As the population ages, FMs in the care sector are increasingly being asked to manage ever more complex systems. Dave Howell reports.

In January 2014, Mitie was awarded a £33 million facilities management (FM) contract with Four Seasons Health Care, the UK’s largest independent health and social care provider. The FM cover that Mitie will deliver includes maintenance and call-out services for 500 care homes, specialist care units and hospitals via a network of over 700 mobile engineers.

Ruby McGregor-Smith CBE, Chief Executive of Mitie, said, “We’re looking forward to forging a strong partnership with Four Seasons Health Care based on innovation and efficiency, to deliver world-class services tailored to their unique working environment.”

Matt Oxley, Group Director, Business Support for Four Seasons Health Care, commented, “Providing a safe and well-maintained environment for the people living in our homes is essential to the quality of care we deliver. Our partnership with Mitie — the largest of its kind in the sector — is part of an ongoing commitment to invest in maintaining and improving our homes, hospitals and specialist units.”

Both of these announcements illustrate a shift in social care provision and also an expansion of FM services into this highly specialised sector. This drive in support for the social care sector is clearly a strategic move. According to the latest projections, 10 million people in the UK are over 65 years old, with the latest estimates stating that by 2050 that number will reach 19 million.

Within this total, the number of very old people grows even faster. There are currently three million people aged more than 80 years and this is projected to reach almost double by 2030, and eight million by 2050. While one in six of the UK population is currently aged 65 and over, by 2050 one in four will have reached this age.

For the FM sector the growing need for around-the-clock care and also for on-call services is pushing FM providers to develop their businesses to deliver the level of cover needed.

David Lilley, Commercial Director at Orbis, told Facilities Management Update, “Customers in the social care sector are often extremely vulnerable and frail and in poor physical or mental health. So facilities management has to differ in this sector to accommodate the special needs of the end users.

“Some appalling scandals have highlighted over the last few years that elderly people in Britain, one section of the social care population, have not been safe from abuse and neglect by the care system even in hospitals and care homes. It’s vital that the skills of the facilities management workforce, not to mention the care workforce obviously, are of a standard to be able to work safely, effectively and respectfully with people receiving care.”

What is clear across the FM sector is that social care poses a number of challenges, but ones that must be met with comprehensive integrated systems. In some cases, new technologies can help deliver some of the services that FMs expect, but in many cases the delivery of these services will mean a human approach with technology just offering support.

Social care

Four per cent of people over 65 are permanent residents in care homes in England, rising to more than 20% of those over 85 (British Geriatrics Society, 2011). There are an estimated 390,000 people over 65 in care homes in England (British Geriatrics Society, 2013) — four times as many as in hospital beds at any given time.

In their report into how to manage health care for an aging population, the King’s Fund states, “Transforming services for older people requires a fundamental shift towards care that is co-ordinated around the full range of an individual’s needs (rather than care based around single diseases) and care that truly prioritises prevention and support for maintaining independence. Achieving this will require much more integrated working to ensure that the right mix of services is available in the right place at the right time.”

The FM sector is an ideal candidate to deliver the kinds of services that the social care sector requires. Whether these are remote or customer facing, FMs are well versed in how to manage diverse systems into a coherent service — something that is a clear trait within the social care systems that the UK currently possesses.

Naturally there are massive risks if FM companies get their provision of social care facilities wrong. The recent high profile cases that have made news headlines are testament to the fact that social care service provision can be a minefield. However, leading FM service providers are applying their knowledge and expertise gained in other sectors to social care, often with modifications to meet the needs of their clients.

Nikki Singh-Barmi, Managing Director, winter maintenance specialist GRITIT commented, “An organisation’s duty of care to its people, whether they are employees, contractors, visitors or customers, is always a top priority, but never more so than in the social care sector, where vulnerable people need to be supported. This means that FM can be more challenging and require a higher specification than other environments. Just like the social housing sector, FM providers are also working with customers in their home environments, which requires a different, more sensitive, approach. Certain parts of the facility may not be as easily accessible as corporate environments, for example.”

The provision of social care, which requires a multi-discipline approach, is ideal for the FM sector if the service providers concerned understand how the social care sector differs from their traditional service delivery.

Future systems

Facilities management is also changing its delivery mechanisms, thanks to advanced technologies. “People and property protection specialist Orbis provides the installation and monitoring of telecare equipment for residents in the social sector,” said David Lilley from Orbis. “This equipment enables the user, generally an older person, to remain in the own home, where the quality of life and independence is thought to be far greater than in a care home. In the event of an incident, they have contact and support at the push of a button or the pull of a cord thanks to the telecare system.

Lilley continued, “There are also issues around the logistics of the telecare service. Facilities management end users are usually in one location. But telecare customers are dispersed across communities, which introduces specific challenges that need to be addressed. For example, thought needs to be given to response times and managing the maintenance schedule of the equipment, and the related costs.”

Businesses in the FM sector that are engaging with social care should also pay close attention to their liabilities, as GRITIT’s Nikki Singh-Barmi explained, “What has also changed over the past few years, in both the social care and other sectors, is an increase in litigation. In the West Midlands, last year for example, a pupil won £35,000 after slipping on ice in the playground.

“This is resulting in all organisations, from care homes to hospitals, looking not only to provide an excellent facilities management service to their customers, but also ensuring that they can demonstrate that they have done everything reasonably possible to meet their duty of care. This is resulting in an increased level of outsourcing for many organisations in the social care sector, who recognise that they can only achieve this level of professionalism with an outsourced provider.”

Social care is a highly attractive sector for FM service companies. Indeed, according to Richard Holden, director at Catalyst Corporate Finance, FM service providers can expect a 10% margin, which is double what they would expect from the traditional sectors they work within.

“Clearly, these are private companies that want to make a profit and what concerns me is how much they are prepared to cut corners and what sort of monitoring will be carried out on the contracts,” Rob Greenfield, SHEQ director at GSH Group and chairman of BIFM’s health and safety special interest group, told FM World.

There is little doubt that many of the larger FM players, such as Sodexo, Compass and ISS, will join Mitie and Interserve. Whether specialists emerge perhaps from mid-range FM service providers remains to be seen.

Would FM services from G4S, which manages prisons, be able to apply that knowledge to the social care space? Indeed, would social care want them to? These are questions that have yet to be answered. The profit motive is a major draw into the social care sector that is inevitable, but it is one that the FM sector as a whole can work with, and it can bring its mass of experience to the ageing population.

Last reviewed 27 October 2014