Deep Green - Caring deeply, stepping lightly

Dragon's den

2010-12-08T08:43:00.000-08:00

We did a "Dragon's Den" type pitch in front of an audience of about 80-100 people at the Good Deals 2010 conference on 16 November 2010. The panel was chaired by Anthony Ross (Bridges Venture Fund) and we had investors from the Natwest "not-for-profit" section, the Social Investment Business and Equity Plus on the panel. The feedback was very useful:

work with partners - it's too big to do on your own
make sure you have done your homework - how long will it take to breakeven point?
couldn't you start smaller?

So we have taken these comments on board now, and with all that we learned at the conference, are exploring some new ideas/partners. We were particularly excited by the potential of "Social Impact Bonds" - as was used to fund an ex-offenders programme, using private money. Recidivism decreased, the private investors made profit and the government spent no more (there must be a catch somewhere...)!

Epilepsy - Past and Future

2010-09-19T07:58:00.000-07:00

I spoke at the Epilepsy Action Diamond Jubilee Conference on 11 Sept 2010. The organisation is celebrating its 60th year. The story of Clara, now aged 99, a remarkable woman who was very active in the organisation until relatively recently, illustrates what life was like for people with epilepsy in the 20th Century.

Clara was sent to an "epileptic colony" as it was considered better all round if "epileptics" (even classed amongst the "lunatics" in some institutions) were kept separate from the rest of society.

In the 21st Century the "lunatics are taking over the asylum" (I am talking about myself - no insult intended to anyone who has epilepsy, or any other neurological condition) - and we will be running Deep Green - and we will be working towards getting everyone who lives there out and about in whatever way they want - outdoors to gardens/ watching football games/ visiting friends/shopping, etc as well as getting other people in. Not just "visitors" in the conventional sense, but people coming in to give or take classes (relaxation, card games, cookery?), local people bringing their dogs in for those residents who wish to stroke or walk as able, or just sit and have a cup of tea in the dining room/cafeteria.

If you want to know more about epilepsy or the work of Epilepsy Action, see www.epilepsy.org.uk

Funding uncertainty

2010-07-11T00:57:00.000-07:00

We went down to London to see our Investment Adviser at the Social Investment Business in June. There was a great nervousness in the organisation, as the new coalition Government had already announced that Futurebuilders, one of the 4 main funds it manages, had been closed. They had no idea whether the Government would continue with the Social Enterprise Investment Fund (SEIF) the specific fund for the healthcare sector, they were waiting for the 5th of July.
Now they know that the fund won't be closed, but they don't know the size of the allocation. It looks like Deep Green will probably still get the money it needs for the preparatory work; planning consent, surveys and preparation of a detailed Business Plan. Fingers crossed.

A Cloud 9 "eco-lodge"

2010-06-06T12:59:00.000-07:00

One of the housing options we are exploring is bringing in some modular houses, or "eco-lodges" for example these lovely ones from Cloud 9.

Potential site!

2010-06-06T12:28:00.000-07:00

Wow, 4 months since my last post. In the last few months we have been busy searching for a suitable site. Have sifted through hundreds of land sale details, some could be ruled out from the details alone, or a quick look on Google Earth - what a marvellous tool that is, and free too. It showed for instance what looked like a landing strip near one site. A bit of investigation showed that it was a landing strip - for where they manufactured and tested Typhoon fighter jets. Some have got through that filter, and we've been to see a quite a few. A couple turned out to be "greenbelt" with no chance of getting Planning Permission. One site was nice, but had a large power pylon right in the middle of it - and a large sink hole. It was the site of one of Cheshire's salt mines, and I read a fascinating account from about 1910 of how one day a huge hole opened up in the ground and the local brook poured into it. Apparently you could see down about 100 feet before it.

Anyway, I digress.

The potential site we have found, after searching North West wide, turns out to be out 3 miles from where we live! On our own doorstep, as it were. The issue is that it is larger than we wanted, and of course is more expensive than we had bargained for, so now we have to work out how we can earn enough from developments on the land to enable us pay for it, as the nursing home business cannot support loan repayments for the whole site .

