MICHAEL YOAKLEY’S CHARITY
BUSINESS PLAN 2014 -2016
Caring with Excellence
1
INDEX AND EXECUTIVE SUMMARY
AREA COVERED IN THE PLAN
(Including brief summary)
PAGE
1. Introduction
Sets out the historical ethos of the Charity
2. Vision, Values, Mission and Aims
Shows the strategic drivers that determine the activity of the Charity.
3. Planning Process and Strategic Approach
This sets out how we will go about tackling the big issues. It goes on to
look at planning and how the work of the Trustees and Officers is
planned over the course of a three year cycle.
4. Providing for the Elderly in Need
5. Providing High Standards of Care
6. Ensuring that the Charity is Financially Viable
7. Ensuring that our Estate and Facilities are Fit for Purpose
8. Employing Dedicated, Motivated and Well Trained Staff
9. Becoming a Local Centre of Expertise
10. Management Processes
11. Appendices
Appendix 1.
Risk assessment
Appendix 2.
Thoughts on Business Planning - S Limentani (May 11)
Appendix 3.
Budget 2011
Appendix 4
Policies developed and needing to be developed
2
1. INTRODUCTION
Michael Yoakley’s Charity was established in 1709. Its Quaker origins have strongly
defined the Christian ethos of its work in the Margate area which is further defined in its
present mission, vision and aims. The Charity’s work is undertaken at Drapers Homes in
Margate, a collection of Almshouses and a purpose built care facility, Yoakley House.
The Charity is established and approved by the Charity Commissioners. Full details of
the schemes are set out in documents dated 9th March 1956 and 20th November 1995.
This Business Plan is written taking into account the legal obligations that fall upon the
Trustees of the Charity to ensure that its affairs are conducted within the organisation’s
charitable status, the most recent regulation being the Charities Act 2006. The annual
accounts are produced in the Statement of Recommended Practice (SORP 2005) format
required by the Charity Commission.
In recent years there have been three dominant business themes that have become of
increasing importance to the Charity’s Trustees and Officers. The first is the issue of
financial viability. This will have to be at the forefront of all activities sanctioned by the
Trustees since there is not only a need to make ends meet, but also to create sufficient
surpluses to ensure the Charity’s longevity. The second is to maintain high standards of
care. This is fundamental to our ethos and is demanded by the ever changing regulatory
framework within the sector. The third is to recognise both the changing needs of older
people and changing responses to those needs. Individuals are living longer and present
with complex social and health needs. The expectations placed upon the Charity by
stakeholders are high. We must be clear of the part we play within this country’s
developed welfare system where a wide range of social and health services are provided
by the State. We have to be very clear of the niche areas in which we can bring real
benefit.
Whilst recognising that the Charity has to be run in a business like fashion, the Trustees
and Officers never forget the underpinning values that were enshrined at the outset of
Michael Yoakley’s vision. The Drapers Homes site is a community in which people are
entitled to dignity, love and care. The environment in which that community exists is
aesthetically pleasing and tranquil and that too must be preserved.
This plan is meaningless unless it promotes meaningful activity.
3
2. VISION, MISSION, AIMS AND PRIORITIES
VISION
To create and maintain a community for older people in which they can flourish and be
valued as individuals.
VALUES and BEHAVIOURS
We work with residents, their families, our staff and a wide range of others. We will:
 Treat people justly and with dignity
 Recognise people’s individuality and their human rights
 Encourage community life by stimulating and motivating residents to live active
and healthy lives
 Create a peaceful and self sustaining environment.
MISSION
To be a Charity that:
 Builds on the Christian ideals of its founder, Michael Yoakley.
 Develops in partnership with social and health care providers.
 Is seen as a leading provider of high quality care for the elderly.
AIMS
1.
2.
3.
4.
5.
6.
To provide for the elderly in need (defined at 4.2 below).
To provide the highest possible standards in all aspects of our care provision.
To ensure that the Charity is financially viable.
To ensure that our estate and facilities are fit for purpose.
To employ dedicated, motivated, well trained staff
To become a local centre of expertise in the care of older people so that we may
shape our services to best effect and can use that expertise to the financial benefit
of the Charity.
PRIORITIES 2014 - 16
1. To maintain high standards of care.
2. To gear our financing to produce an annual 4% surplus of income over
expenditure.
3. To proactively seek and obtain charitable funding.
4. To progress the plan to build an extension to Yoakley House to help meet the
great local need for short term care.
5. To continue to improve and modernise our facilities.
4
3. PLANNING PROCESS AND STRATEGIC APPROACH
3.1 Strategic Approach
Our approach is summarised as follows:
 To sustain our charitable aims, we must adopt good business practices and be
prepared to act commercially.
 The delivery of the plan will be appropriately delegated.
 Performance in achieving the aims of the plan will be regularly reviewed using
quantitative and qualitative measures.
 Risks will be identified and addressed.
 Actions will be aligned to the aims.
 Some aspects of the plan are dependent upon the policies and actions of outside
bodies. We will ensure that we are well informed and will be prepared to
influence political and public opinion.
 Partnerships and consortium working opportunities will be actively sought and
developed.
3.1 Planning Process
This plan follows on from the formalised business planning originally commenced in
2005. Since then planning has been an ongoing process in which the aims are set, action
is taken and results are reviewed. It has not been a “once a year” event. Over this period
of formalised planning:
 Legislative changes have demanded increasing amounts of management time and
effort. This has been costly.
 The role of Social Services has restricted our ability to seamlessly ensure the
movement of people from almshouses to the care home.
 The profile of our client group has changed. The residents coming in to both the
almshouses and the care home are older and have more complex health and social
needs.
 We have changed our service provision and now offer domiciliary care and
respite care as well as the sheltered housing and residential care.
 We have created a training facility to meet our staff needs and to generate income.
 Our investments are providing insufficient funds to meet all of our financial needs
and thus we have looked at other mechanisms to increase our income including
fund raising and maximising opportunities to access state funds.
5
The planning framework for 2014 - 2016:
Time
In April 2014
May – December
2014
January –
December 2015
January –
December 2016
November 2016
Events
2014
New business plan to be agreed by
the Trustees.
