Graeme Lee, founder and Group CEO, Springfield Healthcare
Springfield Healthcare founder and Group CEO Graeme Lee has built his reputation on establishing high quality care environments, offering the full range of elderly care in the heart of the community such as his innovative conversion of the former Terry’s Chocolate Works headquarters in York. Graeme shared his vision with CHP at the site of Springfield’s forthcoming Mayfield View development in Ilkley.
Having grown up in a care home run by his parents, Graeme developed an empathy for elderly people and their needs from a very early age.
“I remember how fascinating old people were if you took the time to talk to them,” Graeme told CHP.
“The second thing that stuck with me was how vulnerable they were.
Having been a senior manager with Marks & Spencer (M&S), Graeme took over his parents’ home following the sudden death of his mother in 1994.
“My father was thinking of selling the home but I said rather than sell it, I think it needs ‘M&S-ing’ and by that I meant modernising and bringing residents’ needs to the centre of all our decisions – the old M&S mantra was that the customer is always right and that’s something I’ve always believed in,” Graeme said.
“As a boy I was used to sitting watching the television with six or seven old ladies so I had a lot of empathy for older people.
“I think we don’t spend enough of our time interacting with older people and I think we can learn an awful lot from them.”
Having run his first home for a number of years, Graeme launched his domiciliary business, Springfield Homecare in 1998.
“I thought delivering care services in the community would be a good thing to do,” he said.
From the beginning, Graeme also saw the opportunity for his domiciliary care to act as a feeder into his care homes.
Springfield now has over 800 carers across Yorkshire, Humberside and the North East delivering services to people’s own homes.
“I wanted to offer a range of services that complemented each other,” Graeme noted.
“Springfield wants people to stay in their own home as long as possible and as long as they want to, but if they can’t, we can provide them with a full range of care services all available under one roof.
“Springfield is passionate about offering a fully integrated service where we can take people from hospital who may be bed blocked into our care homes initially, assess their needs thoroughly and offer them a range of rehabilitation services. During this rehabilitation we would get them ready for discharge with our domiciliary team helping them to get home. With carefully designed care packages, hopefully, we can get them back to exactly where they were before they went to hospital,” he said.
“That’s the Holy Grail of integrated care that I have been aiming for the last 10 years. It’s common that during the journey from hospital to home we find that people have other problems and this isn’t possible. Our teams can help and support people to access the right care for them, whether that’s a permanent placement in a care village or a domiciliary care package that stays within them longer term.
“I would love it if we could start looking at budgets with the authorities where organisations are paid for achieving an outcome,” Graeme observed.
“If we can get someone home in three weeks, why can’t CCGs or local authorities pay us for that outcome?
“What I am trying to do is to physically deliver and offer a service that convinces the commissioners to use it.”
The lack of a pooled health and social care budget means delivering this level of service remains frustratingly elusive for Graeme in many cases, however.
“Ultimately what I would like to be able to do is to offers CCGs 10 or 20 beds and then we can start unlocking this whole bed blocking scenario,” Graeme said.
The provision of a better national framework for health and social care integration tops Graeme’s wish-list for the forthcoming government social care Green Paper.
“There’s been too much intransigence for too long and I think we are genuinely at the point now where real decisions have to be made to make sure we have a sustainable, long term and invested health and social care sector,” Graeme said.
“There’s no one or the other. They are linked and you have got to have an integrated financial model to manage that and allow people to fairly access the system wherever they are and know that they will be well looked after.
“We also need to have clearer guidelines on what the government wants from us in terms of meeting mental health needs in a community environment.”
Aside from CHC services, Springfield offers a mix of private and local authority provision across its residential homes. Private provision ranges from 70% to 90% at its homes.
“Our model is based on a significant private fee payer market but I am very passionate about making sure we also take local authority clients,” Graeme said.
Private weekly fees range from £900 to £1,300 dependent on assessment of need.
While local authority and CCG fees remain well below this level, Graeme was optimistic about the direction of travel for publically funded services.
“They are now paying a lot more than people think,” he noted.
“They won’t admit it but they are having to. I have to say I am encouraged by some of the fees they are starting to pay now.”
Graeme said Leeds council was currently paying £600 a week for basic residential care. While acknowledging that it was still short of covering his costs, Graeme said fees were higher for those with additional care needs.
“Local authorities will pay up to £750-850 on an individual basis,” he added.
“It isn’t possible to have a flat fee for residents because we are dealing with individual people and everyone has an individual care plan design to meet their needs.
“We can take some residents at a lower rate but if we took all local authority residents in Ilkley, the business model simply wouldn’t work.”
Springfield’s residential care services are roughly split equally into the three areas of residential, dementia and nursing.
“We offer a full range of services,” Graeme said.
“If someone’s loved one comes to us we want them to know that we will meet their needs.
“I don’t think it’s right for people to have to move home if they need nursing. I feel very passionately that we have to provide a nursing care element in every building.
“We want families to make one decision and know that we will look after their loved one for life.”
He conceded, however, that, like others, he was finding it more difficult to find quality nursing staff in the current climate.
The CEO said there had been an increasing transfer of staff from troubled larger corporate providers to smaller, regional operators where they feel can make more of a difference.
