Care Home Quality Podcast - episode 1 with Jeremy Walford CEO of Middleton Hall

In this first episode Liam speaks to Jeremy Walford, CEO of Middleton Hall Retirement Village. It's a large site encompassing a retirement village and nursing home care. Jeremy has achieved an overall CQC rating of Outstanding for his organisation.

Here he shares his story and insights with Liam.

Jeremy Walford, CEO of Middleton Hall, joins Liam in an interview in this podcast.

--- Here's the full transcript --

Introduction

Liam:

Hello everyone. This is Liam Palmer your host for the care home quality podcast and this is episode 1 where I interview Jeremy Walford.

Jeremy is the CEO of Middleton Hall Retirement Village and just a few notes before we start that interview.

So I met Jeremy on the 6th of March. I had driven for nearly six hours before meeting him. I was exhausted and slightly anxious actually, it was my first podcast.

"like John Lewis, Jeremy has actually transferred the ownership from him to his staff... that's quite something, it's a very selfless gesture"

Despite my bravado at setting it up I was actually terrified!

My first impression of Middleton Hall was that it was different.

It was more complex and nuanced than anything similar that I'd seen.

This surprised me.

I'd ran retirement villages, Care Homes, high-end Care Homes. There were familiar touches there, but there was something different about Middleton Hall, but it was good different.

It took me a while to get it.

Afterwards on a tour, once I heard a bit more from Jeremy about him explaining his ethos, I started to grasp the depth of Jeremy's work there.

He's developed the site over 22 years, so there's just layers and layers of detail, of excellence.

It's just extraordinary actually.

"in my experience running fairly large Care Homes getting a CQC rating of outstanding when you've got so many residents and a big staff team, there's a different approach to do that"

So a bit more about Middleton Hall. As I said it's a large Retirement Village. It's in Darlington in County Durham in the north of England.

Jeremy and Middleton Hall came to my attention for two reasons.

Firstly Jeremy has decided to move the village to co-ownership with the employees. So, like John Lewis, he has actually transferred the ownership from him to his staff.

So that's quite something, it's a very selfless gesture and he'll talk more about that on the podcast.

So that was one reason why Jeremy and Middleton Hall came to my interest.

Secondly is that they got an overall CQC rating of outstanding.

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Now for any service, that's exceptional. But in my experience running fairly large Care Homes getting a CQC rating of outstanding when you've got so many residents and a big staff team, there's a different approach to do that.

And I just knew that I'd been for something special when I went to see Jeremy and I was to be fair but I'll explain a bit more about that in a moment.

I was genuinely interested in meeting Jeremy.

"what was special was the ingenuity, the creativity, the relentless obsession with championing the needs of the customer"

He had a business background. He had an MBA, the CQC rating, the employee ownership decision.

It's suggested that he'd be a Visionary, it's suggested that he was a man of values and both were proved to be so, but in a way I didn't expect.

What struck me about Middleton Hall as I walked around and saw what Jeremy and his team had done there, he had taken some principles that work and he'll explain those in the interview.

But what was special was the ingenuity, the creativity, the relentless obsession with championing the needs of the customer.

That's what struck me, and I think that's what was different when I walked around, you know subtle differences and Jeremy will explain more of that in the interview.

It was the first time I've met Jeremy and what I found was he's not a man of too many words, but the words he does use he uses with precision.

There's depth behind his statements, his value and his positions.

There are secrets in this interview if you tune in, so let me get out of the way.

I hope you enjoy this as much as I did. It gives me great pleasure to introduce Jeremy Walford.

The interview

Liam

Hello everybody.

This is Liam Palmer here. I'm delighted to have Jeremy Walford with us today.

We're going to be hearing from Jeremy about his career story, about how he came to be managing and running this incredible Retirement Village.

We want to kind of really understand some of the steps and decisions he took that that brought him to here today.

So, the first part of this interview is going to be about his career and the second part is going to be about him as a leader and can what we can glean from those different steps.

So if I may Jeremy, and very warm welcome and would you like to tell us about your work today and kind of where the village is at, so that the listeners can get some sort of idea of what you're overseeing here?

Jeremy:

Middleton Hall Retirement Village today has about 200 people living here. It employs around 180 people and we've grown from being a nursing home in 1996, although found in 1900 originally.

And we now offer several different services on site, which run all the way through from independent living in retirement housing, all the way through to nursing care.

Liam:

In terms of when you were studying either at University or college and then I gather you moved into industry, could you tell us what your thoughts and sort of decisions were that sort of led you from that path?

Jeremy: Yes, actually if you'd asked me when I was 21 leaving University about where I'd be at the tender age of 56, I would not have thought this would be the answer.

"The one thing I had brought with me is a clear understanding of the importance of where the customer sits in making business decisions."