Outcomes
Publication during May
2014
1. Monitor closely budgeted income
and expenditure in view of the
known loss of significant
investment rental income.
2. Complete the rebranding exercise
and launch the planned
improvements to develop the
Charity’s profile locally and
nationally.
3. Progress the plan to expand
Yoakley House to provide short
term care.
4. Ensure the above plan increases
and stabilises the Charity’s
income and surplus potential, and
that capital outlay is afforded
without jeopardising the
Charity’s existing services.
5. Ensure all development takes
place in a way which protects
and enhances the community
atmosphere and culture of the
homes.
6. Ensure the ongoing delivery of
excellent care which exceeds
national standards.
7. Continue Value for Money
reviews of procurement,
including possible consortium
purchasing.
2015
Continue as for 2014.
2016
Continue as for 2014.
Formal strategic review
Redraft the plan
6
4. PROVIDING FOR THE ELDERLY IN NEED
4.1 The Care Environment
The following issues have been taken into account:
The Priorities of Older People
MORI surveys indicate that as people get older they have the following priorities:
 Choice
 Independence
 To stay in their own homes as long as possible
 To have their own room
 To live in an environment where there is friendship
Those same people are anxious to have care facilities that are regulated by rigorous
inspections and by surprise inspections. They expect care providers to talk to the users of
services and their families.
Demographic and Health Trends
“Age Concern” and Department of Health statistics were reviewed endorsing what the
Trustees and Officers are experiencing within Drapers Homes.
 People are living longer.
 The proportion of the population that is of pensionable age is increasing.
(This is above the national average in Kent and extremely high in the Charity’s
immediate coastal locality of Thanet.)
 Over 60% of people aged 75+ have a longstanding illness.
 1 in 20 people over 65 will develop dementia.
 There is an increasing diversity of service users with differing requirements.
 There is an increase in the number of older carers.
 Whilst many older people are financially well off in equity terms (they have
property), they are have little disposable income. At the same time there are many
older people who are neither rich in equity or disposable income terms. It is not as
simple as it once was to distinguish those who are genuinely in need of charitable
assistance.
 There are increased expectations of social and health care.
7
The Health Care of Older People
The National Service Framework for Older People (2000) sets out a clear set of priorities
which the Charity has to recognise in both the way that it works and the way in which it
represents its residents when they require the services of the NHS. Where the Charity
once employed qualified nursing staff, it has to recognise that it is not (and does not
aspire to be) a nursing home. There are therefore practical and legal limitations upon
what the Charity’s staff can do in providing health care
The Charity is fully behind the priorities set out in the NSF such as rooting out age
discrimination, person centred care, and promoting healthy and active lifestyles in the
elderly. The Officers are keen to work with both primary and secondary care agencies to
ensure that the best possible health care is given to the residents. The close proximity of
the Queen Elizabeth the Queen Mother Hospital and good relationships with general
practitioners and primary care nursing staff are seen as fundamental to the Charity’s
work.
The Social Care of Older People
The Charity has three distinct approaches in providing care. Firstly, the Almshouses are
effectively sheltered housing. Secondly Yoakley House is a registered care home within
which there is a resident community. Thirdly the care home accepts temporary residents
where respite care is needed.
The sheltered housing element of the Charity’s work already has clear criteria by which
people access the service and age restrictions apply. There are regular warden visits to the
almshouses and a number of communal facilities available to residents who are
encouraged to participate in activities involving other cottage residents and those who
reside in Yoakley House. In the past it has always been assumed that when a cottage
resident is ready to move into Yoakley House then a place will automatically be
available. The criteria used by the local Social Services Department to fund such care
home places has challenged that presumption and a more discerning approach is required
by the Charity’s Officers.
The legislative framework and the funding arrangements for the social care of older
people are both complex and largely mandatory. In particular the Care Standards Act
2000 defines the national minimum standards appropriate to the Charity’s work in
Yoakley House. These standards embrace:
 The Choice of Home
 Health and Personal Care
 Daily Life and Social Activities
 Complaints
 Environment
 Staffing
 Management and Administration
People who come to us are entitled to be treated as responsible citizens who make
choices and participate in community life. We will encourage learning and active
involvement.
8
4.2 How the Charity distinguishes who is in need
The concern of the Charity’s founder in the 17th century was to provide a home and essentials
for living (heating, clothing, means to produce food) for persons who had worked diligently all
their lives and yet did not have the financial means to support themselves in old age. This was
before the introduction of any national welfare system or state pension provision. The desire to
provide such services for those whose ability to pay for them is limited remains a key principle
of the Charity.
With the current Social Welfare provision, it is increasingly difficult to determine who is “in
need”. For the purposes of admission to the almshouses, a person’s level of regular income and
savings is reviewed and a decision on acceptance is made on an individual basis. The primary
guideline is “Could the person afford a similar quality of accommodation to that provided at
Drapers Homes elsewhere?” In the main, successful applicants are not owners of property, do
not have significant savings, and do not have income notably above the basic state pension and
accompanying benefits.
The services of Yoakley House are open to those who can afford to pay fees privately and also
to those who are dependent on Social Services funding; at present, top-up fees are only
charged for short term KCC funded care placements where government funding is significantly
below cost. Permanent KCC funded residents are accepted at the KCC Social Services ceiling
price, which again represents a significant loss on cost. The number of places for funded
residents is now being limited according to the subsidy the Charity can afford.
5. PROVIDING HIGH STANDARDS OF CARE
5.1 Care Management
Yoakley House prides itself on providing an excellence of personal care and environment,
unrivalled in this locality. The Charity’s senior managers are very much focussed on the overall
direction of the Charity and monitoring its processes, rather than dealing simply with day to
day management issues. They are supported by the Deputy Care Manager and two Admin
Assistants who have taken on more leadership responsibility in recent years.
