Speaker1: [00:00:00] We are still seeing what I would call the long shadow of the pandemic. Spirituality is about connecting with something beyond and when it's adding 3% to our wage bill, how do you do that when the funding is so challenging? You have the creativity of being far more independent. It's not just a feel-good. The money doesn't get passed on and never-ending daily effort and challenge. We've got things like robotic pets and hug dolls, which actually provide a huge amount of comfort. The hard thing is when you know what needs to change, the NHS always draws the resource always draws the attention.

Speaker2: [00:00:36] Voices of Care, the healthcare podcast.

Speaker3: [00:00:40] Sam, welcome to Voices of Care. It's really good to see you here today. It's bright sunshine. I'm just going to give you a bit of warning. We've got some roadworks right in front of the building, so that might interrupt if we have to go back over. Hopefully not. It's been a long time since we've met, and I was really keen to see you. And I think we better start with some anniversaries to celebrate. It's seven years, I think almost since you took the helm at MHA, otherwise known as Methodist Homes. Congratulations. But the other one, we're sitting here five years from Covid. And I guess we should honour and let you honour the people and the whole memory of that, because I think it was very visceral for all of us and for you especially. 

Speaker1: [00:01:23] It was very visceral. And we had a moment of reflection across MHA on Monday at 11 a.m., where all our homes and schemes and our head office colleagues all came together virtually and had a two-minute silence. But I wasn't anticipating within that, two of my colleagues, one from field, one from our central support, who gave their reflections, and suddenly you found yourself falling back into the memory of five years ago. And just how huge, how profound the newness of what we were dealing with and the scale of what we were dealing with and just the sheer sense of loss and uncertainty that we were gripped by. So no, really powerful. And I think we certainly are stronger as an organisation for the way that we came together to tackle and battle through those years. But it had a profound effect on so many people. And I think we are still seeing what I would call the long shadow of the pandemic in terms of the toll on some people in terms of health, but also mental health, and also the toll financially because of what it did to the adult social care sector as well as the nation as a whole. 

Speaker3: [00:02:38] Absolutely. And you said it's perhaps the thing you're most proud of in your professional career to lead through that. We won't go back to fighting for PPE and all the things that you had to do. But you've also said recently that, you know, you've seen the joy return across MHA, across Methodist Homes. Another set of anniversaries of sorts. I want to just highlight there's been, must be something in the water. The last few weeks, you've had half a dozen residents celebrating their 100th and beyond. I think one lady from Poland, 106. I think the secret was vodka or something along those lines.

Speaker1: [00:03:15] Whatever it takes, whatever it takes. No, I think it's been lovely to see the life of our homes, and particularly them being integrated back into their local communities. We do a lot of work with schools and playgroups, and we found that a lot of those took a long time because they were having to focus on getting children, young people, back into school. But we're gradually starting to see our integration back into the broader community taking place. I was at one place, I'll just tell you the other day during Covid, one of our homes set up a community choir, virtual community choir, like a lot of things were going on. That's now grown to 100, and it's a real-life choir, and they come together for their kind of various celebrations through the course of the year. So there's been some amazing legacies that have been so profound and life-enhancing, as well as the challenges that we endured.

Speaker3: [00:04:05] No, absolutely. And now, one of the things I think you've been on record as saying is that during that moment, one of the silver linings, if I can call it that, was that social care became prominent. It's sort of ebbed and flowed since then. And I wanted to get your take with your huge experience around social care. I know you're a theatre fan, and the play from Samuel Beckett, Waiting for Godot, comes to mind. We seem to be waiting forever for change and reform. But interesting start to the year. A significant amount of money for the sector and the Social Care Commission being announced. 

