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What Keeps Me Awake at Night…Sara Livadeas

Sara Livadeas, Chief Executive, The Fremantle Trust

I have worked in social care for many years but, having recently been appointed as CEO of a care charity, the Fremantle Trust, and at the time of writing only five weeks into the role, inevitably my mind is on my new organisation and the challenges that face us going forward. I’d like to say that I am sleeping well but it would not be true!

I am acutely aware of the huge responsibility that running a care organisation brings. There are thousands of interactions that take place every day between individual workers (providing for health and care, meals, cleanliness, a comfortable, safe and stimulating environment and giving emotional support) and every one of these interactions must be respectful and safe. The opportunity for things to go wrong is immense. Providing a safe environment is predicated upon culture, knowledge and treating people with dignity. However, we protect ourselves by requiring colleagues to provide vast amounts of evidence that they are managing risks, checking, reporting and checking again. On top of that we record endlessly in care plans that hardly every get read and are mostly defensive (in case anything goes wrong) or to appease the Care Quality Commission (CQC). I am convinced there has to be a better way of ensuring that people are safe and well supported – starting with getting the right people into the roles and then trusting them to do a good job.

Having just spent time staying in one of our care homes I am struck by the level of skill that we are requiring of care workers these days. The level of acuity of people coming into even residential homes, let alone nursing, is so high. Many people are presenting with severe mobility needs or needing end of life care. For those living with dementia, not only do they experience a loss of agency, but eventually they lose control of their bodily functions, such as eating, walking and continence and they need special care and attention. Care workers, sometimes working as quasi nurses, need to have technical skills, communication skills, emotional intelligence, the ability to deal with everything from the most intimate personal care tasks to administering medication, keeping accurate records, deal positively with relatives, professional, volunteers, the bereaved and the dispossessed, and to hand choice and control to residents to ensure care is person centred – and all on minimal wages. Working out how to increase the wages of our colleagues in the services definitely keeps me awake at night!

I am very aware of the responsibility we give Trustees, often unremunerated, in the charitable sector. I am a trustee of the Disabilities Trust, so I have seen for myself how much expertise, work and worry goes with the role, with little in the way of training or oversight of our performance as a Board. Volunteer trustees are responsible for strategy, managing risk, assembling an effective top team, providing both challenge and support and ensuring good governance. I am grateful to the trustees at the Fremantle Trust, and collectively they have an immense amount of expertise and experience. However, at the end of the day they are running a multimillion-pound care operation and the buck stops with them should things go wrong. It’s pretty impressive that they give their time for free! Supporting them and ensuring there are enough new trustees coming along to provide proper succession planning, is a challenge for the sector and for the Trust.

Finally, the positives of working with people who need support, being able to enhance their quality of life day to day is such a worthwhile experience and far outweighs the worries, even for a novice CEO.

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