Category Archives: Jeremys Blog

“Going Dutch”

Family LivingThis week is Dementia Awareness Week. The BBC have been running various programmes around dementia and the issues that it raises.  Well done the BBC.  A brilliant public service broadcaster – in fact, I would happily pay my licence fee just for the BBC web site, Radio 4 and Test Match Special alone.

BBC Tees asked me to do an interview this morning as part of their week to talk about Middleton Hall’s innovative model of care – Family Living.

For me, Dementia is one of the three big challenges that the world faces for our future and those of our children and grandchildren.  In case you are wondering, the other two are Climate Change and Obesity.  Obviously I am tempted to throw in world peace but us humans have never been terribly good at that throughout history and apparently since 1945 we are killing less of each other in major wars than ever before.  However, I will stick with the three challenges as four seems quite a lot to worry about.

Dementia is a massive issue for the UK.  We cannot afford not to deal with the problem because the next generation simply cannot afford the problem – the continuing increase in numbers of people with dementia will cripple the NHS and empty the national coffers (which are not exactly overflowing), resulting in higher taxes or us all working to 75 before we get a sniff of a pension.

Currently we have no cure, no effective diagnosis and are pretty poor at caring for those with dementia and their families.

The traditional care home model, creaking under the weight of local authority cut backs, is no way to look after people with dementia.  15 minute home care visits are also not the answer. No surprise that CQC published a damning report this week into care for dementia in care homes and hospitals.

Family Living The system in the UK is that when someone is unable to cope at home or their family are unable to cope, we often move them into an institutional environment, remove their decisions and stop them doing what they are able to do.  It is called a dementia care home.  There they will find themselves confronted by long corridors, doorways and we will put them in a sitting room with 20 or 30 other people and then sit them down in a dining room with many other people.  No matter how good or caring the staff, this is an alien environment for most people and radically different from the home life they are used to.  They may get distressed and start to exhibit so called “challenging behaviour”.  So what happens? We give them drugs.  To keep them quiet.  So they sleep during the day and are awake at night.  They go “wandering” and we try and stop them.  They lose their fitness, independence and appetite. And so on. I will stop before I get too depressed.

I am no expert and have no qualifications in this area, but a few years ago I visited the Netherlands and looked at their model of Small Group Living and Green Care Farms.  I also read a few books including the fantastic book by Graham Stokes “And still the music plays”.  He is a psychologist specialising in older people and tells the stories of around 20 people with dementia and their behaviour.  His theme is that people’s behaviour should not be blamed on dementia but on our lack of understanding about the person.  He worked out with each person what lay behind their behaviour and the means of helping them to be happier by adjusting their environment to suit.  I would recommend it to anyone caring for someone with dementia.

Living WellThe result was Middleton Hall’s Family Living, set up to be an engaging, participative and fulfilling service for just eight residents.

At Middleton Hall we will only offer a service if we are confident it will meet our values.  For many years, we shied away from a dementia service as we were not confident of being able to deliver an excellent and innovative service.  Inspired by what I saw in the Netherlands and Graham Stokes’ book, we have given it a go.

And so far, Family Living has made a real positive difference to our residents’ lives and their families.  Which is what social care should be about – a positive experience.


Cricket MatchSeptember is often tinged with sadness for me – leaves turning, darker evenings and rather different Saturday afternoons.  The end of the cricket season. For those of you who do not know my passions outside of Middleton Hall, cricket has been my sport since I could hold a bat. Brief moments of achievement and many more moments of frustration.

People who do not like cricket, bear with me. There is a point!

This year, I have only played twice and done very little coaching. Time (lack of rather than just advancing years) and an injury have kept me away from Saturday afternoons absorbed by the sound of willow on leather.

My absence from playing has resulted in paying slightly more attention to watching cricket. England have had a remarkable roller coaster of a summer with resultant intense pressure on the captain, Alistair Cook.

Non cricketers, hold on – I am getting to the point.

In observing England’s ups and downs, it occurs to me there are a lot of comparisons with business and specifically social care.

The difference between success and failure is sometimes very small in sport. A dropped catch, an umpiring decision going the wrong way or just plain bad luck.

Attention to detail and careful planning is everything in elite sport. And business.