Speaker1: [00:04:42] I think the challenge, if I'm frank, is that that's too long away. We don't get the final long-term recommendations until 2028. There will be another couple of years of argument post that. Then we will have more elections. And I know the government are trying to build cross-party support, but I think our fear is that, like so many of the inquiry reports that have been written into social care, Dilnot, for example, they've kind of remained on the sidelines and they've not led to any permanent or lasting change. I think we all have every faith in Baroness Casey, but I think the hard thing is when you know what needs to change and fundamentally, there needs to be a proper look at reform of the social care sector so that it's well funded so that it integrates effectively with health. And there's been too many reports that have already been saying that for so long. And it's the how, so yeah, that's the struggle. It's good that it's being picked up. But I think it's a long way in coming. And I can't help feel that the NHS always draws the resource, always draws the attention and that social care, particularly adult social care, kind of falls into the margins of consciousness. Certainly during the pandemic, we felt we were having a moment and we thought that that may endure. But I think experience has shown that we're in that fight zone again. 

Speaker3: [00:06:11] Absolutely. And the NHS, of course, Lord Darzi's report made it very clear that its functioning depends on a social care sector that works. And there's been huge changes, as you know, at the board across NHS England as we speak. I guess bringing it down to the fundamentals of now, you've been on record again speaking very candidly as you do. There is a tremendous pressure on the sector from the budget. I think the Nuffield Trust said something like 2.8 billion. And I think King's Fund's recent reports, Social Care 360. If you pass on unfunded costs to the sector, fewer people get care. So I guess the funding issue is immediate and urgent. 

Speaker1: [00:06:54] The funding issue has been long-standing and remains immediate. I think I go around and I go to our homes on a very regular basis, and across the country you're talking about an average shortfall of about 30%, 30 to 40%, sometimes in terms of the difference between what a local authority and I would say probably are able to pay because of their own financial pressures and what it actually costs to deliver that care. And so you've got this real kind of challenge of how do you keep your services going when and meeting regulatory requirements, you know, attaining the quality, providing people with the life they deserve to live, they want to lead. How do you do that when the funding is so challenging? And then to have been hit with the employer's National Insurance contribution? I mean, it's adding 3% to our wage bill. Even aside from the pay award that we're just about to announce to our colleagues. So I think it's an enormous challenge. For us if it goes through, it's still not been completely signed off, but it's going to cost us £4.6 million for next year, which is just enormous.

Speaker3: [00:08:11] It's not funded.

Speaker1: [00:08:12] It's not funded. And although they have said, the government have said there is additional money going to local authorities, I think local authorities seem so financially challenged themselves, we're only hearing about Birmingham earlier this week, that the money doesn't get passed on. And what we experienced during Covid was where money was directly passed to organisations providing social care. That was really effective. Channelling it through local authority just doesn't work. We just don't see that money coming through.

Speaker3: [00:08:43] Yeah, and the danger is again, as the King's Fund 360 report, I think from 2015 to 2023, the number of people getting long-term care fell from 879,000 to 859,000, despite demand growing. I wanted to touch upon the other challenge, of course, in the sector. Before we go into more detail around MHA and that's around the workforce, I mean, vacancy rates have fallen predominantly due to international recruitment over the last two years. They're still well above the average for the economy. I guess that will remain a powerful brake on providers' abilities to provide services.

Speaker1: [00:09:20] I mean, we experienced a huge hiatus post-Covid with so many people leaving the workforce. We are now back to a 20% turnover, which is, for our sector, astonishingly good. And it's back to pre-pandemic levels. It's still, you know, it's still phenomenally high compared to many other sectors. Yes, but we have had a real drive. We're a real living wage employer. We really try to maintain the differentials. Effectively we have got a really solid nursing recruitment strategy. So all those things, but it feels like a never-ending daily effort and challenge to make sure that we retain and manage and support and draw in people. When I go out to our homes, it feels a lot of it is about how well you can sustain the sense of a community within a home that keeps people bought into that. But it's sometimes getting people across the threshold in the first place to make sure they do that. But you can't walk away from the fact that our colleagues are not paid what they should for the skills that they bring, for the levels of care and patience and dedication that they show. It's not remunerated. There's something like 23% gap between what a care worker in the adult social care sector versus somebody in the NHS are paid.

Speaker3: [00:10:40] For the same work.