"stakeholder consultation" - aka "talking to people"

2010-02-06T14:43:00.000-08:00

I don't know how best to refer to "the people who might come to live in Deep Green", we could try an acronym but PWMCLDG doesn't really work eh?). A nurse has her/his patient, social workers and therapists have clients, commercial organisations have customers, and the term I absolutely abhor, that is commonly used by local authorities, "service user", or even worse, just "user". In my business plan I refer to "residents" - but obviously until it exists no one can reside there! The people I'm talking about are stakeholders, but then so are the potential staff, the local authority where it will be based, the neighbours, the funders and so on. I think I'll call them "potential greenies"!

Anyway I have been talking to some of "them", well strictly speaking, to some advocates and campaigners and some family/carers. I have not yet been able to access potential greenies who require me to have special communication skills. In some cases, no one has the appropriate skills, and there has yet to be some form of technology developed to assist. Therefore we are left making assumptions about what people might want. Clearly there are often disagreements between carers (family) and the adult services professionals, about what is in the "best interests" of the potential greenie, or over what it is a reasonable entitlement, which can lead to prolonged "battles" over many years, sometimes with recourse to the legal system.

There are a number of young adults for whom activities of daily living pose considerable challenges. This includes learning difficulties, coupled with physical problems (paralysis, skeletal abnormalities, spasticity, sensory impairment, inability to express themselves in manner comprehensible to those who do not know them, difficulties feeding and toileting. Some behaviours or movements may be involuntary, and can be considered "antisocial" by some. For instance shouting out loudly presents problems in many social settings. These challenges arise from congenital syndromes (i.e. that people were born with), or are acquired in early childhood, as a result of disease or injury. While still a child, the parents/ adoptive parents/foster parents have cared for them. Now that mature, there is a desire to move them on to as normal a life as possible, living in their own home, with some form of social interaction on a regular basis. In a number of these cases the potential greenie has 24/7 care, provided by 2 paid carers, or personal assistants. Some people have taken the option of directly employing their own staff through a "direct payment" budget from social services, and this can work quite well. Unfortunately I have yet to hear of a satisfied customer of the various agencies who provide home care staff, which have to be used if "health" is paying for the care. I have heard family say they cannot trust the carer organisation management to ensure that all care is provided to a high standard. One family said that the carers never took their charge out, despite him having a very expensive motorised wheelchair, and being well enough to go out. I heard of a case of a person's arm being broken by an inexperienced staff member forcing the arm into a shirt, not using the technique which was clearly explained in the care plan. I also heard the shocking case of a young woman being lowered into a scalding hot bath (non-intentionally) and dying some time later from burn-related complications. Even though "the state" is paying for care, the family members feel that they can never relax; that the care provided is not safe, and not as good as they would and had provided for many years. I have heard "I don't know what would happen if I wasn't here" said several times.

So we must create a safe and stimulating environment to engender trust, so that families can relax in the knowledge that their loved one will be well-looked after. I intend to assign each resident a member of staff (a nurse) to be their "special guardian" or "surrogate mother/daughter" - we'll have to come up with the right name - in other words one person to take responsibility to ensure that the care was as good as it would be for their own child or mother. This would be different to the staff on duty providing care during a normal shift. We'll have to work out the details with "stakeholders".

Good prospects

2009-12-06T02:54:00.001-08:00

This document - the Prospectus - is to help us communicate to potential partners what Deep Green is, what it will bring to the local area and what it can bring to the table, i.e. up to £6,000,000 of loan and grant from the Social Investment Business, depending on the package, with a costed business plan for a specific site. We have identified some potential sites of the right size, and are working through our list of local authorities, regeneration agencies and Registered Social Landords. I'd be happy to share this with anyone who is interested - just send me a message.

Beautiful view

2009-11-14T14:35:00.000-08:00

There's been so much going on lately it's been hard to find the time to keep the blog updated - but there is now a lot of material to add over the next week or two. First and foremost we have some lovely sketches of what the nursing facility might look like. The actual design will of course depend on the features of the site, and any existing buildings or structures already present. We will endeavour to strengthen, or at least preserve positive features, and minimise negative impacts on the local area.

Quids in

2009-09-27T03:36:00.000-07:00

Don't know about you, but I always thought when you were awarded a grant there would be a photo of you with a big cheque, like this:

Sadly no, just a transfer made to our bank account, which I only found out next time I checked the balance.

Awhhh.

