Heritage Healthcare is a family-run home care business with over 80 years’ experience of delivering care and support for the elderly.
Operating in 21 territories and with plans to expand overseas, it is also a growing franchise business – and has been celebrated as such with a listing in the prestigious Elite Franchise Top 100 for the last three years.
But franchising and, indeed, delivering home care, were never actually meant to be on the agenda for the company.
For Heritage Healthcare CEO Glenn Pickersgill (pictured centre-right), caring is a family profession. His grandmother Annie ran a successful care home in Darlington from 1955 until 1970, when Glenn’s parents Marion and Jim took over.
Glenn was only ten when he got his first real insight into caring for residents, and went on to own his first care home in 1984, forming Supreme Care Homes.
He then sold the business in 2006 and took a break from the social care sector. But the lure of the industry was strong, and in 2008 he formed Heritage Healthcare with his wife Sally (pictured centre-left).
They had plans to open another care home under the new company, until their paths crossed with a former employee.
Michelle Fenwick (pictured right), who started her career as a care assistant at the age of 18 and had later worked for Glenn at Supreme Care Homes, stayed in the sector when the company was sold and, over a short period of time, noticed a big shift from residential to domiciliary care.
“That shift in society started between 2006 and 2008. I could see that home care was growing and growing, while the beds in the care homes I was looking after were becoming more available,” she said.
Michelle joined Heritage Healthcare in 2009 as registered manager and is now the director of Heritage Healthcare Franchising, and one of just two Qualified Franchise Professionals in the sector.
Here, she reflects on the rapid growth of the business since it started franchising in 2013 and discusses some of the challenges she faces in supporting and recruiting franchisees.
When did the Heritage Healthcare team know that it was the right time to start franchising?
Glenn became a joint franchisee with his son, Daniel. They purchased a Signs Express franchise in Darlington, which is still successful today. That’s when Glenn really first paid attention to franchising, but it was on a basis of a franchisee. So when we started looking into it, we discovered the home care brands that had franchised or had arrived in this country with an American brand, and we realised that they were doing exactly what we were doing. So we decided to look into a bit further, and that’s where my role came in.
Your job is to support the franchisees to deliver a high quality service to the clients. How do you go about doing this?
That’s one of my jobs, but my main job is the recruitment or awarding of a franchise. No franchisee would join our network without being checked by me – I’m involved in their whole journey, right until registration with the Care Quality Commission. So I’m the face of the brand, the franchise expert for Heritage Healthcare and I recruit every single franchisee that we have.
If they don’t have the same passion as we do for care and the same passion for recruiting the right people and caring for those employees, then they don’t make it very far in the process. I also then look after the support team that looks after the franchisees and their staff.
What’s your criteria for a franchisee to work with you?
They don’t necessarily have to have care experience. A lot of people think that if you are buying into this sector then you need to be experienced in the sector, but you don’t. So as a franchisee, I look at their personality and their previous experience in managing people. That’s very important because if you are buying a franchise, that’s the start of your own business, which makes you an employer. I look for somebody that wants to make some sort of an impact within their community as well, but if they are not interested in doing that and they continue to ask me about the financial side of the business then that rings alarm bells for me. It’s also important to us that individuals or partners are fully involved in the day-to-day running of their business. We’ve turned down many potential franchisee because they want to purchase it, but for someone else to run it. That’s not we want within our brand.
How do you prepare franchises for an inspection?
We deliver a very comprehensive audit and then provide strict action plans, if necessary, that will enable a franchisee to show full compliance. We teach franchisees to audit their business as well, so that the CQC can see that they are also familiar with what’s required for them to be compliant. We also discuss recent inspections throughout the network. We are a growing network so we are inspected on a frequent basis because we have so many branches, and once those inspections are carried out, we then share feedback from those inspections with the rest of the network.
What are the biggest challenges when it comes to facing an inspection?
No two inspectors are the same. So every single inspector has a different opinion or interpretation of the regulations, and this then has an effect on the outcome of the inspection. We didn’t realise this was the case when we didn’t have as many branches, but now we do, and this is something we often talk about as franchisors in the care sector. We can clearly see that one inspector will rate and view the same branch completely differently to another inspector. So they bring their own interpretation into it, and their own feelings and opinions, and that really shouldn’t be the case.
The CQC said at its recent State of Care press conference that while there are more people staying at home for longer and there is less demand for care homes, there’s not enough money going into domiciliary care and this is proving a problem. Do you see this as an issue as well?
I do see that there is a deficit in the amount of funds that are available for the home care sector. It’s great that the CQC stood up and acknowledged that, but the CQC is very good at taking a lot of those funds to fund themselves. We pay an absolute fortune to the CQC for a really poor service. If we provided a poor service, they would be very quick to tell us that, but we aren’t able to criticise them. Our fees to them a few years ago would have been about £770 to be registered for the year, but we’re now coming up to over £2,000.
Why have the fees gone up so dramatically?
They would say that they need investment to be able to inspect. I don’t know how much inspectors get paid by the CQC, but the service is actually worse now than it was a few years ago for us as providers. There are areas in the country that are desperate for care services – we hear all the time about people being stuck in hospital waiting for care. We are a growing brand desperate to get our services registered so that we can provide employment and services to the clients, but one of our branches took 19 weeks for somebody at the Care Quality Commission to speak to us. I think some people are a bit frightened to talk about this, but I stand by this. They charge an absolute fortune.