Speaker1: [00:10:41] For the same work and terms and conditions. And you could argue that people in the NHS are surrounded by a greater sense of expertise and an infrastructure that they can draw on, whereas our colleagues are far more out there in their homes and schemes providing that care.

Speaker3: [00:10:57] Absolutely. And I think the other statistic that struck me was from a. Few years ago, I think 2020, 1 in 4 approximately of people working in social care are either in or on the brink of poverty, which is very disturbing. To wrap this part up and to put you in the hot seat a little bit. You began your working life wanting to be a graphic designer. So this idea of designing things very quickly. We've got the Social Care Commission, we've got the ten-year plan. If there were 2 or 3 things that you could design with that in mind that need to be taken now, what would they be for the sector?

Speaker1: [00:11:32] I think fundamentally a proper workforce plan for adult social care. One that is adequately resourced to make it a career destination for young people to come into that and for people to return to that, maybe at different points in their life. I would want to see something around how well we can design the level of integration between health and social care so that we inform not only... I mean, there's been a huge kind of emphasis around discharge, but actually there needs to be a huge emphasis on prevention. And if we can dance with health to ensure that people, when they need health, can get it, and then but it's not this kind of great schism between health and social care that it's kind of who's going to catch and take responsibility for the person. So it needs to be joined up in that respect. I don't think it can be one sole organisation, but there needs to be proper collaboration. I think those would be my two big design asks. 

Speaker3: [00:12:32] So hopefully on those prescriptions. Someone's listening. Baroness Casey et al. That'll be great. I wanted to segue from that. This whole funding issue. Now you've had a very distinguished career working in local authorities, children's services, Barnardo’s before joining here. And one of the things that you're on record as saying is that working in the if I can call it the third sector as opposed to the public sector, has given you slightly more freedom for longer-term planning. And as a charity, I think one of the largest charities that's worked really well in terms of the scale NHS is able to offer.

Speaker1: [00:13:09] I think certainly making the jump probably something like 20 years ago, 17, 20 years ago to the third sector. What I was struck by was you have the creativity of being far more independent, but you have to act with the commercial savviness of the commercial sector.

Speaker3: [00:13:29] The best of both worlds.

Speaker1: [00:13:30] And that's not to say that the public sector don't seek to work with that, but they have a whole range of other constraints and political drivers, and responsibilities that shape the way that they work. So what I really love about working for places like MHA or previously in Barnardo’s is the creativity to explore and look at how you can enhance the core service that you're seeking to provide, and how you can flex and put your emphasis in different places to really give you a distinctiveness and a USP in terms of the work that we do. So I think that whole and it also attracts a different sort of person. So we've got some really creative people, and we also draw from a range of other sectors that then give it a kind of a broader mindset, I suppose, that enables people to kind of fire off one another. And yeah, it's really exciting. And to feel more in control of actually how you present yourself, how it is that you attract people, how it is that you engage with supporters. Yeah, really good.

Speaker3: [00:14:35] Now that's interesting because the third sector, people talk about it and perhaps don't know enough about it. But on a broader issue, just be interesting to get your views as you know, a hugely respected leader. We've had the charity's chief executive survey come out earlier this month, which painted quite a bleak picture. And just to get your view, because there is at the moment I wouldn't call it a crisis, perhaps it is. In terms of charitable grants, non-government grants have fallen massively. FTSE 100,  charitable giving. We've got a really constrained environment for charity sector. The third sector generally.

Speaker1: [00:15:10] I think there are a huge range of challenges for charities generally speaking. I think we know already that there's a hierarchy, so the health charities are at the top and then you work through things like children, animals and then sadly, older people's charities, particularly long-standing ones, tend to struggle in terms of that environment. I think then you've got the compounding pressures of the cost of living crisis on general donations and giving. We get a substantial gift every year from the Methodist Church through our MHA Sunday. We get other legacies that are given to us, but it's a very competitive market out there for a diminished resource. And then certainly the impact, as you say, from corporates, is increasingly challenged. And I think one of the other difficulties, and it's a bit like working to get local authority grants, government grants is people often want the new rather than sustaining what is tried and tested. And I think that's a huge difficulty. So you feel that sometimes you're just jumping through hoops to re-present what it is that you do so that you can carry on the strength of the work which is then founded with good evidence or what have you. But people often want the new.