The search for a site

2009-09-13T06:14:00.000-07:00

Now the really hard part - finding a suitable site. There are so many factors to consider. We've devised a decision matrix, and included the following criteria:

area (~8ha - apparently a football pitch is 0.8 hectares - so this means 10 football pitches)

physical geography - shape of site, slope, aspect, drainage, etc

previous development (was it industrial? are there existing buildings? is there anything we can "reclaim"?)

accessibility and communication - public transport connections are absolutely crucial if we are to keep our carbon footprint down (or a good cycle path in the unlikely event we can find one anywhere 'round here), access roads, Broadband, etc

skills proximity - local workforce nearby (who will be using the bus, cycle path, etc as above!). Deep Green aims to upskill people, so the main factor is a local population with a sufficient number of potential care staff who will share the values of Deep Green.

cost - current ownership has a huge influence here. If public sector, they may be willing to let Deep Green have the land very cheap because of the social capital we will be creating in the area. If a prime site for residential development, the cost could be millions.

Planning permission - a site which was already deigned as residential in the draft Local Development Framework might be easier than a former industrial or retail area.

Environmental concerns - a catch-all for "other" such as green belt, site of special scientific interest, potential for wind turbine, contamination and any remediation needed

Partners - is the local authority supportive? Is there a Registered Social Landlord (RSL) i.e. housing association, covering that area who might be willing to work with us? Is there a regeneration initiative?

Site history and neighbours - has there been any kind of local protest over the site? is it a site used by travellers? are there problems with community safety, vandalism, theft, hate crime, etc?

and last, but not least, the aesthetics of the site, does it look attractive? Does it have potential?

So any readers (either of you!) who know of a site we could consider, please let us know.

Water, water everywhere...

2009-08-18T13:44:00.000-07:00

The weather lately has turned my mind to thinking about how we will use water at Deep Green.
Here in the developed world we are crazy enough to use excellent drinking water to flush our toilets! We transport this precious commodity from beautiful lakes in Cumbria or North Wales - and along the way an awful lot is lost to leakage. It's desirable from a sustainability perspective to use as little as possible. This concept doesn't fit that well with conventional health care, where there is great emphasis placed on washing - bodies, clothes, bed linen and floors! So how to maximise cleanliness and infection prevention and control whilst minimising water use?
We will be exploring:

reusing "grey" water from sinks, baths and wet rooms for flushing purposes.
harvesting rain water for the gardens
low water use laundry - I understand that the new oxygenating washing processes remove the need for extensive rinsing

We will also consider how we can minimise run off from the site, by keeping hard paving/asphalted surfaces to a minimum.

We will be inviting United Utilities (our local water purveyor) to become a partner, initially providing technical advice and expertise, but from there who knows?

We made contact with the Centre for Alternative Technology in Machynlleth, Wales, several months ago, to see if one of the people studying on one of their courses might be interested in examining different methods for treating laundry. Can't understand why no one has bitten the cherry ...

Business Development Grant awarded!

2009-07-18T12:06:00.000-07:00

Very good news Subject to contract, SEIF has agreed to award us a Business Development Grant! Apparently we are the first award of this year's round. One of the first steps is to establish the size and shape of the market for the Deep Green offer, and how much health and social care commissioners would be willing to pay.

The search for a friendly local authority will now be pursued in earnest. We have a real proposition, with likelihood of securing funding, which will create 100 jobs, plus the short-term jobs created in the construction - a sector which is crying out for work at the moment. This factor will make the costs of building cheaper now than they would have been 2 years ago. As we will be using environmentally conscious building methods, this will give the workforce experience which can only enhance their future employment prospects. "Green" building is increasinly making sense as the longer term energy costs continue to rise. So we make an attractive proposition for a local authority wanting to stimulate some business growth, and we "tick lots of boxes" - social enterprise, woman entrepreneur, person with disabilities, ethical, environmental, providing social benefit...how could they possibly say no?

Business Plan and Financial Forecasts complete-ish

2009-07-07T14:44:00.000-07:00

Considering this time 2 years ago I hadn't realised that this was what I wanted to do - to now having written a Business Plan (with a little help from my friends) for a £6,000,000 development is amazing. Paul has written the two 3 year financial forecasts, using the huge, complex spreadsheets provided by SEIF (see previous) - one of those where changing a variable on one page, e.g. monthly utility bill, automatically updates the others, so you can play around with the figures to your heart's content. For instance, I hadn't factored in any extra payment for unsocial hours, so we were able to add on 5 day's pay per year (for staff who will work Bank Holidays - 10 days at time and a half). The forecasts take us up to 2015. We've projected the home opening for business in 2012, but I think that is extremely optimistic -there are so many factors around finding a site, getting it surveyed, getting Planning permisssion, who knows - being gazumped?
The next step is that our Investment Adviser will prepare a case for the development to a specially convened panel - by which I mean a panel which comes together when they have a couple of proposals to vet - rather than working to a pre-determined schedule. It will probably be September before we hear if we have been awarded a Business Development Grant to allow us to take the Business Plan and financial forecasts to a stage where we will be "investment ready". Then it will be a Dragon's Den scenario..... (yipes!)