So, I left University having done a fairly useless economics degree in Practical terms and worked in the automotive industry for a period of time.

What led me to Middleton Hall ultimately was a complete chance.

I ended up working as a Management Consultant following an MBA, and was asked to provide a little bit of advice and a business plan for a nursing home in the north of England.

And I had to put out to the then board of directors that they didn't need a business plan, they actually need a rescue plan because financially it was in a fair mess.

So I ended up having never been to a care home, knowing nothing about social care, becoming a director managing director of the company and indeed the main shareholder over a period of time.

So it wasn't a career choice. It wasn't a career plan.

It just happened and sure what I would say is that it's probably been any question has been the best thing I've ever done it in my life, from point of view of work.

Liam:

I mean, certainly, you know looking at over some stuff you did, basically a website about the consultancy, business planning and customer service, how do you think, or do you think some of those skills have helped you to be successful?

Because it's quite a significant work me talk about a bit later about what you've done here at Middleton Hall, do you want to talk us through that a little bit?

Jeremy:

Yes. I've always had a good understanding of customer service. I worked in the automotive sector for Volvo for a period of time, who in the 1980s were extremely focused on who their customer was and what those customers actually expected.

So, the one thing I had brought with me is a clear understanding of the importance of where the customer sits in making business decisions.

Liam:

Do you want to talk to us, I mean, obviously is it 22 23 years registered in the Hall?

Jeremy:

Yep.

Liam:

Yeah, so, could you give us a couple of steps there in terms of it could be the first X years.

It could be where you've you know developed it kind of a little bit of a narrative over that long period that would be really helpful.

Jeremy:

Well, I used to apologize for the fact that I have no background in Social care or any particular understanding of how things are supposed to work.

I think reflecting on my 23 years, what I would say is it's actually probably been an advantage.

So, when I turned up to view a struggling nursing home, the first thing I did was go and visit some care homes that had been recommended as being good, and actually, I thought they were poor in that I would not have wished to live in them myself or indeed have my parents live in them.

So our initial business plan written in 1996 was all about creating somewhere I would be happy to live in.

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I didn't even know it's called Retirement Village of the time but that is what it turns out to be called and the principle of it was that we would rather be an institution where people are fitted into a building and working practice.

It would work on the basis of people having their own space, be it a property, be it a room, whatever it might be and us providing a service that they wish to support them to live.

The wonderful team of Middleton Hall.

Liam:

And that's contrary to, as you touch on the kind of institutional model that's quite prevalent.

And do you want to explain a little bit about how you've developed with your team, The Village, from that nursing home to t what's here sort of in Broad terms?

Because I think the depth of services and approaches you've got here is quite unusual, so I think that would be really valuable.

Jeremy:

Yes, I think what we do have is relatively unusual for the UK.

The story that it really is, is entirely based on the financial situation that we were in, in 1996.

We were a very poor prospect for a bank at the time so we had to go about it on a very gradual basis. If we'd have greater resources, we would have developed the Retirement Village a great deal faster, but finances never allowed us to do that.

So we spent really the best part of 10 years struggling financially, borrowing increasingly large sums of money, from a very small amount of our first loan of 20,000 from a very suspicious Bank, through to multimillion-pound loans.

But it was dictated by the speed at which we could raise money in order to develop the services, and as time went on we got bolder.

And as we got more successful, we then got bigger as well.

Liam:

Do you want to explain a bit about the specific, if it's okay, to the specific service, you've got on site here?

Jeremy:

So effectively we have three independent Services. The Waterside, which is the UK's first zero carbon retirement housing I believe, built over the last six years. We have Middleton Woods, which is leasehold two bedroom apartments and a few one-bedroom ones.

We have Middleton Grove, which is a really a hybrid product.

It is registered as a care home, but people live in one bedroom apartments with a very Hotel style of service - many of our residents in there would not even know they were in a care home supposedly.

And then we have our main care services.

So we have what was historically residential care which we now split into Hotel living and supported living.

We have Middleton Courts which provides what's conventionally being called nursing care and we have Middleton Oaks, which is a small group living scheme based on the Dutch model of care, primarily but not exclusively for people living with dementia.

"We've based it on what we think is the best for the customer."

Liam:

I mean having just walked around with you today, it was very gracious of you to do the tour. It really is a remarkable facility.

And yeah, thanks for explaining the breadth of services here.

Okay perfect. I want to move on a bit with that just to see if there's anything we've missed regarding that career story that our listeners may be interested in.

So, have there been any significant mentors, encouragers, in this journey that have spurred you on, inspired you, helped you in any particular way?

Jeremy:

Not especially. I think based in the north of England, developing something, completely new service, there was little for us to look at in comparison in the UK.

We did look, and I visited in 1997, America to look at their Retirement Village service, at which point I actually knew what they were then, what a retirement village was because I'd actually physically seen one.