Speaker3: [00:16:23] That's true. And I mean, there has been some interest just to finish on this point, the Centre for Social Justice produced a report, "Supercharging Philanthropy", and Chris Bryant, the culture minister, is on record as saying, actually, that reports there could be billions of pounds unlocked in giving and their argument is that if there's a number of changes but one is to shift the language of philanthropy, which seems to work in the US. I don't know if that gives you some hope. I'm just intrigued about your view.

Speaker1: [00:16:51] I did some, particularly when I was at Barnardo’s. There was a really interesting piece of research that came across, which is that the culture of the country and its history very much determined the way in which philanthropy results out of that. And whereas in America, for example, you tend to get people who are at the kind of the lower end of the financial demography and the upper end both being high givers and a gap in the middle. You just don't experience that kind of in the same way. And the high is not as high in terms of those who are more advantaged financially. And I think there is a real difficulty when we have a whole range of publicly funded institutions and sets of departments and provisions that then people feel, well, that should be something that the state is doing. And so I think what people then get drawn towards is particular causes and particular instances. But I think also with the challenge of the increasing pace of life and the dynamic and what's in the news today is not in the news tomorrow. It's how you sustain that. And I think that's really difficult. So I think you're having a very key ask, which is why at MHA, you know, we're very clear. Any donations that we receive from charitable sources go to support our music therapy, our chaplaincy and our community-based work, without which we couldn't do those services. But they are very clear additionality to the core work that we do in terms of providing our care homes and retirement living, but they enhance and add to that. 

Speaker3: [00:18:25] No. Interesting. Well, let's see if the Minister is right and there's a way to unlock billions, wonderful. Going back to MHA, your core services, it'll be great. Since we last spoke, I know that you've been looking to divest certain care homes. And in Scotland, I think. But just give us a scale, because your core services range from residential care homes and of course nursing homes and supported living.

Speaker1: [00:18:49] So what we do is we've got 75 care homes. Those range across nursing, nursing with dementia, dementia and residential care. Sometimes you will get a mix of all four types of service in one setting. We've then got 59 retirement living settings, and probably about a third to 40% of those provide care within those settings. And then we have got 49 community-based services, which I suppose fundamentally are there to tackle loneliness and isolation, people living in their own settings at home. And really what we've seen, we've done a really good piece of work on social return, on investment, and what we've demonstrated for every pound that we invest in that there is £6 of return in terms of reduced requirements on health, other forms of social care out in the community, because we know that if people feel connected, if people feel well in themselves emotionally, that then has a direct correlation with their health and their health outcomes. So yeah, so it's really important that we continue to support that. It was the area of work that I think first kind of bit the dust from local authority cuts many years ago. And so we're very reliant on trusts and grants to support that area of our work as well.

Speaker3: [00:19:58] No, absolutely. And I think that's important to get that narrative of the return that comes rather than just the cost, which is often the discussion around social care. I wanted to go to you mentioned dementia. I think you pioneered work in dementia back in 1990 with academics. I think your first purpose-built home was 2004 if memory serves me 20 odd years. And you've launched or revivified, I think your dementia strategy.

Speaker1: [00:20:23] We're now on its second iteration, the 23 to 26 version. So it will be renewed and refreshed again next year. But I think it pays because the pace of change in the world of dementia and the learning that we're doing for people who are living with dementia is iterative and so you need to keep revisiting as to what's working. So we've got a whole range of work that we do. So we've got things like robotic pets and hug dolls, which actually provide a huge amount of comfort. We have a thing that we've brought in this year called Key to Me, which is a life story model that enables our colleagues to almost develop a key to an individual with what's important to them, what's been important to their history, because it's all about recognising how vital relationship has been past, present and in the current context in which people find themselves. And then we have done a whole raft of training to better equip our colleagues to support people living with dementia.

Speaker3: [00:21:19] Understand behaviour.

