Gavin O’Hare-Connolly, Chief Operating Officer, Runwood Homes
In a wide ranging interview, Runwood Homes chief operating officer (COO) Gavin O’Hare-Connolly talks about Northern Ireland, care quality, regulation, recruitment, technology and the provider’s move into the premium care market.
It’s been a busy six months for Gavin since he took up the reins as COO at Runwood Homes in June 2018.
Having begun his career as a registered nurse, Gavin’s previous career in social care included leading Priory Group’s older people’s division in Northern Ireland. Gavin joined Runwood as director of operations in August 2017 before being promoted to his current role.
“As an organisation we have seen huge change over the past six months,” Gavin noted.
The COO has set out his vision for the business by issuing a call for every service to achieve at least a ‘good’ CQC rating.
“My focus on getting every home up to the good rating has been looking at building my team,” Gavin told CHP.
“That has taken a bit of time in terms of getting the right people in the right posts. We now have a new Director of Governance and Director of Quality, who are overseeing the key trends in terms of CQC expectations for good and above.”
The COO’s relentless focus on quality has reaped dividends with Runwood continuing to sit above the national average with more than 90% of its services rated ‘good’ or ‘outstanding’.
A number of its ‘requires improvement’ homes are awaiting regrading. Previously requires improvement rated Park View Care Home in Warwickshire was recently upgraded to good in all areas.
Raising quality levels has been achieved through a huge investment in training and development.
Runwood’s Director of Governance Celia Lee has led on efforts to improve homes which require being brought up to a good level.
“She provides the guidance support development for the staff teams looking at the action plans that drive them forward in a very robust and timely manner, as well as engaging at home level with service users, families and key agencies to ensure that we are progressing in the right direction and we are moving towards that goal from a holistic as well as a regulatory perspective,” Gavin said.
“You have to have the buy in from the people who live at the service and it is their voice that is most important in this process.”
Gavin has also taken a hands on role in getting to know the business and ensuring that issues are addressed proactively where required.
“About 70% of my working time is in care homes,” the COO noted.
“It’s vital that I am meeting with key people when getting an understanding of what is happening out there in terms of GPs, key stakeholders, district nurses, families and residents. It’s those voices that shape the delivery of the service we provide. All of this intelligence is vital as we expand and add new homes.”
As well as being visible to staff, the COO stresses the need to be available to residents and their families in order to ensure that their needs are met. Gavin operates an open door policy when dealing with resident and family complaints.
“We have made a very clear pledge that any service user or relative has excess to senior people at Runwood at any time and can get a person who is going to actively listen and effect change,” Gavin stressed.
Quality control issues in Northern Ireland have featured prominently on Gavin’s agenda during his first few months as COO.
The provider found itself at the centre of a storm of bad press following an investigation by the Commissioner for Older People into abuse allegations at its Dunmurry Manor care home.
While fully engaging with the investigation, Runwood has been critical of the tone of the report and some of its findings.
“The Commissioner has published his report and we needed to respond in terms of the recommendations we either agreed with or not,” Gavin said.
“I am very keen to remain open and transparent throughout that process. There are fundamental issues within the report that I feel are flawed. I do feel that the report is based on a minority of people and I don’t feel that the report sets context in terms of how that looks. Nonetheless I accept the findings that we must improve as every care home across the country must improve.”
The COO was also critical of the “insensitive” tone of the report highlighting the “huge distress” it had caused staff at the home.
The provider lost a number of staff as a result of stress and harassment from the public following the report’s headline grabbing findings.
“We lost a number of staff who found it too difficult to work in that type of environment and faced with that level of adverse attention,” Gavin noted.
“We have tried our best to support staff throughout that time.”
With the level of media attention on the home having subsided, the provider continues to offer a counselling service to its workforce.
In issuing a damning verdict on the safeguarding social care agencies within Northern Ireland, the Commissioner was also highly critical of the role played by the regulator, the Regulation and Quality Improvement Authority (RQIA), which had reported that Dunmurry was meeting standards of care when many of the alleged incidents took place.
“The RQIA are a very stringent regulator,” Gavin said.
“They are very detailed in terms of their inspection and they do a very difficult job. I found it difficult to read some of the comments from the Commissioner around perhaps their lack of faith in the regulator. It’s not something I share. I think the regulator does a very good job in a very difficult climate.”
Gavin said he was “incredibly comfortable” with the overall performance of the provider’s 12 homes in the region, adding Runwood remained fully committed to its future in the Province.
“We have developed a very strong senior team in Northern Ireland who are delivering incredibly well,” Gavin told CHP.
“We have a very skilled team of home managers who have worked with the organisation for a number of years and follow that ethos of quality at the fore of all we do. I am very optimistic for the future of Northern Ireland. It is not an area I feel we should come away from. We are in for the long run in Northern Ireland. I personally will oversee that journey.”