5.2 The Almshouses
Drapers Almshouses are essentially independent living but residents’ welfare is monitored by
the daily visit of a warden and an emergency pull cord system which rings through to Yoakley
House where there is 24 hour support. Almshouse residents are invited to attend all activities
organised at Yoakley House, mostly free of charge. This includes quizzes, exercise classes and
learning such as IT instruction, as well as just entertainment. The inclusion of the almshouse
residents encourages social interaction and means that although in independent living, no one
should be lonely. It also eases the eventual transition from independent living to residential
care. Almshouse residents are also encouraged to support one another in their community living
and organise their own activity programme through the resident led Friendship Club.
The Charity continues to do all it can to encourage active lifestyles and an ongoing learning
experience for its residents. The almshouse residents can also benefit from an in house tailored
domiciliary care service (see 5.6 below).
9
5.3 The Care Home
Yoakley House is a popular residential care home with a long waiting list for permanent places.
It prides itself in providing attentive, compassionate care tailored to individual needs, with the
intention of maintaining maximum resident independence for as long as possible. Prior to entry
to the care home, a full care assessment is carried out on the individual which forms the basis
of a comprehensive Care Plan. This Care Plan (now computerised) is the reference document
for care staff in ensuring the needs of the individual are full met. Care Plans are reviewed and
updated at least once a month, more frequently for those with higher dependency. Care staff
keep daily notes three times a day to record the health and well being of individual residents.
Each care shift is overseen by a Senior Carer and a key worker system operates whereby each
resident is encouraged to relate more closely to an appointed care staff member to improve
understanding and communication of their needs.
Opportunity for increasing the number of rooms available for permanent residence is being
considered within the Yoakley House expansion plan.
5.4 Respite Care
5 designated respite rooms were opened in October 2009. Apart from a few weeks around
March /April 2011, when local Social Services were experiencing uncertainties and staff and
financial cutbacks which reduced the numbers of recommendations, the service has been
extremely popular and the rooms busy. Charges levied at first were not sufficient to cover costs
and generate profit but this was rectified from January 2011. Every effort is being made to
maximise the income from these rooms. Demand regularly outstrips availability and we are
aware that other homes which provided such services no longer do so. With the focus on
keeping residents in their own homes, respite care for the elderly is becoming more of a
necessity after periods of illness, hospital stays or when carers need a break.
This need has led to the Charity’s desire to build the designated short term care unit. This
development is being researched and developed in liaison with other local services such as the
local Hospital Trust and Clinical Commissioning Group.
5.5 Hospital Avoidance Beds
Since December 2012, 2 respite beds have been contracted to the local GP surgery (funded by
the Clinical Commissioning Group) as Hospital Avoidance Beds. These are used by the GPs to
place elderly people from the community who are unwell or need support but do not need the
medical intensity of hospital. These beds are block booked and paid for whether they are in use
or not, at the Charity’s private fee rate. The system has worked extremely well and the contract
is continuing.
5.6 Domiciliary Care
This service, also started in 2009, meets the need identified amongst almshouse residents for
assistance with household chores and personal care, especially when their hope of a move into
residential care has been blocked by Social Services. The income covers costs but remains
affordable to the almshouse residents who are of limited income. At present, the service is
limited to the almshouse residents and there are no plans to expand into the wider community,
where there is significant competition. Expansion to the wider community would involve the
need to employ more staff and a detailed review of the feasibility would need to be carried out
should this need arise.
10
5.7 Re-ablement
The concept of re-ablement was introduced to the Board for consideration within the future
development of the Charity by Trustee Sandro Limetani in his paper dated (Appendix 2). This
is essentially post hospital short term care but with additional therapies tailored to restoring the
patient’s full independence. The Charity is in discussion with the local Hospital Trust about the
development of this service at Yoakley. We have learned that this has been trialled successfully
elsewhere in Kent so have a proven model to consider.
6. ENSURING THAT THE CHARITY IS FINANCIALLY VIABLE
6.1 The Resource Environment – Assets and Finances
The following table indicates the financial costs of running the Charity and the assets that are
owned1:
Revenue – Key Facts 2013
 Approximately 70% of income comes from the contributions of permanent
residents. 9% from short term care.
 Approximately 17% of income comes from investments. The markets in recent
years have produced significantly lower returns than in the past decades.
 A modest income is generated from our training annexe and from charitable
donations.
 In recent years there has been no surplus of income to be carried forward for
reinvestment or larger projects.
 68% of income is spent on all staff salaries.
 Total resources expended in 2013 in running the Charity - £1,078,188
 Total income in 2013 - £1,082,217
Capital – Key Facts
The Charity had £2.25m invested in the stock market at the beginning of 2014.
This represents a decrease of £150K in valuation compared with 2010 these funds having been invested in the purchase of a bungalow on Drapers Close.
 Another £432k is invested as an Emergency Repair Fund
 The Charity had property assets valued at over £2m at the end of 2013.
 Declining levels of capital assets forces the Charity to look carefully at all income
streams to sustain the quality of its services to residents.

Details of the annual budget forecast for the current year are shown in Appendix 3.
The current focus is on ensuring income exceeds expenditure following the end of a lease in
2014 which will mean loss of a lucrative investment rental income. The income from the letting
of the training room has fallen dramatically since 2010 with government cuts in training
subsidies. Other ways of generating income from this facility are being considered.
1
Full details are included in the published accounts
11
6.2 The Way Forward
This will:
 Ensure, at the very minimum, that annual income covers expenditure with an aim that
this will be with less and less reliance on investment income
 Develop our finance and investment strategies and demonstrate how we are to gear our
financing to produce an annual 4% surplus of income over expenditure
 Include how we will proactively seek and obtain charitable funding
 Include options for capital investment and development of income generating services
7. ENSURING THAT OUR ESTATE AND FACILITIES ARE FIT FOR PURPOSE
The Charity prides itself on its superb secluded well maintained gardens and grounds. Mr Paul
Twyman joined the Charity’s gardening staff in 2014 and is well qualified to become Head
Gardener, when Mr John Bennett retires, keeping up the high standards.