Speaker1: [00:21:20] Yeah, but also working with their families. So we provided support to 600 families with dementia training so that they feel that they better understand and can support the way in which their loved one is perceiving the world and reacting to the world. So there's a whole raft of work that we're doing, but it's an ongoing array of strategies that can then enhance the life of people who are living with dementia. But I think going back to one of your earlier points, I think people more broadly, certainly within the sector, recognise but more broadly need to realise is the level of care that people are requiring, whether it's because of their living with high levels of dementia or high levels of physical need are seriously increasing. And so actually the levels of need in our homes particularly has considerably risen. And you therefore need more staff, and you need more experienced and expert staff to be able to support that. And I think you also need and when I went out to one of our homes recently, it's the energy that people need. Because clearly with somebody who is living with dementia, there is a constant re-engagement that has to take place. And so the requirement on our staff and colleagues to keep being new in that space and to keep re-engaging and going over the same issues sometimes. But actually that's part of the relationship and that's so vital.

Speaker3: [00:22:46] And actually it's been thrown into relief. The operational guidelines for the NHS 25/26 have dropped targets for dementia, and early-stage testing. And I think that an early diagnosis is really important. I think it's been the biggest killer in the last ten years. I was interested in some of the initiatives that you've had colleagues at MHA. I think it's 1600, it might be more now have become dementia friends. Yeah. What does that entail? That sounds quite interesting. 

Speaker1: [00:23:12] That's part of the kind of the training that we do. I think it's so crucial that people really understand how the broad brush of dementia, but the detail of it, how that impacts a particular individual and actually journeying with that person. So I think the whole thing about being dementia friends is very much about getting the understanding of the nuance and the journey that somebody is on because invariably it is a deteriorating journey. So it's how you keep those tags going. And things like music therapy are absolutely vital in terms of both calming and easing, but also in terms of snapshots of memory and just seeing sometimes somebody with a loved one engaging in a piece of music and then just reaching out and holding their loved one's hand and connecting for the first time in a while that this is their partner, this has been their life partner is so profound. And the power of music, the power of imagery, the power of memory to do that. And if you can activate that memory, it's absolutely vital.

Speaker3: [00:24:13] And that's been a big part of MHA. I mean, I think you've been working with Middlesex University, Padua University, people have heard about music, but music and I think movement is also one of the other parts. I yeah, I understand.

Speaker1: [00:24:26] I think we do an awful lot and I think in the life of a home, what you see is the overlapping of the various strategies. So whether that's our music and spirituality or music and our work in our green spaces or music. And the movement that we do, it's all that interlocking. And you can go, oh, yes, we're applying this strategy, but actually it's the fact that it's in concert with the others that really makes the difference. So yeah, music and movement again, because it can draw back people. And also what we know is as well, if people keep moving, whether that's ambulant or whether that's moving up a body. So I invariably find, you know, I'll walk in on an exercise class going on and people are doing armchair exercises or actually having a dance. It's just so vital in terms of that engagement on a day-to-day basis.

Speaker3: [00:25:14] And that comment you've made around the growing acuity and the requirement for training, etc. I just wanted to segue to one part of the workforce, because I know you have a strategy there, and I think there's a growing, I hope there's a growing recognition that nursing plays a fundamental role in social care. Normally people associate nursing. It's an acute setting, but that's been a big part of your work and helping people to train and become experts in that nursing field.

Speaker1: [00:25:40] I mean, we employ about 370 nurses across all our nursing homes. And they give us a huge depth of knowledge, but you need to make sure that you're attracting because obviously we're competing principally with the NHS, but then with other providers too. So we've got a really clear nursing strategy, which has been around kind of the way we recruit and induct so that people feel they're on a career journey and that we can then develop with them a career path to give them the expertise to work in our sector and to feel that they are progressing through, even to prescribing that they are learning those skills and learning those particular understandings about end of life care, around managing acute and varying levels of physical need and being part of a multidisciplinary team, because that's what our homes are. You know. You've got your coworkers, you've got your activity coordinators, you've got your volunteers, you've got your management staff, catering staff who are all part of that team. So working very closely with them. So we've drawn heavily on overseas colleagues in recent years and they've been a super asset. We've got an associate nurse programme to try and ensure that we draw people in and skill them up to then go on into a nursing career and hopefully build an affinity where they want to stay working in our sector. But we had a joyous moment the other week where I was talking to our head of nursing and she was saying, we've only got four vacancies out of the 370 this month, and that shows the power that if you do invest, you can retain and sustain that level of workforce because it's crucial to your delivery.