2009-06-17T05:41:00.000-07:00

Good news - on 6 June 2009 we finally had contact from the Social Enterprise Investment Fund (SEIF) - a Department of Health fund, now managed by Futurebuilders England, in response to an application we submitted 31 July 2008! We were advised to withdraw that application, and apply under the new terms which were coming out the next week (search for SEIF on www.dh.gov.uk if you're interested). We have since had contact from our Investment Adviser, and submitted draft business plan, 6 year cash flow forecast, and Statement of Investment Use, to her so that she can help us get them sufficiently robust to go before the next Investment Panel.

Two's company

2009-05-14T15:14:00.000-07:00

Deep Green Care Community was incorporated as a Community Interest Company Limited by Shares on 29 April 2009, Registration no.6892280. The Community Interest Company or CIC is a relatively new legal form established specifically for social enterprise. You can read all about it on the CIC regulator's website.
We deliberated long and hard about the legal form, Coop? Charity? Company Limited by Guarantee? We opted for a Company Limited by Shares as it opened up potential ways of financing the venture.
Currently there are only 2 of us who are directors, and also members and shareholders! but there remain plenty of unallotted shares so that everyone who comes to live or work in Deep Green can become a shareholder (of 1 share). I've retained half plus 1 (50.1%) of the shares, so that I can be assured that the vision and values I aspire to for the organisation will be protected until the organisation is mature, at which point I will let it stand on its own 2 feet (I promise).

The search for a site

2009-03-08T08:53:00.000-07:00

We are prepared to consider anywhere in the North West of England, or North Wales, but certain factors will influence the choice:

size of plot - I would like it to be 2-3 hectares (at least), in order to have room for the 75 bed nursing home, my home, plus some other staff and visitor accommodation, plus space for houses, flats, etc to be built on the site at a later date. It is also very important that there is ample space for gardens, with paths, patios etc to provide a variety of interesting and stimulating outdoor environments, also at least a few raised beds for growing our own veg, and an orchard, even if only half a dozen fruit trees.
local support - finding a local authority, or development trust or regeneration initiative based in the area, who would be willing to make a financial (in kind) contribution, e..g. gifting some of the land for a guarantee that it would provide homes, jobs, community facilities, etc
easily accessible by public transport
a sufficient client base. As the offer will be highly specialised, I think Deep Green would have a much wider catchment area than a typical care home. We would ensure that neighbouring health and social care commissioners would be able and willing to send their clients
price
likelihood of getting Planning permission

I scoured the Register of Public Sector Land Surplus yesterday. There were a couple of former NHS sites which seemed worthy of further investigation. I'll report progress.

No blogs for a while

2009-03-08T08:42:00.000-07:00

Sorry, but I was having some problems - which it seemed other bloggers were having as well (error code: bX-ritjb2, if you're interested), but all seems to be resolved now.

Our acquistion fell through!

2009-02-11T13:26:00.000-08:00

I hadn't gone into detail previously, but in November 08 we became aware of a care home, relatively near where we live, which was on the market. It was the leasehold which was up for sale, and there were 14 years remaining on it. It was registered for people with dementia, both nursing and residential beds, so although it wasn't the client group I originally had in mind - we both considered it would help convince potential funders (of the Deep Green vision) that we were capabable of running a care home, and provide invaluable experience.
We had extremely valuable support from friends and family who were used to acquisitions, reading business accounts and conveyancing. St Helens Chamber of Commerce were also very supportive, not only in terms of business advice generally, but in providing us with a generic business plan for a nursing home acquistion, as one of their business mentors had recently acquired a care home in Liverpool. He also made clear that when a new business acquires a nursing home, you have to go through the full CSCI registration again (although the Registered Manager doesn't, if she stays in post).
We were seeking funding (~£2,500) for an independent evaluation, I had phoned UnLtd for a Level 1 application form.
Anyway to cut a long story short, 5pm last Friday we got a call from the Estate agents - the vendor had taken the home off the market.
So in some ways I'm sad we didn't get it, as I was already planning how I would conduct my inital getting to know you interviews with staff, and putting together the Company Handbook with policies and nursing procedures, but in others I'm sure it's for the best, as it didn't fit my specifications in many ways. As we wouldn't have owned the site, it would have made installing any kind of energy generation on site, or the other low carbon features I see as very much part of the Deep Green Care Community.

