Interview With Liz Jones Of The National Care Forum

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There's never been a busier time in Care: Social Care reform, Brexit and of course Covid! Liz talks to Nurses.co.uk Care Manager expert, Liam Palmer, and explains how the National Care Forum is tackling challenges and pressing for more digitization in Social Care.

Liam Palmer

Hello everyone this is Liam Palmer here from Care Quality podcast. I do hope you enjoy the following episode with Liz Jones, Policy Director for the National Care Forum, that's the NCF which is headed by Vic Rayner.

I've long been an admirer of the work of the NCF, both in its broader work to champion the needs of their voice for social care, but also in particular for their work in the NCF is doing to promote the digital agenda to help care providers learn about some of the great technology that's out there.

Liz does a great job of explaining the valuable work the NCF does.

I learn a lot from speaking with her, meeting with her, without any further ado here's Liz Jones.

Liz, lovely to meet you, a real pleasure thank you for joining me on the Care Quality podcast.

Liz Jones

Hi Liam, it's brilliant to meet you. Thank you so much for inviting me. I'm delighted that you thought of us.

Liam Palmer

Pleasure. Liz, we're going to talk about the NCF and in particular about the involvement with digital technology and helping to facilitate the take up of it, but before that for those who don't perhaps know the NCF well do you want to give us a little flavor about the work of the NCF and obviously talk about your role?

Liz Jones:

The National Care Forum represents not for profit providers of care and support services. We have a wide range of members and the key thing that links them all is they are not for profit. They might be constituted as charities but they are not for profit organizations one way or another and I think that's really important characteristic, because it means they come to the whole provision of what they do.

The importance of the quality of the services that they provide is also linked often to the locations and the communities that they're rooted in. Many of them who had they were charities have been around for a very long time, reincarnating themselves to meet different needs and others of them have come out of local authority provision when those organizations have spin out of local authority control. They might be particularly rooted in an area.

Liz Jones:

When we talk about WCS Care for example, they're an example of an organization that's based in Warwickshire and they are particularly linked to the area and meeting needs there.Our members do lots of different type of things, everybody thinks that care and they think about care homes. Mostly care homes for older people and whilst lot of our members do run care homes for older people, people with dementia. They also run care services for people of working age with learning disability or autism. They run a range of day services community based services, they run home care, they run extra care. They do lots of different types of care and support services and our job at the NCF is represent them and support them and help them to think about how they can improve the quality of what they do.

Liam Palmer:

Thank you, that's clear and helps me to understand NCF's role a little bit more clearly and you are the Policy Director Liz, do you want to tell us a little about that?

Liz Jones:

I'm the Policy Director. I've been with the NCF for about 18 months and it splits into Covid and pre Covid and I work very closely with Vic, whose our Executive Director and we divvy things up a bit between us. One of my main roles is being responsible for all things membership and making sure that we are supporting our members and hearing the voice and the issue of our members and helping them to understand what's happening, how to interpret the latest policy and guidance, which is we've been on... that's been an accelerated job during Covid as you can imagine. Helping them to understand and influence that policy landscape, helping them to connect to each other and support each other and making sure that if people have got particular issues or quires or ideas or opportunities we can link people together and we can share that so that we all can improve what we do and how we work.

And I have the responsibility of leading on some particular policy areas with Vic. We do a lot together in terms of working with government, working with key stakeholders, building those relationships, influencing not on behalf of the NCF but the wider care sector. There's a quite a lot of that outward facing policy and stakeholder influencing, trying to get the voice and experience of non for profit sector into those discussions. Challenge some assumptions, challenge some stereotypes, bring some ideas, think about what is it that we need to do to make things better ultimately for the people who are going to be receiving care and support services and can we work with those people to shape what they want.

Before Covid we were doing quite a lot in terms of pushing around things like social care workforce and else we need to improve their reward and recognition. We were doing quite a lot of work around the longer term reform social care and trying to bring different ideas of what that might look like and a range of pre Brexit post issues.

Then we've had Covid and the focus has shifted very much to responding to members and trying to help the Department of Health think with the sector about what it might need and try and improve the support for the sector, but I think it has been quite challenging to be honest, particularly in the early days and it continues to be challenging. And the valuable thing of having a group of very supportive collaborative connected organizations is that we can take the voice and the experience of those organizations to the Minister, to her senior policy makers and we can say, " look this is what's happening on the frontline, this I what we need, this is what we don't need and this is how we think we can improve things in what is a rapidly changing challenging environment."