I used to find opening the batting like meditation – you had to have a clear and uncluttered mind to focus on the ball, the opposition fast bowler and the fielders.  On those few good days, time at the crease required (for someone of my modest abilities at least) intense concentration and complete focus.  You also could not afford to dwell on mistakes or what might have happened but keep looking forward all the time.

Much is the same in business – complete focus on the right strategy is the key to business direction and business leaders, while learning from past mistakes, can only change the future, not the past. Despite Tesco’s attempts.

Alistair Cook has appeared to recover his credibility as captain for test cricket, but there is considerable criticism for the way he and the team plays one day international cricket. Why? Because limited overs cricket has moved on – other countries are playing with greater imagination and creativity while England appear to be stuck with the formula of ten years ago.

Again, the same in business. You have to keep moving forward, improving and reinventing where necessary as competitors move forward and the market changes

And that is particularly true in retirement living and the social care market. The model of ten years ago no longer works as well.

I am always conscious of the danger of complacency. Customers regularly tell me about great things that we are doing at Middleton Hall but I hope I am always aware that we have to keep improving.

And if I can’t see that, it will be time for me to retire to the commentary box.

“Awards – what are they for?”

CBE AwardMiddleton Hall recently received an award from Friends of the Earth – a CBE (Clean British Energy) award. Plenty of charming members of Friends of the Earth came to Middleton Hall for a tour and to drink sparkling wine to celebrate (English organic wine, of course) and everyone had a cheery evening.

So what’s the point? Are awards just an excuse for a party or to look pretty on the wall?

Well hopefully there are at least three points.

We received our first award in 2001 – a rather unexpected one at that (“Best new product or service” in the Tees Valley Business Awards). The first two interesting things happened.

Our staff were really thrilled – they were actually working for an award winning company.

Our residents were also delighted – they were living not just in a nice place with some lovely staff but a facility that was recognised as being the first of its kind. An innovative new service.

A new sense of excitement about Middleton Hall was born.

13 years on, we have received many awards. In addition to staff and residents being proud of their part in our success, as Managing Director, I also take considerable pride in what we have achieved. Running a successful company is a lot easier than an unsuccessful company for a start.

But the third point of an award from a campaigning organisation like Friends of the Earth, is that it helps promote the idea of sustainability in business. Green energy and sustainability are not always seen as natural bedfellows of business. Perhaps in a small way, the publicity about Middleton Hall receiving an award for sustainability might help demonstrate that sustainability should be part of any truly successful business.

“The smiles tell the story…”

SmilesSeveral people have suggested that I should write a blog on the Middleton Hall website. I hope that judgement is not misplaced. Please go easy on a first time blogger!

Friday 20th June staged the second National Care Home Open Day. This is an opportunity for care homes throughout the UK to throw open their doors and encourage people to visit and find out what goes on. After several years of negative media coverage, a positive idea for the sector.

If people relied on reading the papers, watching TV or listening to the radio no one would ever choose to move to a care facility. On the back of publicity from the Southern Cross situation, Orchard View and the recent Panorama programme the sector has been painted in a poor light. However, this is not the story of the whole industry but that of the minority. It is of course wrong to tar all with the same brush. There are issues in the sector, but here was an opportunity to promote some positive news.

If I am ever having a frustrating day, my solution is to take a walk round our retirement village and have a chat with some residents and staff. Invariably I hear about some good things going on – residents satisfied with their lives and staff fulfilled in their roles. Immediately I am reminded why we all choose to be at Middleton Hall. My walk round on Friday was no different.

Although we are a full retirement village rather than a care home, we took part in the nationally organised open day given that three of our six services are care facilities. A great range of activities were going on, inside and outside:

  • Arts and craftsArts and crafts
  • Smoothie making on the Middleton Hall smoothie bike
  • Cake decorating
  • Ping Pong
  • Guided walks from the gardening team
  • Music from one of our youngest members of staff
  • Afternoon strawberry tea

(I also spotted the ominous sight of the Middleton Woods Bowling Team practicing on the bowling green… the annual staff v residents match coming up).

Laughter, conversation and plenty going on to give visitors a taste of Middleton Hall.

Smoothie BikeThank you to all the residents and staff taking part – a great example of the lifestyle that is possible in a retirement village.

I was particularly touched by a board, showing pictures of many residents taking part in varied activities. The common theme? Big smiles.

Hopefully the National Care Home Open Day has shown that there are some great places to live in older age.
Not just somewhere to be – somewhere to live.