Resolving overpayments without wrecking relationships

Late last year, Julian was kindly invited by Principea Ltd to co-present a session at the Payroll World Autumn Conference on the rather thorny issue of employers recovering overpayments.  Here’s a brief overview of what he said.

Firstly and most importantly, get a policy and protocol in place, this protects you and helps the employee to understand the ground rules. As an ex Trade Union official I know that many, many people simply don’t realise that employers are legally allowed to recover overpayments in the first place.

Second – employers work in gross – employees work in net. So when you sit down to talk to them (& believe me, that’s a better way to approach this issue than writing), make sure you have the net figures to hand; this makes the potential debt seem a lot smaller and therefore repayment more manageable.

Third, seek a mutually agreeable repayment plan. Some big organisations for instance refuse immediate pay-back while they work it all out and issue an invoice, only to find out that the employee has then spent some of it and so the debt takes longer to recover.

Fourth, trust your staff, I’ve heard of some organisations who treat every failure to disclose an overpayment as an integrity issue. Not everybody reads their payslips and staff may genuinely not notice an overpayment (This means they may well have missed underpayments too!) especially those in the hospitality or care sectors where a multitude of variable payments means their pay can go up and down by 20 or 30% every month. Lots of people run over their overdrafts and your money may have just made their bank very happy but this means they just don’t have immediate access to a pot of cash to pay you back.

Handling an overpayment badly can ruin your relationship with a member of staff, be clear that it was a mistake and that you have the right to recover it. But, at the same time, be sensitive and understanding in your conversations and, if necessary, with your repayment schedules.

If you want Care HR to help you develop an overpayment recovery system – Contact us


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How to sniff out a good care home (Literally…)

So, how do you find a good care or nursing home?

It’s a question that I’ve been asked dozens of times in the last couple of months.

My first free tip is trust your nose. If there’s a stale urine smell, you may want to think twice. 

What you need most is a caring and compassionate care home with a good strong team team of staff. So try not to just talk to the manager, ask to talk to one or two of the carers on duty. Ask them a couple of questions – good ones to start with are, “How long have you been here?”, “What do you like about working at this care home?”. If the staff you talk to have only been with the home a short time, ask the manager about the staffing – who’s the longest serving staff member? Most long-standing homes should have a few staff who have been there many years. Having lots of new staff can mean that staff are not happy working at the home, don’t hesitate to ask these questions, your relative could be staying here for a very long time and whether you or the state are paying, they are all expensive.

There’s another classic question – “Would you like your Mum or Dad to live here?”; make sure to keep eye contact when asking this one and check for curious hesitation or discomfort as this may suggest that they wouldn’t.

All homes have to be registered with the Care Quality Commission. Make sure you check out the home’s latest inspection report. The CQC try and make it easy by having some headlines – basically ticks are good, crosses are bad. If the home you are looking at has a cross, closely check this aspect out – what was wrong at the inspection?, more importantly what are they doing about it?

The care provided should be person centred. This means that the home should take in to account what your relative’s like and dislike are. Whether they prefer a bath or a shower, what they like to watch on the television or what they like to eat. Seek out people who live there already, they will likely give you a real answer as to how the home takes care of them.

Think about the needs of your relative. If they have a distinct diagnosis, such as dementia, then look for a home that specialises in dementia. Check what they do that’s special – Can they demonstrate that their staff have had special training in dementia care, do they have visiting professionals to undertake therapy such as art or reminiscence? 

Once you leave, think back. Did you feel that the home spent time getting to know you and your relative. Did they take good care of you while you were there? Were they sensitive to your needs at what is a terribly difficult time? If you’re not quite sure, go back again. Most good homes wouldn’t mind you popping back unannounced, you might have a brief wait whilst they are able to give you some time but you should get a good sense of what it’s like when they’re not expecting a visitor.

There’s a great checklist available for when you are looking here and it’s free from The Alzheimer’s Society.

If you’d like help in finding your relative a good care home then please don’t hesitate to contact me.

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And what do HR know about it anyway?

As a HR professional I think the last thing we need is another large set of workers who need to be centrally regulated with all the systems, processes, checking and double checking that takes.

As a Nurse I say, “And what do HR know about it anyway?” and, “well, aren’t HR there to support the business and if the business happens to operate in a highly regulated industry (say, healthcare), then that means getting on and solving the problem.”

So what am I saying? I’m saying I can see both sides of the argument. It’s just that at the core of me is a Nurse that believes that Patients should be at the heart of all we do. If we were, as a society, to truly accept that: then the registration of Health Care Support Workers (HCSWs) is a no brainer. I’ve met both Nurses and HCAs that have been sacked because of what they have done, a Nurse on the register then faces an inevitable (but independent from the (ex) employer) investigation from the Nursing & Midwifery Council and if struck off they can no longer legally work. It is entirely possible for HCSWs to just move on to another Care Home, I’ve seen it happen many times.

So the Code of Conduct and the National Minimum Training Standards for HCSWs published by Skills for Care (click here to view) will certainly help but I’m very keen to see how Employers, the Care Quality Commission and others ensure that all HCSWs across all sectors work to the code and that employers meet the training standards.

I’m just working on the services and packages I can offer employers in setting up policies, processes and training to ensure that they will be and remain compliant with the Code and Training Standards. 

I’ll put a link here as soon as they’re ready.