Routine Quinquennial reports on the condition of the structure of the buildings are carried out
independently, the next being dues in 2014. Recommended works are prioritised and completed
either by the in-house maintenance team or, if outside of their skill remit, by reputable
contractors. Other maintenance issues which arise are reported by residents or staff into
specified books, and the prioritised by the Admin Staff. Repairs are carried out by the
maintenance team or outside contractors. The Charity has a good working relationship with
local builders GW Gardner who maintain the cottage boilers and carry out most other minor
building works, as they know the site well and are familiar with the complexities of the design
and makeup of our listed buildings. For major building works tenders are invited.
Annual visual inspections are carried out on the interior of Yoakley House. Staff are also
trained to notice and report repair and maintenance matters. Interior decoration and repairs are
primarily completed inhouse. Routine Fire Safety inspection of the premises are also carried
out by independent assessors.
Cottage inspections are carried out by arrangement with tenants at least annually. The warden
and domiciliary care staff should notice and report repair and maintenance matters, which are
carried out by the maintenance team. Interior decoration is the responsibility of the tenants.
Any future development of the site and expansion of services will be done in such a way as to
preserve if not enhance the tranquil and picturesque surroundings currently enjoyed by
residents.
The Charity aims to ensure all equipment used by staff and residents is fit for purpose and up to
date, applying for charitable assistance to do so where appropriate. It has been helped recently
by funds from the League of Friends in the purchase of a new industrial washing machines and
lighting for the grounds. A separate fundraising exercise by resident and staff contributed to the
purchase of a new stand aid hoist. This process of applying for equipment funding will
continue.
12
The Charity’s computer systems have been upgraded and developed in recent years. Much of
the residents’ care planning is now on a computerised care plan system which all care staff are
trained to use. Admin staff now use Sage for payroll and accounts work. The use of the internet
has reduced paperwork, particularly in the areas of online banking and the ordering of supplies.
Development of technology and the training of staff in its use are ongoing priorities.
8. EMPLOYING DEDICATED, MOTIVATED, WELL TRAINED STAFF
8.1 The Staffing Environment
The Charity employs an Executive Manager, Care Manager, Deputy Care Manager, and up to
50 other staff who are mostly part-time. A small group of regular volunteers also assist with the
running of the care home.
The day-to day management of care in Yoakley House is organised by one of 4 Senior Carers.
All care staff are trained to a minimum of NVQ level 2 or working towards it. Mandatory
training is ongoing with the majority of courses being held in Yoakley House or being provided
by Distance Learning. In 2012, the Charity lost its in-house trainer but has secured the services
of a self employed trainer who comes to deliver the mandatory courses as and when required.
This has been proved to be better economically. The fully equipped Training Annexe enhances
the Charity’s training provision, and allows the Charity to invite outsiders onto our courses thus
providing an income. Staff are actively encouraged at staff meetings and staff supervisions to
identify courses they would like to attend for their own personal development.
Staff salaries are reviewed annually by the Trustees and tend to be set at a level slightly above
the national average with enhancement for recognised training achievements and long service.
Many staff have taken up the offer of joining the Charity’s staff pension scheme administered
by The Pensions Trust. From 2015, under new legislation, the Charity will be obliged to enrol
all staff in the pension scheme at a level rising from 1% to 4% which will have an impact on
costs.
The Charity is proud of its record in retaining good staff and many have worked for the Charity
for over 5 years, which mean that many of our staff have the benefits of maturity and
experience. The Charity generally recruits new staff by advertising in the local press and
online. More recent additions to the staff team have been younger but the Charity prides itself
on a good team atmosphere and the comprehensive induction course, with the benefit of the
experienced carers means that new staff tend to settle easily into their roles, even those with no
previous care experience.
8.2 Key staffing issues
Management continue to encourage the personal development of all staff and the creation of
teams that work well together. Succession planning within the senior roles is key.
The national economic situation and fears over the Charity’s income in 2011 resulted in no
annual pay rise for staff that year. Happily, this had not been the case in subsequent years with
3% being awarded in 2014. Pay is already above the National Minimum Wage for even the
lowest paid staff and management are actively working towards payment of the recommended
National Living Wage before it becomes legislation.
13
The development of the short term care service, which aims to improve residents’
independence so that they can return home, has meant a change in the way the care staff work.
They have been retrained in areas such as motivating residents and encouraging independence.
Staffing levels are very much governed by the legal requirements calculated according needs of
residents which are increasing. Staff cuts and redundancies are therefore most unlikely
provided that income is sufficient to guarantee salaries.
9. BECOMING A LOCAL CENTRE OF EXPERTISE
The Charity is proud to be regarded as an unrivalled provider of care for the elderly in this
locality, and is beginning to achieve a national reputation for its uniqueness. This is at a time
when care of the elderly generally is receiving a bad press. We want to share our expertise with
others so that we have an effect on the quality of care delivered nationally.
This is already being realised as the Charity continues to expend its service provision to meet
the needs of the moment. In the past 5 years, it has introduced domiciliary care, respite care,
hospital avoidance care (in partnership with the local GP surgery), a small amount of daycare
and palliative care to its portfolio. It is now looking at the emerging need for rehabilitation and
re-ablement care. With all this being available on one site, it models an unparalleled
community based approach to care of the elderly.
The Charity’s partnership with the local GP surgery to provide 2 short term beds as “hospital
avoidance beds” was recognised with second place in the Guardian Newspaper Healthcare
Innovations Awards 2013. This has raised the profile and standing of the Charity not only
locally but also nationally.
This can further be achieved by continuing to
1. Collaborate with other key providers e.g. Avante so we can learn from them
2. Encourage visits from key figures e.g. MPs, Councillors, invited influential guests
3. Market and promote what we do locally and nationally
4. Investigate what we can do to expand and improve our service provision
5. Speak to community groups e.g. Rotary
6. Participate in national consultations and projects requiring feedback
7. Liaise with other local homes on key issues e.g. visit of MPs
8. Invite volunteer and visiting staff to come and see what we do e.g. Nurse Plus
9. Use local news reporting opportunities to our advantage
10. Update and improve the website and promotional material
14
10. MANAGEMENT PROCESSES
10.1 Performance Management
The following controls help to monitor the Charity’s performance as follows:
1. Financial measures are monitored by discussion at the Trustees meetings based on
monthly budget figures, together with annual advice on investments returns from our
financial adviser.