Liam Palmer:

There's certainly a need for a distinct voice to speak for the sector, that's for sure. I've certainly... I remember seeing Vic on the news regularly in the last six months playing that part of her.

Liz Jones:

We made a deliberate decision to try and the media profile of the National Care Forum, in the sense that we felt there was a voice that wasn't being heard in all of the coverage about the pandemic and we did try quite hard to up our game in respective media and commentary. Liam Palmer: Perfect, that makes perfect sense. Thanks for that and do you want to introduce NCF, yours, Vic's interest in digital because a interest has been building for a bit, hasn't it? Do you want to tell us a bit about NCF's interest in digital?

Liz Jones:

I guess the digital focus for the organization started before I joined, certainly and I think it was probably one of those areas that Vic was keen to bring some focus and leadership to, on behalf of both our members and the wider sector. I think in terms of the NCF's strategy I think there was a deliberate decision a couple of years ago to think about the digital space. The latest digital thing came and the latest digital opportunities and try to represent the sector a bit in terms of it's, the way that other people perceived it.

There's always...often and this I think is particularly interesting when you talk about health and then social care because there is perception that in the world of health systems and health organizations there's cutting edge embracing of technology and then they're all sorts of with the new digital opportunities, the development of all sorts of virtual reality and machine learning and all this kind of good stuff. Good stuff and the social care sector is stuck in some deep past with bits of paper and no enthusiasm for digital technologyinnovation and they're not necessarily, don't have to have technology to have innovation but that we're not interested in that and I think when Vic joined the NCF years go she felt quite strongly that there was a real opportunity to see what our member organizations were doing, in terms of their use particularly of digital technology and to think how we could advance the thinking and the practice of the wider sector with what digital tech and innovation could bring.

Before I joined the NCF, the NCF has created two dedicated digital roles, We have two digital transformation leads, and they had done a lot of work with government and the sector, particularly under the banner of Digital Social Care which is a digital program run by care providers for social care providers and has been focused on some of the nuts and bolts of what you need, how to support organizations to think about were they are not their digital readiness space and what do they need to do for things like making sure their data and cyber security is okay, and how did they think about choosing new digital systems and how do we link in to some of the developments in the NHS such as access to NHS mail and what does that mean in terms of our data security and protection?

Some of this, the really important nitty-gritty that it's got to be sorted, but also they've run a whole range of different projects and totally run a Digital Leadership Program for example, that was funded Skills for Care to help build confidence in digital skills amongst managers of care sittings and care's been involved in a range of different projects that are looking at how we might inspire the sector to think about more digital innovation, but do that from within. Looking at what people are already doing and how more people might be able to embrace that. How we get the technology suppliers to work together better. How we get a sense of which suppliers should you trust, all of that good stuff.

They were in place when I joined the NCF in 2019 and that digital focus and championing the sector to say they was some innovation out there, there was a real appetite out there. There is a challenge about paying for it, but lots of people are lured to using tech and with Covid we've seen the drive to become more connected much more quickly. I think Vic's always had real championing role of the sector in the digital space and wants to help use whatever NCF can do to support both our members and the wider sector to take up tech for the purposes of improving what they do, releasing more time to care in effect is what you get from a lot of the digital solutions out there and of course we've got some innovative NCF members who've embraced technology and been real leaders in using it and sharing what they did and what they learnt and what worked with other people.

Liam Palmer:

I think having run a few services for various brands, what've come to learn about technology for care is like you said," it's not interest in technology for technology sake, its interest technology so that the quality out come improves, so that care homes can run better." So that as you said, " time be freed up," and I think for those who haven't come across some of the technology out there, it maybe quite advanced now isn't it? With various technologies, is quite impressive and you come across WCS and their innovation hub, do you want to tell us a bit about that? Because that's a... they do a really Interesting work there.

Liz Jones:

About, I think probably in my first or second month at the NCF, I went over two one of WCS's care home in Kenilworth, Castle Brook where they have created an innovation hub and they did that because they had been experimenting with and implementing a range of different types of digital systems and tools to enhance the care that they gave and they realized there was a lot of interest in what they were doing and they had this real leadership role in trying out new things and seeing what happened.

At their innovation hub, they were hosting I think it was every week or it might have been every other week. They were hosting visitors from other parts of the care sector to come and see what they had put Into place and some of that technology was quite innovative, it is still quite innovative. They were using acoustic monitoring which is a discreet listening system, I think it also has a video function but it enables you to place dictators in individual rooms with consent. There was always a discussion about people's consent and that's important and you can't do this without people's consent but the acoustic monitoring system is fundamentally designed to help people have a better night sleep because it will alert people much more quickly to somebody getting out of bed or trying to get out of bed or experiencing distress and it means that you can respond very quickly to that person to try and prevent some hazard, but it also means you don't have to go and open the door and check on them at night when they are asleep and then wake them up which is a very counter productive thing to do.

