Contracting out


Contracting out essential services: the pros and cons


Care home managers have to concern themselves with a range of ancillary tasks on a daily basis. Richard Newton, principal of independent care home consultancy Opeque, suggests that they might want to consider offloading some of the burden by contracting out


So, you’ve started up a new care homes business, and you soon realise that there are a whole bunch of ancillary tasks and services that need to be carried out – everything from cleaning windows to doing the accounts, from maintaining the building, machinery, and services, to hiring and firing staff. You want to get on with the main core business, but all these chores get in the way. With a care home, the most important job is caring for the health and wellbeing of the residents, but you have to present an image of broad and total competence to attract the customers and keep them happy 24/7. Back of house, you have the kitchen, laundry, plant room, staff roster, pharmacy, and infrastructure to support and keep almost invisible until an enthusiastic family member or local council inspector or the CQC want to pull back the curtains to examine. In the wider world, a whole new ‘opting out’ culture has developed in recent years, and facilities management has become the name of the game, with companies contracting out all the chores, and buildings management teams taking over the running of essential services. Look at hospitals, office blocks, sports stadia, airports – almost all are in the hands of one of these facilities management companies. Generally it works, so that you can manage the core business and they do the chores. Nonetheless, as the care home supervisor/manager/director, you are


November 2023 www.thecarehomeenvironment.com


the duty holder and the responsibility of ensuring that these chores are undertaken successfully, pass inspection, and do not impact adversely on the residents or your staff, is yours. Even when everything is operating smoothly, you still have to think about health and safety laws, infection prevention controls, food hygiene, water hygiene (particularly Legionella control) and temperature, heating, and ventilating efficiency and maintaining your budget for all their costs.


Then a resident falls and has to go to hospital or there is a Norovirus outbreak or as you/we have all experienced, something even worse! Maybe have a read through the government guidelines1


once again and


reflect on what your responsibility for duty of care really means and then look at the latest CQC Inspection Toolkit2 for their next visit.


You want to get on with the main core business, but all these chores get in the way


and get ready


Care on the map


The history of care homes – from the very first almshouse in York in the year 936 – has seen development through much needed regulatory and legislative actions; the key stages being the post Second World War healthcare reforms, the efforts of sociologist and social policy campaigner Peter Townsend in the late 1950s, through to the NHS and Community Care Act of 1990 and the Health and Social Care Act of 2008, culminating in care homes becoming the lucrative industry they are today, driven by the near exponential growth of the elderly population. The pandemic did a lot of awful things which many of us experienced directly, but, in a way, it also put care homes ‘on the map’, highlighting their essential role, given that so many of us have relatives in care homes. Yet have we used this increased


awareness to bolster the image of – and respect for – care homes and carers and all the tasks on their agenda? Quite simply: no, we haven’t. But it’s


never too late. The general costs of living and operating


have increased massively, adding to our already existing challenges, so should we


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