2. Inspection reports and self assessment requirements from KCHA and CQC are a source
of quality control.
3. Quality Assurance questionnaires are given to residents, relatives and regular visitors to
the home, such as the chiropodist, inviting comment on quality of care at least once a
year. The Care Manager must prepare an annual Quality Assurance Audit report for
submission to CQC. Residents’ meetings are held every 2 months for feedback on their
perception of the care they receive and the Charity operates a full “Open Door” policy
where concerns can be addressed to management or Trustees at any time.
4. Books of complaint and compliment are available in the foyer for comment by residents
and visitors.
5. Incidents/ accidents are fully documented and the reports retained for review by the
Management and Trustees, as well as copies being sent to CQC as required. Trustee
representatives attend residents’ meetings to hear concerns and discuss grievances.
6. The Executive Manager and Care Manager produce monthly reports to keep Trustees up
to date with happenings. These also provide the basis of the Annual Report for the
Charity Commission.
7. Voids are reported on the monthly Executive Manager’s report.
8. Trustees visit the site as often as possible and give reports. This is often linked with the
individual’s professional expertise.
9. Performance management for staff in the care home is carried out through staff
supervisions where open one-to-one interaction is encouraged between the Care
Manager, Executive Manager or Deputy and the individual.
10. The Care Manager and Executive Manager will keep Trustees aware of external drivers
affecting the running of the Charity such as legislation changes.
15
10.2 Risk Management
The risk management status of the Charity is reviewed annually and the latest report is as
attached at Appendix 1.
10.3 Health and Safety (H and S)
The Executive Manager takes overall responsibility for H & S with the support of the Senior
Maintenance Man, Senior Housekeeper and Head Cook. Risk Assessments on all rooms in
Yoakley House have been completed. Risk assessments on all machinery and in the workshop
have to be maintained. Visual H&S surveys of the interior of the cottages are carried out
annually by staff.
10.4 Policy Development
In order to ensure the development of standards in each of these management areas, it is vital to
have policies in place which are understood and used by staff. A list of polices that have been
developed (last reviewed January 2014) is attached at Appendix 4.
16
APPENDIX 1
MICHAEL YOAKLEY’S CHARITY: RISK MANAGEMENT
INTRODUCTION
The Charity’s business plan determines that risk management should be reviewed during the
annually. An approach used within the Home Office, the Security Industry Authority and
Canterbury Christ Church University has been applied to the Charity’s business risks.
Any risk will have a likelihood of occurring and a potential impact. The likelihood and impact
of each identified risk have been scored using a “risk rating” as set out in table 1.
Score
1
Table 1.
Risk Ratings
Likelihood
Guide
Score
Very low
V. unlikely to
1
occur (1x in a
few years).
2
Low
Isolated
occurrences;
less than 1x per
year.
2
3
Medium
Few
occurrences; 1x
per year.
3
4
High
4
5
Very high
Many
occurrences
expected; more
than 1x per
year
Several times
per year. Near
certainty.
5
Impact
Guide
Insignificant Financial
impact of less
than £5k.
Internal impact
on reputation
only.
Minor
Financial
damage
impact of £5k £10k. Minor
outside impact
on reputation.
Significant
Financial
harm
impact of £10k
- £20k. Local
impact on
reputation.
Major
Financial
damage
impact of £20k
- £50k. Local
impact on
reputation.
Catastrophic Financial
impact over
£50k. National
impact on
reputation.
Each risk is then scored for both likelihood and impact and the two figures are multiplied which
will create a green, amber, red or black risk as indicated in table 2. It will be seen that the
scoring mechanism gives added weight to “impact.”
17
I
M
P
A
C
T
5
4
3
2
1
Table 2.
Risk Management Scoring Matrix
LIKELIHOOD
1
2
3
4
RED (5)
RED (10)
BLACK
BLACK
(15)
(20)
AMBER (4) RED (8)
RED (12)
BLACK
(16)
AMBER (3) AMBER (6) RED (9)
RED (12)
GREEN (2) GREEN (4) AMBER (6) AMBER (8)
GREEN (1) GREEN (2) GREEN (3) AMBER (4)
5
BLACK
(25)
BLACK
(20)
RED (20)
RED (10)
AMBER (5)
Depending upon the colour risk, the Trustees can determine their level of risk tolerance as set
out in table 3. If risks are regularly reviewed, they can either be excluded or re-graded.
Black – very
severe.
Red - severe
Amber –
material
Green manageable
Table 3
Risk Tolerance
Major financial or reputational consequences. Disastrous.
Comprehensive action is required immediately. Trustee involvement is
essential.
The Trust is concerned about carrying this risk. The consequences
would be severe. Some immediate action plus a comprehensive action
plan is needed. Trustees need to be aware and involved.
The Trust is uneasy about carrying this risk. Whilst the consequences
are severe, they can be managed through contingency plans and
management team actions. Needs regular monitoring by the Trustees.
The Trust is happy to carry the risk. The consequences are relatively
unimportant to the business. The risk should be reviewed at Trustees’
meetings.
ASSESSMENT OF PRESENT RISKS
This risk register first developed in September 2005 by Peter Hermitage and is reviewed by the
Trustees. Our stockbroker gives regular written feedback on risk. The revised schedule of risks
has been drawn up taking into account activities over the last 3 years and listing the risks
according to the Trust’s aims as set out in the business plan.
18
Risk associated with providing the highest standards of residential care (CARE STANDARDS [CS])
Risk Number,
Description,
Rating
CS 1
The Charity fails
to reach CQC
standards.
Likelihood
Impact
Existing controls
Further actions
1
3
Recent CQC and KCHA
inspection reports have been
excellent.
1
3
At present:
 We are required to have 50%
of staff trained to NVQ 2
standard: we have over 90%.
 Mandatory training of all staff
in manual handling, fire, health
and safety, infection control
and adult protection has been
achieved.
 Ongoing refresher training for
all staff in the foreseeable
future can be covered.
 A performance and
development appraisal system
has been developed in which
individual training needs can
be identified.