They had been trying out the acoustic monitoring system. They wanted to show people how it worked, what it looked like, what it didn't look like, how they used it and what the impact had been a significant reduction in falls for example, and they thought that was probably because people were having a better night's sleep.

They'd also embraced things like Electronic Care Planning and I think because they were pretty early adopter of person-centered software Electronic Care Planning, they worked closely with the team PCS to ask them to adapt the software to some of the things that they wanted, that it wasn't currently providing. To give them a date to capture on other things and better analytics. For example, they were particularly in making sure that they'd got everyone was having enough to drink everyday so that people's hydration levels were good because it was clear from some of the analysis that... and we know this is that if older people are struggling to take in fluids and that can lead to dehydration which can lead to horrendous of problems.

I think what's very inspiring about WCS Care was that they had to embark on this journey, they were trying different things ain different homes. They were evaluating it and then they were sharing that learning with other to show the impact and they also had to test and learn process. They'd created an ability to try out new technology before they put it in practice in their home and that in itself generated interest, people would come to them with new technology to say, "what do you think about this," and of they thought it was a glower they would then try it out and feed back to the tax supplier and say, "this worked and that didn't." They quite an inspirational bunch and Christine Asbury was the CEO at the time and ED Russell was the Director of Innovation, his now become the Chief Exec as Christine stepped down to go and other things.

I think that the prospects are really good, that they will continue to look at what tech is out there to improve the quality of what they do and by improving quality of what they do that's not just for the experience of the people that they are providing the care for. They're also very interested in the experience of their work force and making sure technology can enable their work force to be more effective and to free up the time of their work force to be providing care in it's full decency. While there is...be doing things that could be much more easily done by a tax system.

Liam Palmer:

I think I went along to that. The innovation helped the day and I was blown away by how they developed it as you said, "their strong sense of leadership," but also their generosity in spending some of their time to help the sector. I think it is commendable and we've got the Harbor Project and in some ways which is from Wiltshire, in some ways this WCS work was inspiration for that, is that right?

Liz Jones:

It was, it created for us the proof of concept that this idea that an organization that was innovative and forward thinking in the technology that it was using and the interest that inspired from the sector that made us think, that's interesting wouldn't it be great if we had some more of those showing different types of technology? And at the time there was a funding opportunity from NHS digital through there had a Pathfinder Funding Program and that opened last year, you could put a bid in, I think it was last summer maybe July, August, June something like that and we thought we weren't entirely sure that it fit fully within the speck of the program but the program was all about think about innovations that would benefit health and care.

We thought this would... something like this magnified, replicated would potentially be helpful for the sector because organizations who'd already taken the time and the effort to go through the journey of deciding what technology they wanted on the basis of what they were wanting to achieve and then going through that process of finding it, buying it, implementing it and then seeing what impact it had, we thought these are really good stories that might help other care providers who haven't made that decision yet or who are thinking about those decisions or are overwhelmed by the potential that's out there and want to see, is it worth it? Will it work?

We put together a bid to choose some of our members, we asked our members in the NCF and said, "what technology are you using and what different settings and would you be happy to work with us to create this series of mini innovation hubs, would you be happy to show case and give us your time and show case the tech and help us understand the journey you've been through so that we can share that with other people and they can benefit." We had quite a lot of interest and we put a biding to NHS Digital and originally we were planning on doing physical visits to the hubs in the same way that WCS Care had.

We were for range of different types of tech, for different types of care setting settings to make different types of needs in different parts of the country. As we went through the whole process we got to January, February, where we were starting to put the detail plans together, to create the hub experience, thinking about creating a...what is the visitor experience going to be like? How do we make sure it's consistent ? And what other information do we need to support that.

It became clear that we were going to need to move to a virtual approach and if I'm honest, I think that doing it virtually has bought loads of benefits that we wouldn't have got from physical visits. It's had a couple of disadvantages but because the whole sector has had to move into operating much more virtually. Back this time last year we wouldn't have thought so many people would be able to operate via Zoom or via Team whatever. We took into a virtual design and we ran virtual visits and I can tell you a little bit more about what happened to each of those visits. I guess these visits was a weaponeer.

