Short-notice care home closures

Communication: Examples and tips

In this section we provide you with more detailed information about the various elements of communication that you will need to consider. It includes excerpts from local authority protocols, policy documents from the assemblies and governments of the UK and feedback captured during the development of the website.

• How providers can help communicationOpen

  To stem rumour, speculation and distress, home owners have a responsibility to provide factual information that sets out the options for all their stakeholders. Whilst there may be times when information is commercially sensitive to be shared widely, providers need to gauge the point at which it is counter-productive to staff morale and quality of care to continue to withhold information. And when it is provided, information needs to be as simple, explicit and unemotional as possible. Providers use internal teams and networks, bulletins, news-sheets, notice-board, staff meetings etc to regularly communicate with staff; they need to ensure that all staff have access to information as soon as it is available. 

  Commissioners may be able to provide their own networks and routes of releasing information. In the case of high-profile closure, providers also need to have a media-handling plan and be aware of the level and quality of information others may be posting on their websites.

  For instance in a recent case that attracted national media interest, Age Concern made fact sheets and advice available for anyone searching their website for guidance - Advice on closure of Southern Cross

• Managing enquiriesOpen

  It is important to agree key messages and how they are communicated at the earliest opportunity.

  Kent County Council recommends that a briefing note is agreed by the designated operational manager, to include the contracting, health and media impacts of the closure. This should be used as the basis for giving out information to the public. The media and press offices for the local authority and PCTs/clinical commissioning consortia should be provided with the briefing note and should handle all media enquiries. (Source: Kent Adult Social Services: Protocols for managing the closure of a care home (post decision) March 2010)
  

• Developing a communications plan for the homeOpen

  Residents, relatives and staff must be kept informed about what is happening and when, so a specific communications plan for the home, as part of the broader communications strategy, should be developed.

  A communications plan needs to be developed that includes consideration of appropriate methods, frequency and content of communications.  Effective plans are likely to include a mix of approaches such as:

  • homes newsletter produced as regular intervals
  • large meetings
  • small group meetings
  • individual one-to-one discussions
  • electronic communications including using social networking such as Facebook and Twitter
  • registered manager and/or nominated individual to publicise their availability for personal questions and discussions. This could be 'open door' or planned and bookable times
  • notice boards giving updates, timescales, photos of new options for moves, information about planned moves for people, notice of meetings and contact details of significant people and organisations like CQC.
  • A media strategy, including clear protocols for  responses to queries and use of media during consultation and subsequently
    

  (Source: Managing Care Home Closures, Social Care Association, 2011)

• Communication with individual residents and familiesOpen

  Typical letters supplied by a number of commissioners commonly include the following basis information:

  • reasons for the decision
  • decisions that remain to be taken (about how and when the closure will take place) and what further consultations will take place
  • process for decision making (this will need to reflect the type of owner and how they make decisions)
  • timescales involved
  • people's rights and how they can be exercised
  • (in the case of the local authority owner) options for appeals or representations
  • complaints process
  • proposed arrangements for managing the closure
  • clear detail of when specific information will be available
  • support that residents and families will be provided with.

• Informing relativesOpen

  • The resident should be consulted on who they wish to be informed
  • The resident and relative should agree on a single contact person
  • Notice should not be less than two months and there must be flexibility if possible where the closure is planned
  • Information provided should include:
  • Reasons for the closure
  • Reassurances places will be available elsewhere
  • Information about vacancies
  • Steps relatives will be expected to take
  • Who will provide assistance
  • The contact person/point
  • Messaging should be consistent, open and honest
  • Regular updates are advisable

  (Source: Protocols for managing the closure of a care home - post decision, Kent Adult Social Services)
  

• External mailOpen

  Some people (for example residents, families and care staff) may need hard copies of letters and other information to be sent through the post rather than by e-mail. One thing I would have done differently .... a commissioner stated that she learnt a lesson with information going out to residents and their relatives on a Thursday but mistakenly by second-class rather than first class post, arriving at the weekend when there was no-one available in the office to field queries and provide further information

• Rumours and speculationOpen

  Staff may be very acute about picking up that their employer is in difficulties and sometimes this feeds a rumour mill. Whilst uncertainty is very disruptive and anxiety provoking, managers should not leap to making hasty emphatic denials.  Rumours that are ultimately found to be with foundation can damage trust if they have previously been categorically denied.  Managers therefore need to be clear that, if there is no definite information one way or the other about a potential closure, then they should not contribute to the speculation or make emphatic denials. Where there is uncertainty it is important that commissioners press organisations for decisive information as early as possible. Cogent and timely information is the best way to stop speculation and managers need to be clear about agreements for when and where to divulge information so that any questions from residents, families or employees can be answered accurately and honestly.

  (Source: Managing Care Home Closures, Social Care Association, 2011)

  
  

• Communications - roles and responsibilitiesOpen

  Designating clear roles and responsibilities will minimise the possibility of duplication or inappropriate messages being disseminated.

  • The Head of the Directors Office and the Customer Care and Communications Manager need to be contacted as soon as possible and need to have sufficient information for a first level briefing.
  • The Customer Care and Communications Manager will keep the Press Office and in particular the Head of Press through the media alerts process
  • The Executive Member will fully briefed and kept informed of developments by the relevant Assistant Director
  • The Project Lead will ensure that the local Hampshire Action Team is notified and kept fully informed of developments
  • The Contracts Section will notify the Department of Works and Pensions of the change in each resident's circumstances. 