 A fully equipped training
annexe has been built.
 Staff turnover remains low.
Reports on
inspections and
related
requirements
delivered to the
Trustees at each
meeting.
Continue to
encourage all
staff to reach their
full potential with
available training.
AMBER
CS 2
The Charity fails
to adequately train
staff.
AMBER
Progress of
actions
Owner
Monitor staff
turnover
19
CS 3
1
The Charity fails
to find the funding
for training.
4
Funding has been acquired to
cover training costs as much as
possible over the last 3 years with
the balance being covered within
the Charity’s budget.
Future funding
streams being
monitored by the
Executive
Manager.
Income from the training annexe
feeds into the general budget
Monitor the use
of the training
annexe to ensure
its potential is
maximised.
Financial impact
to be built into the
budget.
AMBER
CS 4
The Charity
looses in-house
training provision.
1
2
The Charity did lose its in house
trainer but has adopted the services
of a self employed training
provider so training continues to be
delivered on site.
Identify a second
self employed
provider of
training for
mandatory
courses.
CS 5
4
Increased numbers
of high
dependency
residents will
challenge the
Charity’s ability
to maintain high
standards of care.
3
Residents in Yoakley House are
seen to be getting older and having
greater care needs, both physical
and psychological. The proportion
of care time needed for each
resident, the numbers of staff
required per shift, and the level of
staff competence has increased and
is likely to continue to do so. The
Care Manager monitors this on a
monthly basis to ensure the home
meets its legal requirements for
staffing and that quality of care is
maintained.
Analysis of
projected changes
to be made. This
continues to be a
consideration by
the Trustees.
GREEN
RED
20
The domiciliary care service has
helped to meet the needs of
almshouse residents, whose care
needs are also increasing as their
pathway into residential care is
often delayed.
Develop and
expand
domiciliary care
service as demand
dictates.
Risk associated with providing the best residential environment (RESIDENTIAL ENVIRONMENT [RE])
RE1
2
The government’s
policy to
encourage people
to remain in their
own homes results
in the need to
adapt cottages to
meet the particular
needs of residents.
2
GREEN
RE 2
Inadequate
attention is given
to the décor,
fixtures and
fittings of
Yoakley House.
2
2
The renovation of existing cottage
bathrooms to include purpose built
walk in showers instead of baths
has helped almshouse residents to
maintain their independence.
Other bathrooms
not renovated (at
resident’s
request) will be
done as and when
the properties
become vacant.
Trustees took a decision to
purchase bungalows on the access
road to the site (Drapers Close) as
they become available, to be
available for use by more disabled
residents. The Charity now owns 5
out of 12. These are now rented
with the tenants paying their own
utility bills.
Purchase more
bungalows as
appropriate if
they are at an
affordable price.
The corridors, communal areas and
offices of Yoakley House are
decorated during the winter
months. Residents’ rooms are
redecorated and carpeted between
occupancies.
Continued
monitoring of the
interior state of
the home and
works completed
as necessary.
GREEN
21
Risks associated with financial stability (F)
CS3, CS5 RE1 and RE2 also have financial implications
F1
2
4
Stock market fluctuations have
Income is
adversely affected the Trust’s
insufficient to
ability to produce surpluses of
meet the Charity’s
income. This has resulted in
commitments.
increased emphasis being placed
upon financial planning. The
RED
current situation is:
 Charles Stanley Stockbrokers
manage the Charity’s
investment portfolio
excellently and have been
given strategic direction by the
Trustees.
 A phased approach to
increasing income from
residents is in progress.
 Cottage residents are
encouraged to apply for
benefits to which they are
entitled.
F2
Financial controls
inadequately
enable Trustees to
exercise their
duties of
governance.
GREEN
1
2
1. Continuation of
this approach.
2. Finances to be
regularly
considered by
Trustees in their
business
planning.
3. Approaches to
increase
charitable
donations are
being considered.
4. Other income
generating
services to be
developed so
there is less
reliance on
investment
income
Income and expenditure particulars 1. Continuation of
and patterns are reported to
this approach.
Trustees meetings.
All accounts are fully audited to
2. Finances to be
comply with legislative
regularly
requirements.
considered by
Trustees in their
The Charity’s Stockbrokers have a business
clear financial strategy to follow
planning.
and report upon achievements and
market trends regularly in writing
and in person.
22
The performance of the Charity’s
investments in land and property
are regularly reported by the
Executive Manager to the Trustees.
3.Control the
number of KCC
funded
placements and
challenge
A long term approach to residents’ underfunding by
fees has been put in place to ensure them where
that as much as possible fees cover possible.
cost of care. KCC funding falls
way below this target so the
4. Focus on
numbers of funded residents is
fundraising and
been limited. Vacancies are
the support of the
actively managed and voids are
League of Friends
few.
F3
Social Services
fail to take on the
financing of “selffunding” residents
in Yoakley House
in the event that
their income fails
to meet charges.
GREEN
2
1
Trustees are actively looking at the
area of Fundraising. The League of
Friends group was created in 2008
to facilitate this and has been
successful in raising over £24k to
date.
A consequence of the Charity’s
response to F1 has been greater
willingness to accept self funding
residents. Social Services will only
finance such people in the event of
their savings being used if they
meet Social Services care criteria.
1. Early
assessment of the
needs of selffunding residents
to be made by the
Charity before
admission.
2. Liaison with
Social Services to
ensure that any
changes in their
standards are
monitored.
23
Risks associated with staffing provision (SP)
CS2, CS3 and CS4 all have staffing issues contained within them.
SP 1
3
1
The staff structure works well.
High staff
Historically the Charity has
turnover decreases
retained a loyal and satisfied work
the Charity’s
force. The replacement of a
ability to ensure
number of long standing staff on
continuity of care
their retirement over recent years
of residents at
has been successful.
Yoakley House
The employment of younger staff
and monitoring of
has raised new challenges eg team
the wellbeing of
dynamics, maternity cover.
cottage residents.
Younger staff are being
encouraged to take more
GREEN
supervisory responsibilities within
the home.
A rewards strategy for staff is in
place and conscious monitoring of
salary levels compared to other
local organisations takes place
annually.