We had three hubs. We had one run by Parkhaven Trust. They offered us The Beeches, which was a newly built specialist dementia service and they took the opportunity to use that new built process to really think hard about what they wanted in terms of technology and they went and got some learning from Stirling University and the Dementia Design Center there In the overall design of the service but they also used that to think about new tech and they've installed the acoustic monitoring that I was mentioning WCS had to use and they used Circadian lighting which changed the quality of the light in line with your body circadian the day, and Electronic Care Planning as well.

They've got this suite of tech which they felt would definitely help with their stuff and the people, the residents there were providing care and support for and they've got some quite powerful impact stories about how it's improved the quality of care they can offer. It's reduced the number of falls people I've had, it's improved people's quality of sleep and therefore their level of engagement and activity during the day and it's given them a wealth of data at their fingertips that they can analyze and see trends with but that's quite interesting for the next hub, because the next hub was Rashwood, which is in Elizabeth Finn Care Home near Droitwich.

They had implemented Electronic Care Planning and Electronic Medication System and they were, the systems were linked. I don't know If they were totally fully integrated but they were semi-integrated and that enabled them particularly in Covid to track unusual symptoms and presentation by residents made them think that they had Covid while before we had any testing in care homes back in the day March, April and they were able through the use of their data to quickly identify people who they thought were unwell and isolate and care for them differently to try and avoid any bigger outbreaks and that's a fascinating insight there.

The third hub Is more about independent living Johnnie Johnson Housing have a spare house which is extra care housing with individual apartments, people have their own apartments and they had explored a whole range of different types of technology to support Independent living what they would call Technology Enabled Care, passive censor technology so you can see if people have switched the kettle on or opened the fridge or gone out of the front door, I know it's a wearable tag, if you are a bit anxious about going out and doing your shopping or going out for the day, something happened to you then wearable tag that you could, someone help with and because they also run Astroline which is an alarm receiving center, they respond to calls from some of those wearable devices.

They work with quite a lot of different suppliers to make sure the technology they were supporting was good quality. They have a whole procedure of checking out suppliers and doing all that quality checking before they invest in using it, the thing that's been dead interesting about all of it is how each of the different organizations have had to bring their cultures and values to the decision to invest in technology, and be clear about what the wanted to achieve and for whom and whilst one of the selling point to win suppliers is often, it will free up time.What all of our members have told us is it will free up time so that we can have our carers doing the things that they should be doing rather than working through endless amounts of paper or trying to do analysis without the right tools to hand.

Freeing up time yes, but not to have fewer people if so to mean freeing up time to do better. To provide better care, more into action, better engagement with their residents and for the Independent living tech, enable people to say its independent and its supported for as long as possible while they... as they want to. It's been fascinating.

Liam Palmer:

It has, that sounds really fascinating. I was fortunate to run a large extra care retirement village and there is so much potential there isn't there? To assist some people to save new homes for a lot longer, I think, fascinating.

Is there any other specific learnings Liz from The Hubble Projects, appreciate it's fairly any particular learnings that you want to share from?

Liz Jones:

We took initial feedback from our participants with a post visit survey and that's been quite interesting. We had never run a series of interactive weaponeer in this way before, we didn't know whether it would work or not. We put lots of things in place to try and make it work. Each weaponeer had combination of pre recorded footage like short films themed, talked about the vision and the leadership and having to go and procure stuff and then implementing it and then getting the voice of stuff and residents as to what difference it made.

We've got a series of short films that also had the CEOs or one of the Director's of the organizations that were hosting it. They were on all of the calls so that they could answer questions and think about the specifics of their setting and their organization. What we learn from dong those sessions was that people really liked that combination of pre recorded short films and the ability to ask questions then, by what they had seen. They found that interesting.

Different people had different views about the balance of footage versus questions. We played around with that and made sure that we had enough time to ask all of the questions that people had and answered them as far as we could. If they were very technical questions we'd prepared a visitor take away pack that they got at the end of the visit which had details about the technical specifications from the suppliers, and I think people found the sessions really valuable because of the way that they were pitched, they were quite informal and we had a limit on visitors, we had probably about a maximum of 20 on any virtual weaponeer.

We tried very hard to facilitate it, we knew where people had come from, what organizations they had come from and where they felt they were out in terms of their digital journey and we put quite a lot of effort into getting that flowing. I think people appreciated that and Interestingly we didn't have very much bad feedback. Generally people had valued the opportunity, found it much more informative I think than they thought they were going to be honest, and really felt the opportunity to ask any of the questions they wanted was very valuable, and we had a real mix of people.