They also brought in a new way of charging us for our registration for the year, and it was going to be charged per client, so dependent on how many clients you had was the rate that you paid. They were wanting to target companies who had lots of clients, not on the basis that we’ve done very well, recruited very well and grown our clients list. We were now going to be penalised. What it’s also done is said that for those clients who don’t require substantial services, but need social support or respite care, ‘we are not going to take on those packages because you pay the same for that client as you do for a client paying 40 hours’. They didn’t get it right at all. I think that billing has now been thrown out after a year, so all that money has been wasted.
Some providers have accused adult social care inspectors of creating a barrier to innovation and preventing a shift to digital. Would you agree?
Yes. We seem to be moving forward much more quickly than the Care Quality Commission is. We are three quarters of the way through with implementing electronic document systems, call monitoring systems and electronic MAR charts into our branches. Lone working now is not the issue it was a few years ago because we can physically see where our staff are and that they are safe and have attended calls. These systems are very expensive, and we are all funding this to keep ahead of each other, but we are way ahead of the CQC. We’ve had inspections recently where inspectors didn’t know how to use the systems and because they didn’t understand them they instantly didn’t like them, and they want to see evidence on paper, but that’s not how we run now.
We are not doing anything wrong – the regulations say we don’t have to present documents on paper – but that’s what’s expected and if you don’t deliver that then you can be given a poor rating. And if you receive a poor rating then you are stuck with that poor rating for at least 12 to 18 months, and the damage that can do to your business is scary. The thousands of pounds that we pay to the CQC every year should be enough money for inspectors to be able to understand these systems. But some inspectors may only have a few years left in the role and don’t see why they should go and learn something new.
Moving on to your role as director of franchising, you were the first person to become a Qualified Franchise Professional in the care sector. What did this programme entail?
I qualified back in May 2014. The qualification takes the form of four courses – how to understand a franchisee’s financial performance, how to speed up the growth of the network, how to monitor the performance of franchisees and how to motivate franchisees. After you successfully complete those four courses, there is then a dissertation on two random subjects. You are then interviewed by a panel of franchise experts and find out whether you have qualified.
Why do you think there aren’t more care professionals studying for this qualification?
There’s a lot of work, and also a lot of expense, involved. It’s all done over at Warwick University, which is nowhere near me, so I had to stay overnight at hotels when I was there. Also, to take the time out of your business to study for a qualification is quite difficult. For me, we didn’t have a whole network of franchisees at the time, so it wasn’t as hard. There was a lot of value for us as a company to have a QFP within the team, but I also think it’s important for credibility – you need to evidence that you know what you are talking about in franchising. Obviously I could support people in care – I’ve lived care for the last 25 years – but for the franchise side of things, I needed to make sure people were confident in what I was saying, and I think the QFP certainly brought that.
Heritage Healthcare has now grown to provide care and support in 21 territories. Given that you weren’t planning to go into franchising, were you surprised by this level of growth?
I wouldn’t say I was surprised – I was pleased with the growth – and we’ve done that while still running our existing care business in the North East, which is a very large area that we cover as company-owned. I would also say that we have grown at a rate that was sustainable for us and our support team, and I think that’s what’s really important to our franchise network as well. We could easily have opened 40 franchisees, let’s say, but that would have affected the quality of support that we could offer. So we were very selective about who we awarded a franchise to, which has certainly worked in our favour.
Having started out in the social care sector as a care assistant at the age of 18 and gone onto become the director of a franchise business, what advice would you give to young people hoping to follow the same path?
I think that all people can be successful if they are hardworking and determined enough. Being a carer is a career and it’s not the low-paid job that it has been viewed as over the years. Because people are staying at home for longer, their needs are more complex and our carers need to be far more highly skilled than they ever used to be. Some of our carers are borderline nurses now, because of the level and the standard of care that we give within a client’s home. So I just hope people remain within the sector wherever possible because it’s desperately needed. I have been lucky enough to have been involved in the care sector for the past 25 years, but it doesn’t feel like a job – I love what I do. But you do have to love it, otherwise you would give into the exhaustion that there is sometimes within this sector. Also, as carers, we need to be supported by the people at home who love us. It’s difficult to care for people every day, particularly within palliative care services.
Recruitment and retention are two of the biggest challenges facing the social care sector at the moment. As someone who has worked their way up the career ladder, what are the biggest barriers to recruiting and retaining staff and how can we overcome them?
I think people still view it as a low-paid job. We try to advertise as much as we can that we don’t pay minimum wage in any of our branches – we always go higher than that – and we try and achieve as much investment as we can for our staff and we look after them. So rather than having staff drive all around a territory, we give them runs that are well thought-out and we match them with clients that match their personalities.
From a recruitment point of view, the difficulty we have now is that lots of other jobs within the local community, such as working in shops and bars, are paying about the same rates. So we talk to potential employees about how they can develop within this particular sector and all the opportunities that there are. We also talk to them about investment in their key skills, so things like English and Maths, if that’s appropriate for them. We look at incentives as well, so we offer them mobile phones in some our branches. This saves them money because they don’t need to have their own mobile phone. There’s also a lot of competition between care providers too, so we have to make sure that your offer is as attractive as it can be.
What are your ambitions for Heritage Healthcare Franchising over the next 12 months?
This is very simple. Over the next 12 months, we would love our network to continue to grow. We would like to award a franchise within the North East as we don’t actually have anyone within our home ground. We also hope to launch or first master franchise within the next 12 to 18 months. We launched Heritage Healthcare International in April 2018 and have since received interest from potential franchisees in the Netherlands, Denmark, Sweden and Norway. We think Scandinavia is a good fit for the brand and the quality of the services that we provide. So we have consultants in place and we are looking at growing internationally. The master franchise will run a pilot operation for 12 months before it is eligible to sell to franchisees within their territory.