2009-02-01T05:06:00.000-08:00

Values

Involvement - To maximise quality of life for the residents, their family and
friends, all to give some of their time, according to their abilities, to
the running of the community. Features will be incorporated in the design
to support people with a range of (dis)abilities to be as involved as they
wish to be and as independent as possible.
Clinical excellence -Developing excellence in standards of nursing and
social care. Teaching, providing placements and running short courses.
Staff development, and multi-tasking. Health promotion a cornerstone.
Environmental sustainability - To showcase environmental best practice.
Minimising negative impacts on the physical environment, in both buildings
and processes, resource minimisation principles, e.g. low carbon, waste
minimisation, reuse of “grey water”. Locally sourced materials and food
where possible.
Ethical - Non-exploitative, i.e. using fairly-traded products wherever
available. Respecting and upholding belief systems (various faiths,
vegetarianism, sexuality, etc
Design - The project will seek out and include the best of contemporary
design in terms of the physical build, the environmental sustainability,
the ergonomics and the accessibility of the site.
Not-for-profit - It will be a social enterprise, all financial profits will
be fed back into the organisation to further develop the core aims.

What is Deep Green?

2009-01-25T15:28:00.000-08:00

The Deep Green Care Community will provide a setting where the spectrum of care for people with complex needs and (dis)abilities can be provided. The needs for care may vary over time; they may be due to a degenerative condition, or one which is characterised by acute exacerbations, interspersed with less troublesome periods. The hub of the community will be a nursing home, which provides 24 hour nursing care, and serves as a physical base for the care staff. This will be surrounded by residential units of varying size, design, and tenure, where the people with nursing needs may live with their family and friends, or on their own, as they prefer. Care can be arranged flexibly, so that provision of assistance with daily living to complex nursing care can be delivered to fit around the lives of the “carers” who may work, or go on holiday, or just go out for an evening. Some staff accommodation will also be provided, and temporary accommodation for visitors. The site will also have a number of communal facilities and gardens.

Phase I of the project will consist of acquiring land, building the nursing home, and establishing it as a viable concern.

Phase II will be building the first tranche of residential units.

Phase III will consist of building the remaining residential units bespoke for specific individuals/families, to accommodate different types of disability.

As Phase II and III are developed, the Deep Green Care Community will be available to people at any stage of their illness. The highly specialised nursing care will be available to people who live in their own homes within the community, if and when the need arises, without them having to move. The reason for the mix is to provide a mixed community, where mutually beneficial interaction can occur, and to allow for couples/friends/families to live there, even though one, or several members of the household, may not require nursing care. It will provide an attractive proposition for ageing parents of young adults with complex nursing needs.

Why I'm establishing Deep Green

2009-01-24T15:59:00.000-08:00

I had been having severe headaches for some time, when in 2005, I was diagnosed with a large brain tumour. The neurosurgeon was surprised that I hadn’t experienced any problems with walking or other “motor” functions. I underwent surgery 3 weeks later. In the days following I experienced “acquired brain injury” at first hand – I couldn’t really do anything for myself for a few days. It was a real eye-opener into the experiences of people who are very vulnerable, and reliant on others for fulfilling their most basics needs. Communication was a problem, as I couldn’t speak as well as I had done – the right word didn’t come sometimes. My facial muscles didn’t work particularly well so that my loved ones couldn’t tell my mood.

Due to the excellent care I received I had recovered enough to go home 8 days later and could walk, if a little unsteadily, and over the next 3 months substantially recovered. However the surgery left its legacy; several months later I developed epilepsy.

This life-changing event gave me cause to reflect, particularly on people who suffer from disabling conditions, neurological conditions, and other degenerative conditions, and the impact this must have on how they/we live their/our lives. Some would need considerable help. Some would be able to live at home with suitable adaptations and care packages, but there would be others who would need to live in a “nursing home”. I had never seen a nursing home that I would like to live in. I asked around my friends and acquaintances, and looked on the internet. Nothing appealed at all. I resolved to create the sort of community I would like to live in, should the need arise.