Thanks for reading my blog, much appreciated, Julian



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With compliments…

I was picking something up at the printers the other day (I’ll leave it to your imagination what the something was, answers on a postcard or maybe, the comments section below)

It got me round to thinking about feedback.

I thrive on feedback or at least I like to think I do, boy, can I hoover up that praise! Social media, twitter especially means that individuals and companies can get it immediately and in amounts never seen before. Just think of Amazon and Starbucks with their tax arrangements or poor old Justin Bieber last week when he turned up a bit late for work. And no, I’m not a fan.

But feedback has to be given in a meaningful and insightful way you say, yeah, I’ve read those articles too. I do wonder what you can learn from really, really honest feedback. Maybe what your colleague said last week (Her view – that you like to dominate office meetings) in the heat of the moment was actually much better feedback for you than the highly considered politicly astute feedback she felt obliged to put in the box on your 360?

So step back a moment, what have people told you recently? What could you learn from it and how could it help you grow? 

There’s a strong opinion now that any NHS Chief Exec who isn’t on Twitter, probably isn’t fit for the job. The old ‘if you can’t stand the heat, get out of the kitchen’ adage.

My twopennyworth to sign off with: embrace all the feedback you get, learn to live with it and make use of it, however it comes to you.

By the way, I’ve just had a new portrait done for the site, what d’ya think?

One of my favourite things in the world is to help people learn and spread their wings, if you want some support with your personal or team development, get in touch with me here

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Early thoughts on the Francis report published today

Well, it was incredibly thorough.  There were many more hard hitting recommendations than I’d anticipated and I’ll touch on a few that I think are really key.

Duty of candour

This is really significant in an NHS that in my experience has been focussed on the need to defend itself from litigation and complaint. The culture that this has engendered has meant that honest and transparent dealings with patients and their families are prevented by the need to avoid any acceptance of liability on behalf of the professional or the employer. This duty of candour should allow and promote the early acceptance of mistakes having occurred and therefore mean that the trust and relationship can be rebuilt quickly. This should improve health outcomes and mend the relationship between the public and the NHS because it allows for apology, a chance to make right what has gone wrong and diminish the need for patients to engage in drawn out legal battles to get to the truth. 

Registration of Healthcare Support Workers

I have spent many many days in my career with rooms full of staff who are delivering the bulk of direct patient personal care.  They are an intriguing and often inspiring group of people who have a clear thirst for knowledge and a true desire to meet the needs of and care for their patients. My experience of standing in front of 100s of Health Care Assistants at a time is that they want registration. They believe that this backed up with some minimum training standards, very clear clinical roles and a code of conduct will allow them to deliver care to the best of their ability and enable them to speak out when they know standards are not being met.

The merger of CQC and Monitor

For me this makes perfect sense. There is little objective reason for having two masters for a large number of NHS Trusts. The need to focus on care just as much as money is well articulated in the Francis report and having a single watchdog to monitor the NHS will allow this happen. The work by NICE on clinical standards and the need for NHS Trust Boards to publicly report on them will allow the Chief Inspector of Hospitals to lead this new invigorated organisation in ensuring that the failings highlighted in this report are much less likely to reoccur.

The Registered Nurse for Older Adults

This is a great idea and a potential solution to a very real problem in nurse education and post registration careers. Caring for older people, (just as for mental health or learning disabilities) can be seen as a real Cinderella career move. The nursing profession as it has become increasingly academic has had a focus on technical skills, such as nurse prescribing or minor operative procedures. Placing compassion at the forefront of nursing and the NHS as Francis aims today will allow the arguably more vocational caring side of nursing as is required in older people’s care to shine through in a newly designed role. The role is clearly about spending time with and caring for some of the most vulnerable members of our society. To help them eat, drink and understand what is happening to them with their health and social care whether in hospital and or the community.

I would be really pleased to receive your comments and I have extensive experience in all the above so please do contact me if you would like me to support you with reviewing your care and developing your care team.

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Too many mental health patients have freedoms restricted

And the fact that this didn’t come as a surprise should be shocking.

The Care Quality Commission published their Mental Health Act Annual report today. It found that 15% of people were not directly involved in their own treatment decisions. The use of detention under the Mental Health Act has increased by 5% in the last year.

This is not great news in a society that generally seemed to me, at least, to be improving in its ability to talk about mental health in a more open and less stigmatising way, helped by the recent disclosures by footballers about their experiences of depression. Yes, I know they were treated badly by some sections of their own community but I don’t think any footballer would have dreamed discussing it in the open when I started my nursing career.

What made me sad more than anything else, was that the culture seems to be coming more and more about control and restraint and restrictions than about therapy. I can remember when the decision was taken locally to lock the doors on all the mental health in-patient units.

For me it was a disaster. It seemed to mean that rather than having to need to have therapeutic skills and relationships with the people you were caring for, it meant all that was needed was somebody with a swipe pass. Some of the best interventions I’ve ever been involved in were when people were determined to leave the ward, sometimes it was a good decision, sometimes less so. But unless there was an immediate and very high risk, people chose for themselves whether being an inpatient was right for them.

There are lots of brilliant nurses and carers out there. There are some fantastic service user groups and advocates. Let’s hope this report spurs them on to retake the lead and move back from restriction to therapy.

If you’d like to involve me in a review of your care, culture and practices, please don’t hesitate to contact me.

The report is available here.

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