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Paula Keys

Paula Keys is Managing Director of HC-One.

Reflections on the last decade

The last few years have tested the sector’s resilience and creativity. Austerity, a shortage of nurses, the paucity of skilled managers, a more rigorous regulatory regime and the increased dependency of people using our services have all affected how we operate and deliver kind care.

Our own history sets out the challenges. Born out of the demise of Southern Cross, HC-One’s early years have been shaped by the sector’s challenges. We are a spirited bunch, however, and I’d like to think that we have faced these head on and found new ways of working and creative ways to do what we do best every day.

The challenge of developing a skilled, aligned workforce is not new, but we have had to be ever more innovative. To do this well, it has demanded speed and agility to ensure that developments such as the Care Certificate are incorporated into our learning programme quickly and effectively. As resident needs have increased, alongside workforce challenges, we’ve had to find new ways to measure and manage clinical risk. We’ve developed a set of key clinical indicators to see trends and risks in pressure area management, weight management, infection control and medicines management etc.

It is all too easy to become distracted by challenges and be overwhelmed by the volume and necessity for change. Remembering why I do this job and what brought me to this sector always focuses me on what I need to do. We work hard at putting the resident at the centre of what we do and living up to our ambition to deliver the kindest care possible.

Projections for the next decade

The challenges will continue. We’ve only just started to see the impact of the National Living Wage (NLW). This will require a reshape of what we do and how we do it. Our staff deserve to be rewarded appropriately for the valuable role they play and I agree wholeheartedly with the NLW to help us do this. The reality of applying this however, given the continued squeeze on fees, is tough. We need to work harder to highlight to Government these realities, and the consequences if we cannot find a way through the dilemma of a fair fee for care.

That said, there is so much opportunity for us to work in true partnership with health, to create a better way for clients. This is the biggest challenge ahead of us. If we can work through this, we have

an opportunity to create a better way to support people when they need it most.


I started working as a retail pharmacist and discovered a passion for customer service that shaped my career. My retail roots taught me the value and importance of an eye for detail and the need for continual focus and follow up. These core operational skills were drummed into me and I’m grateful for how they’ve served me.


My dad once told me to work hard and believe. I’ve been lucky to work with great people. An old boss once taught me the value of staying close to the sharp end of the business. I hold this dear and make sure that I take time to visit homes, talk to residents and meet staff teams. My current boss has been equally influential. He has reminded me about the power of kindness.


I am privileged to visit homes, meet teams and residents. I see great homes and, from time to time, homes that need to do more to deliver the kind care we aspire to. The difference is always the manager. A great manager sets the context, leads the way and has a real grip on their business. They know residents, value staff and develop relationships with commissioners. Great managers are busy, organised and focused. But they are never too busy to stop, care and be kind. A great manager makes for a great home and a happy place to live.


I have been given some advice that has stood me in good stead. Do what you say you will do. Never over promise and under-deliver. To deliver a great service, be visible, listen hard and act quickly.

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