David Glover is responsible for driving the multinational growth of Caremark, a network of franchises specialising in both private-pay and state-funded home care for the elderly, as well as adults and children living with physical and learning disabilities.
In an exclusive interview with Home Care Insight, he discusses his business strategy, the industry challenges that keep him awake at night and new company innovations that are transforming the way quality care is delivered.
Caremark launched in 2005, but the roots of the company go back to 1987, when Kevin Lewis established a care home in Brighton. What prompted his decision to diversify into the home care sector?
Kevin saw an opportunity to diversify into the home care sector after the National Health Service and Community Care Act 1990 came into force. This revolutionised the provision of care because it meant that, instead of being the supplier of care, local authorities became the enabler of care, meaning care could be provided to people in their own homes by an independent company.
What does the structure of the UK business currently look like?
We currently have 128 offices throughout the UK and internationally. At head office level, we employ around 35 staff. However, across the business, we employ around 6,000 people.
What does your business strategy look like now, compared to 2005?
The market has changed quite considerably. When we started in 2005 most of our work was from local authorities. It’s now a 50/50 split between local authority work and private work. That’s because local authority rates can be challenging and there is greater security for franchisees associated with private work.
We don’t want to be a purely private customer-based business. That goes against our ethos and values, and that’s what separates us from other companies. We want to provide care to everybody – not just people who can afford it, so at Caremark a mix of local authority-based business and private business is the norm.
When did you begin your career at Caremark and what is your background?
I was originally a qualified solicitor specialising in franchising law. My biggest client was Subway. It was just coming to the UK market and we bought the rights to develop Subway in the south of England, establishing the brand in Essex, Kent, Surrey Buckinghamshire and Oxfordshire. I then sold this business and went to work for a parcel and logistics company as franchise director. After that, I worked for a property development company that was building hotels and entering into franchise agreements. The company developed its own brand of apart-hotels, which were a new concept in the UK, and it became the largest apart-hotel operator in the country. I worked there for 10 years before moving on to Caremark, joining in September 2014.
What attracted you to Caremark?
I’ve always been involved in franchising. The legal firm I worked for was an affiliate firm of the British Franchise Association. I wanted to get back into the day-to-day environment of franchising, which is what attracted me to Caremark. I was also attracted by the ethos, the values, and the beliefs that the company had – namely to provide outstanding care services to those who need it.
A carer that does a good job is invaluable and it’s inspiring to work with carers that are delivering such excellent service to their customers.
What does it take to be a successful franchise owner in the home care sector?
We are looking primarily for people that share the same values and ethos. People that put the emphasis on the quality of the care that they deliver rather than solely on the bottom line. We’re also looking for people with management experience and resilience because there are lots of ups and downs in the business. For instance, you may have a couple of major customers pass away or go into hospital, meaning the hours of care you deliver can go down quite quickly. Because of the high turnover of staff in the care sector, Caremark franchisees need to be good employers. They’ve got to be good at motivating, inspiring and valuing staff in order to retain them.
What criteria do you look for in a franchise partner?
As mentioned, we’re looking for people whose focus is not solely on the bottom line, but on the quality of care that they are providing. They need to be entrepreneurial, but at the same time comfortable with buying into and following our business model. Also, they need to have management experience and the necessary capital to invest in the business.
What sets Caremark apart from other home care providers in the UK?
Our values. As a wholly UK privately-owned business, we are focussed very much on the quality of care we deliver, rather than solely money. Our brand values and ethos are what drives the business and the individuals behind it.
You launched the PatchCare system last year. What inspired this new innovation?
We always want to innovate, improve and challenge the way that we do things. PatchCare simplifies care at home and allows us to react to our clients in a more responsive manner. Full-time PatchCare Assistants are appointed to a patch that consists of no more than 10 clients. They responsively operate and move around them as and when required between 7am and 10pm. PatchCare is completely new within the home care sector, but it is not particularly complicated. It is logical and makes sense. It’s no different to a group of nurses looking after patients in a hospital ward.
We want to be known for providing the highest quality of care, as well as having the largest number of franchise businesses.
In what ways has the system benefited a) your franchise partners b) your care workers and c) their clients?
a) PatchCare benefits franchise partners as it enables them to differentiate themselves in the marketplace. The service offers a potentially alternative revenue opportunity but, more importantly, it enables them to deliver a method of care that is significantly better than the current one.
b) PatchCare gives care workers a lot more security. They’re on fixed contracts with regular hours, and they can build stronger relationships with customers, so PatchCare increases job satisfaction significantly. There is an incredibly high turnover in the care industry as I mentioned previously. However, we are seeing 100% retention rate of care workers that are involved in PatchCare.
c) PatchCare is very needs-driven so we respond to the needs of clients. It allows us to spend extra time with them and do even more to make a big difference to their quality of life. We’re also able to help clients get out and meet other like-minded people.
Has this system now been rolled out across the network? If so, how challenging was it to implement?