We tried very hard to learn to notable see recommendation that you needed the right people from the organization to come, we were trying make sure that we did have leaders or influences or decision makers but we had such a wide variety of organizations and there was a real interest in how we might use technology to support people with learning disabilities which I don't think we clocked in advance, we thought about it and we thought some of the tech independent living would help but I suspect there is more to bed done in that space to be honest.

It was very positive and the only thing that stopped them coming or made them leave early was the Covid crisis.

Liam Palmer:

It was bit of a distraction for the sector wasn't it?

Liz Jones:

Yeah.

Liam Palmer:

Sadly. I think probably a final question, with the knowledge you got now of tech that's out there what would you say to a care provider a 1,2,3,4,10,20,15, 100 times who perhaps hasn't embraced digital yet beyond Zoom calls and emails? What would your message be to them about the state of play with digital and benefits out there?

Liz Jones:

I think my message would be don't be scared, there are a lot of people who can help you. There is a lot of experience in the sector. I guess my second message would be having the right technology for your organization can be quite transformational for you. It need to fit with the things you wanted to achieve, you've got to be clear that it fits with your culture and your values and there will be hump to get over which is what exactly is you want that technology to achieve?what are the outcomes that you are looking for? And then working through the potential market but there are people out there who've experienced the market, that was one of the aspects of The Hubble Project, and that's one of the aspects of WCS Care.

It's knowing the questions that you're asking of the people you are going to provide that technology for you and being confident that the relationship that you can create with that supplier is going to work for you, and then I think one of key messages from all of the hubs has been to make sure that you're talking to your stuff at the right time about your plans, so that they understand what your ambition are, what are those outcomes that you're trying to achieve? What might be their fears? What might they see is the barriers, also what might they see as the opportunities? And listen, you need to take your stuff with you and you need to talk to the people who are your providing care and support to, making sure that you're clear with them about the outcomes that you are coping to get from the systems that you want, but its definitely doable and, the benefits are enormous, they are benefits that you don't... you will get benefits in the future that you haven't thought of now.

The different types of technology offer different types of benefits, certainly from a data and analysis point of view and Electronic Care Planning brings you all opportunities to interrogate your data, spot trends, spot things that might be going wrong, spot things that are going well, that you can't possible do on paper, and some of those other technology like Acoustic monitoring and Circadian lighting will help to improve the experience in the home on a daily basis.

There are lots of good reasons to do it, the real challenge is making the right choice of tech for you and then of course there is money and one of the things that we will consistently say to the government is if you can support the sector to make this initial investment then that will bring huge benefits to everybody. People working in the sector, people who need to use current support services. If the government could help us with a bit of that investment that would be brilliant.

Liam Palmer:

Fantastic. I want to... I think we've covered quite a lot today it's been a fascinating conversation for me. I've learnt a great deal and I hope the listeners enjoyed this episode and Liz, thank you very much for your time, lovely to meet you today and wishing you...how would people get in touch with you or NCF or whatever to follow the work Liz?

Liz Jones:

There's lots of information on our website, particularly about The Hubble Project, come to the National Care Forum website, nationalcareforum.org.uk and then we also hoping to be doing the next phase of Hubble if all goes to plan, at which will be creating some soundalane films that people can watch, they're not facilitated live weaponees but which use a lot of what we've learn from doing the weaponeers so people can watch it separately in their own time, we're hoping to do those. Keep in touch with us, we're on twitter under NCF_Liz, we've got an NCF twitter account, come and talk to us. We'd be delighted to hear from you and we'd delighted to point in the right direction if they are questions that we can't answer and the digital social care website is also worth checking out for other resources.

Thank you very much for having me, its been delightful to come and talk about technology and innovation and some amazing that are happening in the sector. Thank you very much.

Liam Palmer:

Pleasure Liz, thank you very much. They have it thanks again to Liz Jones of the NCF. I wonder what stood out for you. For me it was understanding the impact of the pioneering work of WCS Care with their innovation hub which was established by Christine Asbury and Ed Russell. This was an innovation hub that accepted guests, I was either weekly or fortnightly where they showcase the technology that they themselves were using in their group and the difference it made. I attended I found it to be excellent, it was helpful to see the technology in situ and I think that there was a sense of credibility and integrity they had in sharing the message because they were actually using it themselves and interestingly it was this work that inspired the NCF with their excellent Hubble project. Isn't that a great example of the influence of visionary leaders and about how they create space for others.

In closing then, I like to acknowledge Ed Russell and Christine Asbury and also Liz and Vic of NCF, for their effective leadership in engaging care providers with some of the exciting technology. Thanks guys.