Speaker3: [00:27:21] Absolutely. And one other. I haven't got time to delve into it enormously, but I know it's important to what you've been doing in your own views is that the role of technology in social care promises so much, and I think we have to keep grounded this AI and all these things. But I think that going back to dementia, you mentioned obviously it's not a diagnosis of an individual, it's a diagnosis of a whole family and a group when that happens. But you've used technology quite innovatively there, I think, to keep communities and families connected.

Speaker1: [00:27:50] Yeah. We came across a really good product called Familia, where it's an internet-based product where people can create a newsletter with their loved one. So our home, the colleagues in the home will be creating the profile of what's been going on for that person that week. And similarly, whether the family are in Australia or down the road, they can all contribute to the family newsletter. And what I was a lovely moment. I was in Wales at one of our homes and they have a Monday afternoon tea and cake, but everybody brings their newsletter, so the residents are then sharing their experiences across the group and keeping in touch with each other's families. And it's just a real window. I think anything that we can do to break down the walls of our care homes, retirement living so that people don't see them as a separate community, but as one that's integrated within the local community, but then within the broader context of their family is absolutely vital. And I think the challenge, though, coming to the fast developing state of technology and we've developed blueprints for all our areas of service over the last three years, which are then the underpinning of our new strategy, which we're launching next month. But we recognise the fast pace, we recognise the potential benefits. I think for many providers, though, it's just how you do that at scale and how you get the right product, because what you don't want to do is replicate that across 75 care homes and find out a new product is coming out six months later, which is going to far outstrip it. So I think it's that judgement call and the financial level of investment that's required. And I think sometimes that's maybe where we can do the real draw on the philanthropy is that actually people always give if they can see something tangible. 

Speaker3: [00:29:32] Yes.

Speaker1: [00:29:32] And so if you can say this particular investment is going to do this, then people can maybe get a better handle on that.

Speaker3: [00:29:41] It'll be interesting to see. Hopefully the sector is very much embracing technology. And as you say, the new and the groundbreaking. Moving from the new to the perennial, I wanted to end really in a conversation to something that's very ancient and that's the idea of human beings as spiritual beings and Methodist Homes, MHA. I think 1943, Reverend Walter Hall said it. He established this or that it was established before the welfare state. At a time of the deepest need and divine goodness, I think, was the phrase that he used. Can you unpack that a bit? Because it's quite distinctive, your commitment to spiritual care and holistically looking at all the people that you provide support for?

Speaker1: [00:30:28] MHA sets out its stall as we want to meet people's physical, emotional and spiritual need recognising that that may manifest itself in a whole variety of ways, for some people it will be kind of formal religious adherents of whatever faith. Yes, we happen to have a methodist heritage and a methodist history, but we're here for people of all faiths and for people who wouldn't espouse a belief, because that spirituality is about connecting with something beyond. It's something sometimes ritualistic. It's something that particularly at a point where, you know, in all honesty, people are facing huge amount of loss and change and a recognition of mortality to be able to tangibly express that through the person, a chaplain in all our homes and schemes is intrinsic to the life of that home, and gives people permissions to have conversations that they may not feel able to have with other colleagues. And I think one of the things I was really struck by when I joined MHA seven years ago and I was kind of walking around, was, yes, our care staff are continually stopping and tending and supporting, but clearly they can very easily then have to move on to the next person who has a particular need at that time, or there is a routine of meds or whatever that is going on. Our chaplains can kind of hover over and target those who need it and spend whatever time is needed with those individuals at that particular moment. And that could be from praying with. It could be holding somebody's hand.