Graeme said agencies remained the biggest challenge for care home providers seeking to establish a long-term, committed workforce.
“They can get paid more for not having any overall responsibility and turning up as and when they want,” he noted.
Springfield maintains a relatively low agency use at its homes ranging from 1% to 10%.
The business has launched a big staff retention drive this year, including improving the induction and on-boarding process and offering a better working environment with more incentives.
Graeme told CHP he was aiming to reduce staff turnover from 25% to 15%.
He said the CQC had made a big difference in improving service quality but added more consistency was needed in terms of inspections.
“The way they do inspections is vastly improved but there are still too many inspectors that are subjective and you can get a very different assessment in different parts of the country,” he highlighted.
“There’s more enforcement and more embargoes and whilst that is a negative for the sector to read, it means they are starting to make a difference and add value and punish poor practice. Ultimately this can only benefit the sector as a whole.”
Graeme proved his heart of the community model through the second home he built in Starbeck near Harrogate in 2006 which he subsequently sold to Southern Cross in 2007.
The Springfield founder then used the money from the sale to buy two derelict listed properties in Seacroft in 2009.
“I thought it was the best site I had ever seen for community care,” Graeme said.
“As well as sitting on the village green, it had a pub 100 yards away and a church and village hall across the road, a walk-in medical centre and two GP services 50 yards away, a library around the corner and the biggest Tesco in Yorkshire with its own bus terminus 100 yards away.”
Having received planning permission to knock down one of the buildings, Graeme converted the other to a 95-bed home offering services from day care to end of life. He added a second 76-bed home offering nursing care at the site in 2017.
“I don’t want to build in the middle of nowhere where there are no amenities nearby,” he said.
“My model is about building really innovative environments in the heart of communities where people aspire to be. I am all about changing people’s opinions on what long term care feels like.”
Having delivered Seacroft Grange and Seacroft Green in East Leeds, with Business Growth Fund investment the plan has increased to deliver five more villages with the total funding being £25m. This includes the development of two new sites in central Harrogate, as well as Mayfield View just off the main street in Ilkley and a further service in the centre of Beverley, which on completion will give Springfield 650 beds.
The plans include the conversion of the listed Grove House into 23 apartments for senior living on a six acre site in the centre of Harrogate. The planning proposals for the site also include construction of a 70-bed home specialising in dementia care in the grounds. Graeme has already commenced plans to share the grounds with two local schools facing the site.
“We are going to create the most genuine intergenerational care home in the country where school children are coming onto our site every day,” Graeme said.
“For me it’s all about delivering amazing environments with amazing care that people choose to come to.”
Living space has been key for Graeme in improving Springfield’s care model.
“We are now building homes with bedrooms of 22 square metres as an average,” he said.
The provider also offers more than double the 4.1 sq metre day space recommended by the CQC.
“We have 12 sq metres per resident at the Chocolate Works, which is unrivalled,” Graeme said.
“You can see the difference. It’s much quieter and much calmer. You have much more choice of where to go. You have four or five different locations to have your lunch and to spend your day.”
Graeme’s vision of aspirational community care reached new heights with his conversion of the iconic York factory and the amazing internal market square.
“People are choosing to come to the Chocolate Works,” Graeme told CHP.
“That’s what Springfield is about. I am changing people’s perceptions of what long term care looks like. People are wanting to come to our homes because they think it’s a positive choice.”
Graeme took a leading role in the conversion of the Chocolate Works, which was named Best Care Village at the Pinders Healthcare Design Awards this year.
“From day one I saw its potential and I thought I can do something with this,” he noted.
“Thousands of people have worked in that building over the last 100 years and a lot of them are still living in the area.
“It inspired me to create something in the heart of that community where people would say ‘I want to live there’.”
The £8m conversion of the building included the creation of an internal market square complete with pub, coffee shop, gym, spa, hairdressers and a life sized oak tree as its centre piece.
Graeme works closely with Norr Architects on the creation of all Springfield’s innovative conversions and purpose-built homes.
Creating homes which are spacious, light and bright through the effective use of windows was key to the success of the Chocolate Works as at Springfield’s other homes.
“I will not build anything that is not light and bright,” Graeme told CHP. “It’s all about well-being.
“With the Chocolate Works we really had a chance to make a difference to how architects and people perceive how care homes should be built in the future.
“We want them to have a lovely space. We want them to keep opening up to the outside world and to be interactive with the community.”
Sharing his homes facilities is another means of ensuring Springfield remains at the heart of the community.
Mayfield View in Ilkley, which is due to open at the end of September, for example, will house a coffee shop that will be open to the public. The home will also boast state of the art German manufactured winter gardens previously installed at Seacroft which maximise daylight exposure for residents.
The Chocolate Works was also the first care home in the UK to install Italian manufactured CoeLux artificial skylights which help improve the mood of people living with dementia and the technology will also be included in Mayfield View.
In terms of other technology, Springfield uses ICare care home management software and the eMAR system for medication management.
Looking ahead, Graeme said he was looking to introduce more sensor technology around his services.
He confessed to having mixed feelings about the installation of CCTV in his homes, however.
“I can see the benefits but I have my concerns about how it would affect people’s privacy,” he said.
The chief exec said he was mulling over whether to install the technology in communal areas of future homes.