledge there are issues,
not easily dealt with by regulation.  Regulation may keep bad providers out of the
market, but it doesn’t deal well with the mediocre or ‘good enough.’  Additionally, it has proved very difficult to
provide easily accessible information on the quality of provision that can
prove really useful to users.

A perfect market requires informed
and discerning buyers.  We need to be
honest about this and that means acknowledging that the market mechanism is far
from perfect or straightforward.

How does demand
shape provision?

Market processes involve dialogue and
negotiation.  I may know broadly what I
want, but until I go out shopping, I don’t really know what’s available – and
what’s more, I may find something that I hadn’t been aware of that meets my
needs more effectively or economically.
It’s not the customer who designs the motor car, but that doesn’t mean
they don’t play a central role in shaping the product.  A successful provider will be close to
customer demand and will be able to innovate to get an edge on competitors.

But look at how we commission
residential care.  We develop a specification
and go through a procurement process, the major requirement of which is that it
must be scrupulously fair and transparent (it’s public money).  But the process is also bureaucratic – it
allows little, if any, room for negotiation.
A provider that has something better and cheaper, but not necessarily in
line with the specification, can’t really be considered even if it’s a
legitimate alternative way of meeting need.
At best the process inhibits collaborative service development.  At worst, it stymies innovation and diversity
in provision.

Even at its best, the procurement
process consumes a huge amount of organisational energy and can become a
diversion to the real issue of meeting services user needs.

Is the market
analogy the best way of getting the best services?

A market that effectively meets the
needs of consumers requires several elements.
Choice is at the centre of it, but there are a lot of things that can
inhibit the range of alternatives available.
There may be scope for a lot of choice in a heavily populated city, but
if you’re living in a remote area and you want to stay there, there may not be
a lot on offer.

Effective markets imply that
consumers are well informed and act rationally in negotiating and meeting their
needs.  I’m not convinced that this is
the case – the criteria driving a commissioner may not be the same as that
which drives the end user.  I am far from
convinced that players in the market work to a shared, rational approach.

Where does this take

This is not a treatise – it’s just a
blog.  It’s not the purpose of this paper
to advocate a way forward.  Its purpose
is to raise questions and challenge thinking.

It’s a long time since we moved to a
mixed economy of care and I’m not advocating any return to the old status
quo.  However, in securing publicly
funded residential care, we find ourselves in a model which is dominated by a
market paradigm.  The market provides a
reasonable analogy, but its only an analogy.
It has driven a lot of improvement, but we need to consider its
limitation.  Does it facilitate planning,
leadership, collaboration, innovation, diversity?  These are issues we need to think about.

Further information

As I said, this is just a blog and
responses and comments are welcome.  For
further information, resources and thought-provoking material go to our

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