Speaker1: [00:32:08] It could be hearing them talk about experiences in their life that have been hugely meaningful and impactful for them. And I think also the other thing that was very profound for me when I was going around on my visit before I got the job, was I said, oh, it's so good that you've got chaplains in your homes for your residence and for their families. And the deputy manager who was showing me around said, and for our staff, because they are day in, day out, working alongside people who are coming to the end of life. They are working with people who sometimes are in quite a lot of pain, quite a lot of confusion, and actually having the resource within our teams, within our homes and schemes to take time out. And that could be a work-related thing, or it could just be something that's going on in somebody's life that they've lost somebody, they're going through a particular trauma or difficulty and actually having the capacity within the organisation to recognise the otherness that not everything is just physical or emotional. But there is that broader spectrum, however people may vision or interpret that. And I to be frank, I probably get more compliments from people who I would say are people who would say I am not a person of faith, but about our chaplaincy service from them just because they can recognise that at that point of need, there has been that resource there available to them.

Speaker3: [00:33:33] No, it's very interesting and you speak very passionately about it. I saw I think it was expressed very well in spirituality is about the goodness that we seek for each other, which I thought was really beautifully put. And I'm familiar with the work of Professor Harold Koenig, who's at Duke University. He's a psychiatrist, a physician who's written about the spirituality, religion, and healthcare nexus for decades and has promoted its efficacy very, very powerfully. You mentioned the chaplaincy a couple of times there. I think, again, that's a distinctive part. And these are individuals who are not brought in from outside. They're part of the program.

Speaker1: [00:34:12] Yeah. I think we recognise the pressure on churches generally in terms of diminished numbers. And so people are ministers. Priests are stretched across, and other religious leaders are stretched across a whole diversity of people in their communities. So MHA has invested and I'm not sure where we stand in their rankings, but I think we employ about 120 chaplains across our homes and schemes. One of the largest employers of chaplains as a workforce. And so it gives us a real command and understanding that we can then share in terms of the learning. And we see it as something where it's not just a feel-good, but where we can actually start to measure impact. So we've got a range of work going on at the moment to actually test the outcomes. And there was a really interesting one that came up the other day, which was we've just had our resident and relative feedback from our care homes, which was really strong and supported about 94% satisfaction, which is what you want to hear. But what we did in the analysis is realised that where we know we've got really engaged chaplains, that really seems to have an impact on the residents feeling safe, feeling that they belong somewhere and are part of a community and that they feel heard within that space. So we're starting to kind of sift out what the feel-good is in terms of the realities of that as well.

Speaker3: [00:35:32] So to finish off, new strategy coming out, you're clearly as passionate as you were seven years ago when you joined it. Any particular things you're really looking forward to over the next 12 months at MHA?

Speaker1: [00:35:43] Yeah, I think we have got the launch of this strategy. It's got clear focus on our people, our places and our processes. We've been working on these blueprints for the past three years. It's the culmination of that. So I think it's the energy. And I think, you know, frankly, we have been through five very, very tricky years. That long shadow of Covid has had a huge impact. And I think it feels a moment where we start to step forward and start to look at how we're going to grow and develop into the future with more solid foundations and with a workforce that is so passionate and so desirous to try and make that difference. And so, yeah, it feels like a real moment of opportunity and I'm just hugely humbled on a daily basis by my colleagues out in the field and at our head office, just for the way that they work in concert, to try and make sure that we enable people to live the life they want to lead in their later years.

Speaker3: [00:36:46] On that inspiring note, Sam Monaghan, thank you so much for your time and your wisdom today.

Speaker1: [00:36:51] Thank you.

Speaker3: [00:36:52] Pleasure. If you've enjoyed this episode of Voices of Care, please like, follow, or subscribe wherever you receive your podcasts. And if you want to learn more about how we're turning the dial on health and social care, please visit newcrosshealthcare.com/voicesofcare. In the meantime, I'm Suhail Mirza. Thank you very much for joining us and I look forward to seeing you on the next episode. 

Speaker2: [00:37:11] Voices of Care, the healthcare podcast.