As with the sector as a whole, recruitment remains a major challenge for the provider, with Gavin noting that the already serious climate being has been exacerbated by uncertainties around Brexit.
“The ongoing Brexit negotiations have had a huge impact on how we are recruiting from EU states which has hit the public and private sector in a huge way,” Gavin noted.
“We have seen an 80% drop in applicants from EU member countries.”
Despite the challenging recruitment climate, the provider has achieved a “very significant drop” in agency use over the last six months thanks to the efforts of a new specialist recruitment team.
Gavin said Runwood was focused on values based recruitment and was targeting to be agency free within the next three months.
Turnover rates too are below the national average with the provider targeting a rate of 4-5%. Gavin told CHP he was seeking to offer greater career development opportunities to his nursing staff.
The provider is seeking to offer bespoke career development programmes with the Royal College of Nursing and recently ran a deputy manager development programme in Northern Ireland looking at succession planning for future managers and giving them the skills and opportunities to see social care as a valid career option.
“We need to offer a career ladder approach as a sector,” the COO noted.
The provider has looked at staff grading and offering more senior roles for care home staff, including Care Team Manager roles giving care assistants the potential to gain NVQ and Care Certificate qualifications.
Gavin called for the creation of more funded nursing places with bursaries and more specialist nursing roles to attract people into the sector.
“There needs to be a sense of development and opportunity in terms of the nursing model,” Gavin said.
“I call on the Government to look at the commissioning of nurses across the UK which I feel needs to be drastically increased given the uncertainty of Brexit. We need to see our nurses in the private sector valued for the service they provide in an often lonesome environment working as single clinicians.”
The COO also urged a greater focus on apprenticeships and foundation degrees to attract more people into the sector.
“There’s fundamentally going to be a bigger crisis for the industry if we don’t address this issue and fail to really engage with the potential workforce,” he warned.
Given the climate of challenging local authority fees that often fail to meet the cost of care, Runwood, as other major providers, is shifting towards the private pay market.
The launch of its Premium Collection brand is key to this strategy.
The provider recently launched its first Premium Collection unit at its Four Acres care home in Warwickshire and is seeking to step up the programme with two new homes in Solihull and Leicester, adding a further 200 beds this year.
The major plans also include the refurbishment of a number of homes for relaunch under the premium brand.
With private payers currently accounting for around a quarter of Runwood residents, Gavin said he aimed to increase numbers by between 5 and 10% over the next 12 months.
“I think it’s very important we have got that opportunity within this market and equally that we continue to deliver incredibly high standards within our local authority services,” the COO said.
“The quality of care will not be different irrespective of where you go. The difference will be about that lifestyle choice.”
Increasingly stringent regulation is another factor adding to the stress on care home providers with Sunrise Senior Living and Care UK amongst the operators targeted by the CMA’s investigation into breaches of consumer protection law.
Gavin said he was “incredibly confident” that Runwood was “completely compliant” with after death and upfront fee regulations. The COO said the provider operated a no after death fees policy.
Offering his thoughts on where the CQC could improve, Gavin said it could do better in terms of consulting with the industry when introducing new processes, citing the RQIA as a model of good practice.
Gavin added the CQC also had a key role to play in offering guidance on appropriate fee levels.
Looking to the future, Gavin said technology would be crucial in helping raise care quality levels at Runwood.
The provider is currently in the first phase of the roll-out of Person Centred Software’s digital care planning system in 12 of its homes.
Gavin said the technology was already having a huge impact in terms of freeing up more carer time to spend with residents.
“The introduction of the software has been genuinely exceptional in terms of what that has done for our care homes,” Gavin noted.
“I am seeing much more meaningful engagement. People are having time to sit with residents and do one to one activity. It’s an incredibly simple system to use. From a governance perspective it provides me and our team with a very clear overview of our services. We can spot trends incredibly early. It offers assurance for the regulator.
“We have had to evolve as an organisation away from the files to something that is instantaneous, very up to date and in your hand. Carers are now equipped with the most up to date, relevant information for their residents. It’s been a win-win.”
In terms of other areas of technology, the provider has trialled EMAR in a number of its homes and is looking to explore a partnership with large pharmacies.
It has also been carrying out work on a falls toolkit, which is awaiting accreditation with the College of Occupational Therapy, which Gavin said would complement its digital care planning system.
Summing up, Gavin said Runwood’s solid financial model, having been developed by owner Gordon Sanders over the past 30 years ago, stood it in good stead to capitalise on the significant growth opportunities set to arise from a frenzy in acquisition activity amongst the UK’s leading care providers.
“I think we will see huge openings over the next 12 months as we move forward,” Gavin said.
“We could very well be involved in any of those discussions around sales and acquisitions. We have become synonymous with taking on care homes that may not be in a good place.”