PatchCare has been successfully implemented by our Belfast business with their local trust in Northern Ireland, and our company-owned business in Pulborough. It has also been successfully trialled by our franchise business in Haywards Heath. The system is now available to all our franchisees, but its implementation can be challenging. It requires people to change their mindset regarding the way that care is delivered, but it is just a question of educating people to the benefits. There is no additional cost to providing this system of care, and it’s going to take time, but we’ve had a lot of interest from local authorities and I think we’ve made significant progress over the course of the last 12 months.
You also rolled a virtual dementia training course last year. What specific benefits did that bring?
The Virtual Dementia Tour, provided by Training2Care in a special mobile dementia simulator, sees participants clad in goggles and headphones then taken through an instructor-led, eight-minute immersive sensory experience comparable to dementia. It allows carers to receive specialist training to experience, to some degree, what people with dementia experience, and to understand the challenges and issues that they face.
The training also enables us to interact with the local community because we invite local dignitaries and commissioning officers, as well as families and our client’s loved ones. So, it’s not just a question of educating our own staff, but also the wider community as well.
As far as industry challenges go, what keeps you awake at night?
The biggest challenge is recruiting quality care workers. The majority of our businesses are turning away work, and I get frustrated because I do believe that the quality of the care that we provide is fantastic and that, with more care workers, we could provide that quality of care to a huge number of other people.
Of course, recruitment is linked to the funding challenges in the care sector, partly caused by local authority budget cuts – something else that keeps me awake at night! At present, there are no clear solutions to this, but we remain hopeful.
All profits generated from our business in India will provide free care and support to people in the country who cannot afford to pay.
How have you been affected to cuts to government funding? And is it becoming more challenging to carry out local authority work when many councils are unable to pay the minimum price for home care that allow providers to pay their staff well?
With government funding, it’s not so much local councils have been making cuts, it’s more that they do not increase care budgets in line with expenses such as the National Minimum Wage and the National Living Wage. The recommended hourly rate for home care providers made by the United Kingdom Homecare Association (UKHCA) is currently £20.69, but many of our franchised businesses do not receive this for local authority work.
So, yes, it is challenging, but our franchisees are passionate about providing high quality care to everybody who needs it, not just those who can afford to pay for it. Most have a mix of state-funded and self-funded customers to help manage this.
Many home care workers must be highly skilled to deal with complex conditions, especially given the increase in the number of people wanting to stay living at home for longer. Does it frustrate you that care workers aren’t widely recognised as such?
It does frustrate me that carers aren’t very well recognised for the work that they do. A carer that does a good job is invaluable and it’s inspiring to work with carers that are delivering such excellent service to their customers. We rolled out a shadowing programme here last year where we went out to shadow care workers to see what they do and how they do it. I found that experience extremely humbling and inspiring. When you look at us as a society, I think there is a lot of respect for nurses and people working in hospitals and rightly so. However, care workers, who do a similar job, are not held in the same regard. I find that incredibly frustrating and disappointing.
What are your plans for 2020 in terms of new projects, campaigns, services etc?
We want to grow our network and continue to attract the right high-quality franchisees – meaning those who want to be with Caremark and share the same values and beliefs.
We want to work hand in glove with our suppliers and have a close relationship with them.
Apart from your virtual training programme, which other solutions and innovations have you adopted across the network to help manage operations and improve outcomes for people using the service?
We put a lot of emphasis on the support that we offer our franchisees. We recently recruited more regional support managers and a national operations support manager to improve the way that we support our franchisees. This helps them deliver a high-quality care service and enables us, as an organisation, to better ensure that our franchisees are operating in compliance with the Caremark model.
What do you look for in a supplier partner?
We don’t really have many supply partners, but a symbiotic relationship is key for those that we do have. We want to work hand in glove with our suppliers and have a close relationship with them. The more successful they are, the better the service that they will be able to bring our franchisees.
You have also expanded into Malta, India and Ireland. How successful is Caremark in these markets and how many offices do you have there?We have one office in Malta, one in India and 12 in Ireland, and we are experiencing success in each of these countries. In Malta, we are the largest domiciliary care provider, although it is a relatively small market.
The India business, which is company owned and supported from head office, has proven to be remarkably successful and we are now looking at replicating the concept across India. Whilst we currently have just one office in India, the potential is for 1,000 offices. All profits generated in India will provide free care and support to those who cannot afford to pay. We have just started providing free care in a home for 180 people who have been ‘abandoned’ -as is the common reference in India – by the system and their families.
Monday to Friday, between 8am and 8pm, two of our carers attend the home to support the nuns completely free of charge. Our carers provide personalised care to the home’s residents, restoring their dignity and vastly improving their quality of life. This initiative is funded from the profits we make by providing home care to people in India who pay privately. Ireland is similar to the UK in terms of the challenges our franchisees face, but they are all happy, successful and contented.
We are already a leading provider of home care in the UK but there is plenty of room for expansion.
Do you plan to enter any other markets around the globe? If so, when and where?
We are focusing on developing the UK market at the current time, although we would of course consider international opportunities should they present themselves.
What are your ambitions for the next five years and beyond?
We are already a leading provider of home care in the UK but there is plenty of room for expansion. We want to be known for providing the highest quality of care, as well as having the largest number of franchise businesses, so this is our primary aim. In the long term, we then plan to focus on international growth.