1. Staff structure
to be monitored
to ensure the long
term care needs
of residents are
met.
2. Staffing levels
and age mix to be
monitored
3. Continued
review and use of
staff rewards
strategy
Other Risks (O)
O1
Inadequate
attention is given
to health and
safety provisions.
GREEN
1
1
The Executive Manager takes
overall responsibility for H & S
and annual training is given to all
staff. 1 member of staff from each
department assumes responsibility
for carrying out risk assessments
within their department. The
Executive Manager reports
annually to the Trustees on general
H & S issues (especially in case of
emergencies).
Continuation of
present
arrangements.
24
APPENDIX 2
Thoughts on Business Planning for Michael Yoakley’s Charity
Sandro Limentani May 2011
1
Background
The Public Health Annual Report for Kent recently reviewed the health needs of older people and the
coalition government has issued a vision for adult social care. From these and other documents the
context of the size and types of needs of the elderly and the types of service available are clear.
1.1
Population
There is a significant increase predicted in the numbers of older people over the next 15 years. Older
people tend to have increasing health and social needs with increasing age. There are significant
numbers of people in the local community (greater than in most other areas of Kent) who have limited
social and economic opportunities and who depend on benefits and other welfare support to survive.
1.2
Services
The government‘s vision for the future of adult social care is one of integration of provision with
personalised services delivered in partnership with a plurality of provision.
1.3
Core functions
Michael Yoakley’s charity was originally set up to provide housing for the elderly poor and has
continued to do this with the addition of some residential and respite care. These remain desirable and
worthwhile objectives now and in the foreseeable future given the demographic and economic trends.
There are factors that are however different now than in the past: there is a developed welfare system
and a range of social and health services provided by the state. There is also more that can be done
now than in the past to sustain older people in health (through prevention) support them in maintaining
an active life, (through social re-ablement and rehabilitation), and by providing more sophisticated
treatment and support for chronic physical conditions and physical frailty as well as mental health and
dementia care.
It is the trustees’ responsibility to ensure that the charity continues to flourish, specifically to be
sustainable economically, and to continue to expand where that is possible and relevant to the core
functions. Accommodation and services for older people is now more diversified and specialised.
Yoakley, although a large organisation, can only provide a relatively small quantity and range of
services compared to the totality of need in Thanet.
2
Financial future
It was clear at the last trustees’ meeting that running costs are currently exceeding income and although
the charity has a significant capital investment in portfolio and in estate, it is necessary to make
changes in order to provide greater security in the future, and in the longer term, survive. The question
Barry asked is: what is the most effective way forward?
2.1
Almshouses and Yoakley House
There is little scope to increase income from the almshouses and Yoakley House without undermining
the core functions. However, it is important that income is obtained where possible by ensuring that all
housing benefit entitlements and other relevant benefits are received from the Council and any other
means of generating income explored.
25
Suggestion 1: undertake an exercise to explore how income can be increased from the administration
of the existing housing and care provision without compromising core values.
2.2
Expansion of existing services
Would it make sense to expand the existing residential or respite care on or adjacent to the Yoakley
House site?
For example, a new building could double the capacity for residential and respite care. This would
build on the existing strengths of Yoakley staff and be within the existing ethos. There is definitely a
need for additional accommodation, and more service provision would benefit a greater number of
people. The business case would depend on demonstrating that investment in capital and increase in
provision would provide sufficient economies of scale to cover the additional costs incurred and
contribute to supporting the existing service without changing the core values and functions of
Yoakley. This option could also explore the possibility of providing social and residential dementia
care in addition to existing provision.
Suggestion 2: a business case explores the option of expanding existing provision at Yoakley House to
provide more residential care and respite care and examines whether this could include an element of
dementia care.
2.3
Development of services into more specialist areas
Would it make sense to develop new services on or adjacent to Yoakley House site?
There is a spectrum of provision of care for older people which ranges from home support to hospital
care. This is illustrated in figure 1 below. Michael Yoakley charity is not currently set up to provide
hospital or specialist health care such as nursing care or rehabilitation. These services require
substantially more nursing and therapy input that the existing services and would present a new range
of issues to fund and run in themselves and be unlikely to contribute to the support of existing services.
It should also be noted that there are a number of community hospitals in East Kent that provide an
interface between the hospital and residential care and have been subject to discussion and agreement
between the local NHS and KCC recently. It is unlikely that the local NHS Hospital Trust would wish
to invest further in new nursing or rehabilitation facilities.
2.4
Re-ablement
There has however recently been a policy initiative from the government in developing “re-ablement”
services which are not a health-care provision but aimed at social skills.
What is re-ablement?
Re-ablement is a short-term, intensive programme of support for people who have had a spell in
hospital. The aim is to help them relearn daily living skills so they do not need long-term support or to
go back into hospital.
It is different from both prevention and rehabilitation:
26
PREVENTION
Services for people with poor
physical or mental health to help
them avoid unplanned or
unnecessary admissions to
hospital or residential care. Can
include short-term emergency
interventions as well as longer
term low-level support.
REHABILITATION
Services for people with poor
physical or mental health to help
them get better
RE-ABLEMENT
Services for people with poor
physical or mental health to
help them accommodate their
illness by learning or relearning the skills necessary for
daily living
Councils have adopted different approaches to delivering re-ablement, but despite the variety of
schemes (including titles, staff skill mix, structure of service) the principles and features are relatively
consistent, namely:

helping people ‘to do’ rather than ‘doing to or for’ people
Figure 1. The place of re-ablement in the spectrum of care for older people (taken from reference 3 below)
 outcome focused with defined maximum duration

assessment for ongoing care packages cannot be defined by a one-off assessment but requires observation
over a defined period.
The objective is, through the use of timely and focused intensive interventions:

to maximise users long-term independence, choice and quality of life

to appropriately minimise ongoing support required,
and, thereby, minimise the whole-life cost of care and be cost-effective.
