Written evidence submitted by John Richardson, Founder Chairman and Chief Executive, Horizon Senior Care Ltd  [SOC 021]

 

 

Summary

 

  1. With the greatest respect the inquiry should first consider the failings of the care system; it is fragmented inefficient and out-of- date and has not developed since the introduction of domiciliary care in 1989. It provides limited choice and has a record of poor staff retention, bad practice, low staff morale and poor productivity:

 

 

Failings of the existing system create health issues adding to cost and pressure on local authorities and the NHS. Greater choice is needed to enable people to select the best option for their needs; an alternative system is long overdue.

 

  1. I developed the first Close Care Retirement Complexes in the UK which provided a quality of care within a limited budget and gave definition to a comprehensive and holistic care system documented below under the heading ‘Background’.

 

  1. Extensive research and development and an executive team specialists in specific disciplines has culminated in a modern progressive care system at the cutting edge of technology and a business model supported by a high level of social responsibility.

 

  1. Our programme takes the failings of the existing system into account considers present and future generations and addresses other important issues beyond health and care which affect most families:

 

 

Introduction

 

  1. We have the expertise in a pioneering group of companies to develop total care solutions incorporating a care service, accommodation, wellbeing and cost in a single corporate structure to establish brand and set the benchmark for operational excellence.

 

  1. Horizon Senior Care Ltd has divisions for Construction, Marketing and         Management each operating as an independent legal entity. Our Management Division will operate as an employee owned Community Interest Company.

 

  1. Our corporate structure enables us to control client / patient costs, terms of employment, viability of our business and return on investment independently.

 

We support continuing growth and development; the knowledge and ability of our executive team is important to establishing training programmes and apprenticeships:

 

  1. John Richardson FRSA – Chairman and Chief Executive

 

An entrepreneur with extensive experience covering all major facets of business discipline. Founder of Close Care Retirement Complexes and businesses in retail, manufacturing, entertainment and service industry.

 

  1. David Thebridge FCA – Finance Director

 

Fellow of the Institute of Chartered Accountants with extensive business experience in establishing a framework of financial control, reporting, tax planning and corporate governance.

 

  1. Ron Allen – Chief Executive, Qbik Construction Ltd (a division of Horizon Senior Care)

 

A diverse and highly respected career in construction at all levels with an extensive portfolio of successful major projects in private sector companies, PFI, education and leisure. UK Construction Consultant for Care and Student Accommodation for Bouygues UK.                               

 

He brings with him key construction personnel; their collective knowledge and experience brings together the latest construction technology and a supply chain with the ability to deliver projects on time and within budget. He has worked with the Princes Trust for many years.

 

  1. Paul Boult RGN, DN – Chief Executive Horizon Management

 

Extensive management experience with the NHS and private sector. Following the formation of the NHS Commissioning Board he undertook a leadership role with Ian Bainbridge Deputy Director (South) for the Department of Health and 34 County and Borough Councils to improve the discharge of patients from hospital and avoid unnecessary admissions reporting to the Rt Hon Norman Lamb MP, Minister of State for Care and Support Services.

 

He has developed the infrastructure for a Care Academy to meet the highest standards for a Care Certificate and apprenticeships in health and care to achieve operational excellence.

 

  1. Jamieson Helsby Mistd – Chief Executive Horizon Marketing

 

Qualified in graphic design, marketing, publishing and brand development. He has developed a multi-media marketing network as a tool for market exposure and product promotion.

 

Background

 

  1. My father’s stroke and mother’s responsibility as carer prompted me to develop Exmouth House, Exmouth the first Close Care Retirement Complex in the UK in 1980. The alternative would have been the cost of care / nursing home fees for the rest of my father’s life with the loss of companionship and quality of life for both of my parents.

 

  1. The pioneering development was ahead of its time and established the model for care villages and extra care housing. It established the basis for a comprehensive and holistic care system combining a care service, accommodation, wellbeing, care for carers and cost in a single co-ordinated structure.

