The care sector is growing fast. People are its most valuable asset and investment in care-home developments is being fuelled by an ageing population and a growing demand for specialist skills. 

Scalability and Replication Have Now Become the Building Blocks That Will Enable Residential Elderly Care Providers to Sustain Growth, Deliver Successful Change and Achieve High-quality Service Outcomes

Dean Jones, former Investment Growth Programme Manager for Care UK offers insight into how REC providers can take advantage of market opportunities by building a sustainable and scalable system. Jones’ experience includes programme managing a £250 million investment-growth programme from 2012 to 2015, which involved building and commissioning 20 new state-of-the-art care homes and their services. He also oversaw a £60 million 3-year investment in a Suffolk programme, for the building of 10 new care homes and 10-day clubs and bringing much needed additional nursing and dementia-specialist care to the community.

REC Providers Can Develop Their Own Blueprints to Replicate and Scale Growth

REC providers can learn much from Jones’ involvement with scaling successful care homes. In his work at Care UK, Jones employed innovative ideas for evolving the next generation of care homes and introducing a competitive edge through unique selling points to harness market potential. The trendsetting programmes have led to phenomenal success, with more than 30 new homes built over a five-year period, a level of growth rarely seen in this sector. Jones describes how REC providers can develop their own blueprints to replicate and scale growth.

Building a foundation

The organization relied on a guiding principle as it developed a scalable system. It consisted of a toolkit that would outline how to manage projects and launch new homes, along with the standard of care the organization expected once a home is operational. The first system in the toolkit, the Project Management Blueprint (PMB) consisted of methodologies, processes and systems that would guide the creation of an ambitious and exciting growth pipeline for new homes.

The Blueprint ensured that the programme and project’s team resources would deliver high-quality outcomes through the practice of sound project management, both at a programme and individual project level. However, the Blueprint was just one of three tools the organisation would use to govern the commissioning and operation of new care homes. The other tools, a Home Manager Launch Manual (LM) and a suite of Standard Operating Procedures (SOP), complemented the programme on the whole.

Building the Capability to Service the Demand Is the Key to Driving Growth

The blueprint

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Creating the demand for growth and the environment for change is not enough to generate scalability. According to Jones, building the capability to service the demand is the key to driving growth. Instead of control, managers need to:

  • Introduce a framework and certainty about processes.
  • Implement repeatable best practices.
  • Build the ability to drive quality.
  • Equip people to do the best job possible.
  • Introduce a suite of project documents that directly suit the organisation’s purposes while ensuring consistence use.
  • Increase efficiency and productivity.

As a result of the Blueprint, Care UK was able to construct the building blocks for scalability and replication that would encourage change, growth and quality outcomes. When the foundation of an organisation is built on highly standardised and formal processes underpinned by highly developed performance-monitoring systems and the ability to control quality, it has a scalable business model. Another component involved in the process, evolving the product offerings through a process of service innovation enabled Care UK to apply standardised business-model concepts.

The requirements

Building a methodology for scalability involves considering project and business requirements first. Then, the organization can develop a system that meets the business and management-style needs to deliver successful outcomes. Jones employed a methodology that outlined the standard project-management methods to be used, and practices and guidelines to follow when managing new-home opening projects and business-transformation projects. With a disciplined, well-managed and consistent methodology, Care UK promoted the delivery of quality products and services, on time and within budget for each location.

The essential benefit of adhering to such a defined project- and programme-management methodology is the ability to demonstrate repeatable successes, rather than learning the same difficult lessons again and again. The objective of the methodology ensures that each new home opening was delivered to the highest possible standards via:

  • High-quality product or service that adheres to the business case.
  • Excellent standards of care and service.
  • Financial performance that achieves or exceeds the business case.
  • Homes or change initiatives delivered on time.
  • Projects executed on budget.

Relationships

Effective working relationships are also critical to the success of large-scale projects. Management tactics based on a matrix structure ensure that functional and operational resources are aligned across the business. This approach results in significant advantages, as it enables effective and responsive participation from different parts of the organisation that have specialist expertise. In Jones’ matrix, people from different parts of the business took a lead role in managing a specific work stream and were known as Work Stream Leaders. Jones also adopted the RACI technique for identifying functional areas, key activities and decision points where ambiguities exist.

Project Lifecycle

The management of any large, complex project is made easier when broken down into more manageable chunks. This unique approach to the project’s lifecycle enabled Jones’ to establish clear controls, e.g. review points, or gateways, at which to consider progress before moving on to the next phase. The Care UK project lifecycle methodology consisted of five distinct stages, with each stage considered as a sequence, providing the structure and approach to progressively deliver the required outputs.

Risk and issue management

Focusing on critical risk issues helps programme managers mitigate threats. Regularly planning and leading benefit reviews helps organizations drive success and ensure that profits aren’t eaten up by largely avoidable risks. For example, a slight reduction to a home’s expected average weekly fee (AWF) – although based on a more up-to-date market analysis – could have a detrimental effect on the bottom line. However, if this market analysis re-evaluation were to take place at the pre-planning stages, then the organization has an opportunity to review down spec. Key decisions like these must be managed with due diligence and care, by referring to the original business case and using a clearly defined change-control process, and then directing such matters to the programme board for approval.

Recommendations

Programme managers embarking on a scalability journey should note that before diving into the planning of a system of methodologies and processes, it’s important to first understand what needs to be fixed. Jones began his appointment at Care UK by working with a small team. They spent time getting into the nitty gritty of launching care homes, reviewing checklists, liaising with the Care Quality Commissions (CQC), and understanding the business and identifying gaps. Only then did he present the findings and gain support for the project’s Blueprint. Managers also need to understand the organisational culture in which they operate, and then adapt their approach accordingly. Finally, gaining senior management trust is another critical step, as approval and support helps form links throughout the organization – including the lower-management levels.

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Successful organizations need managers with a breadth of knowledge – not necessarily construction management expertise – to successfully drive the outcomes of the project. They also require some understanding of IT systems, staff, marketing strategy and more. Only then will the organisation reap the strategic benefits of higher management-level expertise. With the right approach to project management and creating repeatable systems, care home organizations can seize market conditions and drive growth, while delivering quality outcomes through scalable building blocks.