27
On 21 June, a revision to the Operating Framework for the NHS in England 2010/11 was issued. In
future, hospitals will be responsible for arranging and paying for aftercare, including any re-ablement,
for the first 30 days following discharge from hospital. Local arrangements will need to be in place so
that the NHS supports re-ablement – further guidance on this will be issued later this year. In the
meantime some councils are initiating early discussions with local acute hospital trusts and NHS
commissioners on capacity issues.
The government announced on 5th October that £70m of extra funding to be spent in 2011-12 across
the health and social care system rising to £300m by 2014-15.
It is still early days in re-ablement service development and recent research suggests that people’s
quality of life is improved (more those recovering from an accident or illness, rather than suffering a
long-term condition) but its costs are relatively high and wipe out most of the savings offset from
health and social care services.
Any development in this area must be predicated on joint local agreement between the NHS, the
Council and independent providers. It could not be a stand-alone development, and must be consistent
with the overall strategic approach of the statutory agencies, and could not proceed without their
agreement.
Although robust local multi-agency plans would provide some security for the future, integrated
collaboration can also limit an organisation’s ability to control its own affairs, so some caution should
be observed.
Suggestion 3: An initial sounding-out of the attitudes of the NHS and KCC with a view to exploring
the possibility of providing re-ablement services.
References
Vision for Adult Social Care and Supporting documents. 18 Nov 2010 Local Authority Circular LAC (DH) (2010) 7.
Homecare Re-ablement: Efficiency Delivery, supporting sustainable transformation. Discussion document 2007 www.dh.gov.uk .
Department of Health. Local Authority Circular on the personal care at home Act 2010 and charging for re-ablement. LAC (DH) (2010) 6.
The Guardian. ‘Reablement’ savings wiped out by costs, says report. David Brindle. 12th January 2011.
28
APPENDIX 3: BUDGET FORECAST 2014
FINAL FIGURES 2013
DRAFT BUDGET 2014
INCOME
Investments
Interest
79,029
82,000
669
700
1,845
4,000
Rents from properties
110,254
68,664
Residents Yoakley
544,825
578,000
Resident Drapers
200,191
210,000
Domicliary Care
22,156
21,000
104,168
112,000
11,159
8,000
Training annexe letting
Respite Care
Sundry
Fundraising/ Donations
TOTAL
Lease end King St
Non guaranteed
Mainly meals
7,921
1,082,217
1,084,364
Est increase 3% unless stated otherwise
EXPENDITURE
Wages
Provisions
Residents Welfare
729,101
767,500
71,765
74,000
3% increase
6,832
7,250
Household/Cleaning
16,225
17,000
Equipment- Repair/Replace
17,543
13,000
Washing machine 2013 £4,800
Gas
47,966
50,500
Fixed rates
Water
19,679
20,600
Electricity
16,436
17,000
Insurance
8,761
9,000
Telephone/Internet
1,550
1,700
Medical/ Chiropody / Staff PPE
8,584
7,750
Subscriptions
7,226
7,800
Staff Uniform/Training/ Other
5,625
5,150
14,970
6,000
Office/Postage
4,963
4,400
Council Tax
1,148
1,550
Audit/Accountancy
5,182
5,250
Professional Fees
Bank Charges
40
50
Repairs & Maintenance:YH & DH
59,527
42,000
Repairs: Other Properties
13,900
3,000
Garden/ Grounds
17,655
10,000
Training Room costs
Sundries
Trustees Expenses
TOTAL
283
500
3,088
3,500
139
250
1,078,188
1,074,750
Fixed rates
Extraordinary payts 2013
29
APPENDIX 4
INDEX OF POLICIES
Abuse Policy
Accident Policy
Adult Protection Policy
Advocates Policy
Aims & Objectives of Yoakley House
Alcohol Consumption Policy
Bathing Residents with Dressings
Care of the Dying
Cleaning Policy (Domestic Staff)
Clinical Procedures Policy
Complaints from Residents or Relatives
Confidentiality Policy
Consultation Arrangements
Continence Policy
Control of Hazardous Substances
Critical Incident Policy
Discharge Policy
Disaster Recovery Plan
Emergency & Crisis Policy
Emergency Admissions/ Referrals
Fire Instructions For Residents
Fire Instructions For Staff
First Aid Policy
Guardianship under the Mental Health Act
Head Injuries Policy/ Bangs & Bumps to the Head
Health & Safety Issues
Health & Safety Policy
Home Remedy Policy
Hospital Admissions - Medication Policy
Infection Control Policy
Involvement of Relatives
Kitchen and Dining Room Infection Control
Legionella Policy
Locked Bedroom Doors
Maintaining Confidentiality
Medication Handling/ Reporting Medication Errors
Medication Policy
Missing Persons Policy and Procedure
No Lifting Policies (Yoakley House & Drapers Homes)
Nutrition and Food Safety Policy
30
Our Staff
Personal Records / Data Protection Policy
Philosophy of Care
Pressure Areas Policy
Privacy & Dignity Policy
Procedure in the Event of a Resident Falling
Procedure in the Event of Death
Quality Assurance Policy
Racial Harassment Policy
Residents' Rights
Residents' Valuables Policy
Restraint including Cot Sides
Risk Taking
Self Medication Policy for Residents
Sexual Harassment Policy
Sexuality and Relationships Policy
Smoking & Substance Abuse Policy
Staff: Absence Policy
Staff: Communication Policy
Staff: Conduct during Grievances Policy
Staff: CRB Disclosure Information/ Employment of Ex Offenders
Staff: Disciplinary Procedure
Staff: Equal Opportunity Policy
Staff: Financial Control Policy
Staff: Financial Welfare Policy
Staff: Grievance Procedure
Staff: Manual Handling Guidelines & Policy
Staff: Prevention of Violence Towards Staff
Staff: Probity Policy
Staff: Recruitment , Interviews & References Policy
Staff: Redundancy Policy
Staff: Sickness Policy
Staff: Supervision Policy
Staff: Training Policy
Staff: Uniform Policy
Staff: Whistleblowing Policy
Staff: Working Time Regulations Statement
Transmittable Diseases Policy
Unwanted Visitors Policy/ Procedure for Unannounced Visitors
Working with Volunteers Policy
31