 

  1. Developments consisted of purpose built accommodation adjacent to a care home providing independence with 24 hour on-site care and support for emergency and continuing care needs. Extensive communal facilities for residents and visitors included restaurant, reception rooms, cafe lounge, library, hair and beauty salon and therapy rooms for visiting doctors and chiropodist. Facilities and services were provided for day care, respite care and rehabilitation.

 

  1. Low level care needs were met to prevent residents and day care visitors from becoming part of the group with ‘greatest needs’ reducing hospital admissions.

 

  1. Activities were encouraged, social groups were formed and developments became living communities.

 

  1. Staff were involved in front line decisions, their opinions were respected, support was given for personal development and staff retention was high.

 

  1. Domiciliary services were introduced for elderly people living close to developments which included ground and property maintenance before domiciliary care was introduced in the 1989 Community Care Bill.

 

  1. I developed Housman Park, Bromsgrove following the same model. The developments were extremely successful; all the properties sold from plan ahead of construction.

 

  1. Recession in 1989 with 20% interest rates stopped further developments and the introduction of domiciliary care directed attention to a care service delivered in family homes.

 

  1. I returned to improve the model and develop specialist care complexes in 2008. Research and development highlighted technological advances and the need for a hybrid corporate structure and an executive team with technical knowledge, commercial experience and social objectives.

 

Business Development

 

  1. The business model that led to the collapse of Southern Cross received considerable criticism. Speculation regarding the future of Four Seasons continues to give concern. An Interim Report by ResPublica indicates the loss of 37,000 beds in the private residential care sector in 5 years if nothing in the funding regime changes; this places the future of residential care as a main care provider in question:

 

 

  1. Our business model is based on property investment returns; outright sale of apartments under long lease with service areas, rehabilitation, respite beds and a dementia unit generating rent to allow investors a longer term revenue stream or the option to refinance:

 

 

  1. The ownership and management of developments will be gifted to a Community Interest Company allowing the on-going operation to limit costs, invest in training and reward staff as there is no return to investors and no involvement for investors in the delivery of care. This establishes the infrastructure for an efficient and competitive business adding value to developments and brand.

 

  1. High specification developments will set the benchmark for operational excellence creating a demand for future developments; critical to a 20 year or longer expansion plan with scope to grow in many countries.

 

Project Development

 

  1. Village developments operating as centres for excellence benefit from economies of scale and become living communities where independence is respected, isolation eliminated and companionship and friendships develop. A wide choice of accommodation and extensive communal facilities are provided with 24 hour on site care and support at competitive prices benefitting from the ownership and management of an employee owned Community Interest Company.

 

  1. Developments will have the capacity to support extra care housing restricted by limited facilities and services; maximising the use of digital health systems will improve the reach, impact and efficiency of operation. 

 

  1. Developments target the self-funded private sector and provide services and facilities for public sector use. The final design and specification will be determined by regional needs and the opportunity for providing additional facilities and services beneficial to the local community.

 

  1. Additional facilities and services may include: Medical Centres, Dental Surgery, Pharmacy, Retail Shops, Post Office and Library amongst others subject to feasibility and market demand.

 

  1. Core facilities and services include:

 

 

  1. Extensive facilities for social, recreational, professional and community use include:

 

 

Sustainable Developments

 

  1. State-of-the-art technologies throughout will ensure high energy efficiency and CO2 standards are met achieving cost savings and a high level of certification in both BREEAM and LEED schemes.

 

  1. Developments will use solar power and ground source heat pumps to generate its own energy and will incorporate rainwater harvesting, black water treatment, solar heating and automated building management systems.

 

Staff Training and Retention

 

  1. We encourage and support personal development; training for care workers will be extended to include long term health conditions and a wage structure introduced with incremental increases in line with accredited training.

 

  1. We are developing a Care Academy to meet the highest standards for a Care Certificate and apprenticeships in health and care. Work placements will be available for medical students.