  (Source: Care Home Closure - Contingency Guidelines, Hampshire County Council)
  

• Communication in situations of institutional abuse Open

  Closing a home in the context of allegations of abuse brings additional requirements around communication. The whole scenario may be more complex because of police investigations and emotions will be heightened.

  Where a Safeguards issue concerns a service user's care that is managed by a health care trust the consultants for safeguarding for that trust must be informed. This will ensure that a senior professional from that health trust is involved in the strategy meetings, so that any urgent physical or mental health assessments required are facilitated. Cross border representatives should be informed of any action that may relate to service users funded by them.

  Service users, carers and relatives
  The full and appropriate engagement of service users, their families and representatives at all stages is fundamental. Service users must be informed of any decision that impacts them in a professional, timely and supportive manner. 

  Consideration must be given to a variety of forms of communication that can be utilised to liaise with and inform service users and their families including email, phone and in person.  Practical considerations must be given to any meetings including location, access, timing and the amount of information that can be shared. An information pack including a brief statement of the situation, leaflets relating to advocacy services, the Residents and Relatives Association and complaints procedures for all partner organisations should be provided.  This is not an exhaustive list and additional documents / information may be helpful e.g. CQC report and full contact details. Communication must be clear and transparent and contact details (24/7) for all key personnel should be provided.  Regular meetings for residents and relatives should be arranged throughout the process and newsletters/information from providers/ECC to residents and relatives can help during a closure process. Views of service users and relatives must be captured for the lessons learnt exercise at the end of the operation.

  Safe and effective communication
  It is imperative that staff members are aware that all records (e.g. emails, notes, diaries, minutes) may be evidence (for the prosecution) or subject to disclosure (to the defence) where a criminal case is pursued. Detailed contemporaneous notes should be made of any discussions with the owners of the home or service users. Ideally any discussions should be undertaken with a colleague present who can witness the conversation and countersign notes of the discussion as a true and accurate record.

  Where it is necessary to communicate via email under no circumstances should the name of individuals or the home be disclosed in the title or body or an email.  If it is necessary to communicate this information it should be in a password protected attachment. The password should only be disclosed verbally to the recipient i.e. it should not be transmitted in a subsequent email or sent for general use at the inception of the project; in this circumstance it should only be released to project members. The project will be allocated a code name and all documents must have password protection.  Face to face and telephone conversation may sometimes be more appropriate than emails

  Staff should be cautious when information is requested over the telephone and should always verify who they are speaking to e.g. if it is a previously unknown switchboard.

  The Freedom of Information Act and access to records procedures must be considered when recording information and ECC protocols must be used.

  (Source: Essex Safeguarding Adults Board)
  

• Communication plans will need to address the what, when, how and with whom of communication:Open

  • Who to communicate with : There are three key groups of stakeholders to be addressed in any communication plan:-
  1. Residents and their relatives,
  2. Those involved in 'the care system' - e.g. staff, other commissioners, health professionals such as GPs and district nurses; regulators; other providers; Administrators if a company is put into liquidation;
  3. Those with an interest in holding public services to account - i.e. Elected members, the Press, the general public, advocacy groups

  The intended audience will affect all the other dimensions of communication (see below)
  

  • What to communicate: factual and unemotional information which is clear on detail and spare on unnecessary narrative.  For residents and family it will be very important that messages are sensitive to their likely concerns.
    
  
  
  • When to communicate: immediately a decision is taken on closure or as soon as definite information is known that a closure or significant management change is imminent.  There should be a hierarchy of timescales, tailored to the requirements of the various stakeholder groups (see above).  As well as the initial dissemination of information, consideration will need to be given to the requirements along throughout the whole process - i.e. information that might need to be communicated at regular intervals, or at key decision points, or upon request;
    
  
  
  • How to communicate: this is needs to be tailored to each stakeholder.  For residents and family, individual arrangements should be considered involving anything form face to face meetings, telephone (including dedicated phone lines), e-mail, post or in some cases, public meetings.  For other stakeholders some of these means will be appropriate (e.g. email and phone) but could also include press briefings, meetings for targeted groups, web-sites etc.

  (Source: Care Home Closure - Contingency Guidelines, Hampshire County Council)

• Communicating with people with cognitive impairmentsOpen

  Careful consideration should be given to how and when people with cognitive impairments are informed about the closure of their home, as this may increase their confusion or agitation. However, whilst receiving such information in advance of the event may be distressing for some, discovery at a later date by other means could be more so.  It is important to involve staff who know the individual resident well and seek specialist advice if necessary, so that the right decisions are made with the best outcomes. Such decisions should be made on an individual resident by resident basis. It is also important to work with and support any relatives who are involved in such situations.

  Residents of homes or people who use our service have a right to be consulted about proposals which affect the service even where it may cause them distress.  This is relevant particularly for people with learning disabilities where carers have argued that residents should not be informed about options because it would ‘upset them considerably’. The argument has also been made about the residents of homes for older people.
  What is important to consider is the timing of the consultation, how it is presented and how the process is handled so that distress is minimised and support is given to residents and people who use our services. (Source: Protocol for care home closure and transfer of frail/vulnerable adults, Sandwell MBC , 2009)