 

Digital Health Systems

 

  1. Monitoring systems installed in service apartments during construction connected to an Operation Centre in the development will be made ‘live’ at the request of individual residents. Similar connections to satellite developments and individual homes in the community will receive an immediate response by trained personnel.

 

  1. Broadening the reach and range of telehealth and telecare and progressing to a single view of people linked to the system will enable us to identify individual needs and match staff trained in complex needs to demand.

 

 

Wellbeing: social and recreational activities

 

  1. The capacity for life does not stop with age and long term health conditions. Social inclusion addresses depression; a wide range of social and recreational activities developed with existing organisations and the general community extends the range of activities and social and intergenerational integration.

 

  1. There is an unacceptable amount of depression particularly amongst young people. We will participate with all responsible organisations through special interest groups which will inevitably grow in a village development to develop intergenerational activities to address this and other problems in our society. Cross reference with YMCA paragraph 43.

 

Care and support for carers

 

  1. A chronic illness creates a major lifestyle change. Caring for a long term condition is demanding; it places a great responsibility and anxiety on the caring partner who is at risk of stress and depression placing their own health in jeopardy. Providing support for carers in a family setting relieves stress and anxiety with important financial savings.

 

YMCA

 

  1. We have been asked to provide a YMCA accommodation and community block for homeless and disadvantaged young people within the curtilage of a development.

 

  1. Our programme has the capacity to help support the multi disadvantages many young people face by providing training and apprenticeships to assist them to belong, contribute and thrive for the rest of their lives.

 

Asset Based Wealth

 

  1. A business model based on the redistribution of personal wealth by downsizing to purpose built accommodation in total care developments releases funds to pay for care and a quality of life while retaining home ownership and a future inheritance. This is in contrast to selling a family home to pay care home fees to the end of life without knowing life expectancy and the final cost.

 

  1. An inheritance provides the means for the next generation to achieve home ownership and asset based wealth and the means to fund care and a quality of life in later years.

 

The Failings of Extra Care Housing

 

  1. A mix of low, medium and high care needs exist in extra care housing schemes. With finances for adult social services under pressure local authorities are only able to fund high care needs under their eligibility criteria leaving some in need of care without funding. As the majority of extra care housing developments consist of 50 flats or less they are not financially viable when providing facilities and services to care for the few that may fall into a high need category.

 

  1. Although the title ECH would suggest that equal importance is given to both housing and care in practice this is not the case; far greater attention has been given to housing and less consideration to the true level of care that may be required as people become frail. Care to the level expected by tenants and the ability to provide good quality carers has been underestimated.

 

Satellite Developments

 

  1. We propose developing extra care housing and modern energy efficient low maintenance properties for individuals and couples 65 and over with a 24 hour emergency call service connected to village developments together with the availability of the professional facilities and services and social and recreational activities. Efficient bespoke solutions will be developed with partner organisations to link existing and new developments. Supporting active and healthy ageing enables older people to contribute to society and the economy.

 

Growth and Expansion

 

  1. Our proposals could open the door to the largest investment in specialised housing with care releasing existing properties onto the market and assisting first-time buyers achieve home ownership. The scope for expansion would provide work for the construction industry for decades create employment in construction, marketing and management of specialist developments with benefits for the UK economy and a proposition for investment during times of uncertainty and low interest rates.

 

Employment, Training and Apprenticeships

 

  1. Staff training and retention is fundamental to support growth and expansion. We will provide:

 

 

Funding

 

  1. We are operating in one of the most assured businesses in the world; people do not stop ageing, the need for care and support is increasing and the supply is inadequate.

 

  1. We are in discussion for investment to launch a brand and 20 years growth and expansion of what we believe will be the largest and most important business in the UK for many years touching the lives of practically every family in the country.

 

  1. Growth and expansion can deliver short and long term commercial returns. We have declined introductions to investment from China and Dubai in favour of discussions with UK Pension Funds and Insurance Companies.

 

House of Commons Presentation

 

  1. We have agreed a terrace presentation at the House of Commons to raise awareness of the significance of our proposals subject to investment.

 

 

August 2016