But there wasn't very much to go on with, in the UK, and we were aiming to do things differently all the way through.

So, if you look at Middleton Hall today, all our services are differentiated from our competition in one way or another to make sure that you know, we haven't based anything on what other people do.

We've based it on what we think is the best for the customer.

The other thing that's important to explain, is that whilst we've developed physically by building, we've also spent a lot of time developing the people, to develop with the physical development because there's absolutely no point in building new facilities if you then don't fill it with dedicated, suitable people to actually run it affects the customers.

The team that makes it all possible!

Liam:

I know that that kind of whole staff engagement is something really really important to you.

I know you got some awards for skills for care, I think? And various other things.

Do you want to explain about the transfer of ownership? Does that make sense?

We can always edit to that, but otherwise, do you want to just explain then, Jeremy, about this next step in the next month and your motivation for doing that, please?

Jeremy:

So, I think I could safely say Middleton Hall at the moment has a brilliant, dedicated, very engaged team of people looking after our residents and customers.

And in many ways on the private ownership, I feel that we've taken the level of engagement as far as it can naturally go.

So, employee ownership solves two problems for us.

First of all, it deals with what happens to the long-term ownership of the business, because in selling somebody else there's no guarantee that the vision and values and the ethos of what we're actually doing here, stays with the company.

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And secondly, it gives us the opportunity to perhaps even enhance our level of employee engagement, because from April all our employees will be co-owners under an employee ownership trust similar to John Lewis.

So; all the employee-owned organizations I've visited over the last three years while I've been researching employee ownership, all tell me that staff become more engaged, customer service improves, employee/ staff turnover drops and they see many subtle benefits of being employee-owned.

Now, I happen to believe at the moment we have some very engaged staff, offering excellent customer service, which is what both our staff tell us and indeed our customers tell us, but if there's some room for improvement in that, then that's terrific from our point of view.

Liam:

Yeah. It's a really really exciting innovation that you're bringing this to social care, so I look forward to following that with great interest. So, thank you for sharing that.

And just three other questions then to sort of wrap up this career part of the interview.

So firstly Jeremy, what's been the most challenging aspect of running this Village, or developing it over the last 23 years?

Jeremy:

I think probably in our case the most challenging aspect has been some of the financial issues because of where we came from.

So, raising the money, we went through the credit crunch with some interesting banking pressures on us, at a time of doing our first very significant development and offering lease-hold properties for sale, which was pretty challenging.

And in the midst of all that, we'd built Middleton Woods as a joint venture with a housing operator who went bust on us during the recession.

So that was pretty challenging because we actually had to buy them out and borrow more money from the bank at a time that banks were pulling back on lending, so that was pretty exciting.

Mysteriously, we managed to get through that and certainly we've had some other financial challenges.

Organisationally, I think we seem to have been very blessed from a people point of view.

And actually, the challenges in terms of employees have been pretty limited, I would say.

Middleton Hall Retirement Village.

Liam:

Okay, and secondly, I just wondered, you know reflecting on your career trajectory and a mixture of experiences, what would you consider your kind of strongest transferable skill to this work?

Jeremy:

I think the most important thing is having an absolutely clear vision of where you want to get to and everything is started with us wanting to be absolutely the best that we can be, and that applies to what we physically built and how the people have developed around that.

So, absolutely Crystal Clear Vision of where we need to be, and then embedded values in how we've actually gone forward at all times with all the team on board.

"Residents come first, employees come second, and financial performance comes third"

Liam:

Brilliant, superb, and thank you, it's extremely succinct.

A lastly on this section then, what do you, obviously you've added lots of parts, as you show me on the tour, to the Village overall and obviously some of that will have some sort of personal meaning to you.

What are you specifically most proud of regarding the village?

Is there anything in particular or is it just one big piece of work and part of your life? How do you see it?

Jeremy:

I think there's much that all our team will be proud of it at Middleton Hall, and I think my overall sense of achievement with it is the fact that we actually make a difference to people's lives.

That means both our employees because we're giving them opportunities they might not otherwise have had, and most significantly, residents who actually live here because social care is often regarded particularly Care Homes as being a kind of place to fester away.

Middleton Hall has clearly set out that people should be coming here with the opportunity of actually improving their lives.

I think the thing that gives me the biggest pleasure in terms of what we've achieved Is seeing residents in making significant improvements to their lifestyle as a result of moving to our village.

More about Jeremy

Liam:

We are now going to look a little bit more about the makeup of a leader, about what makes someone's motivation, their drive, and to ask a few questions to Jeremy about his life, and what makes him the sort of person he is, and therefore to know how to kind of connect that with what he's done, and kind of to know him a bit as a person as well.

"I wanted to do something that would make a difference."

So, firstly Jeremy, where were you know brought up?

Any particular interests at school? Any particular sort of stories from day dot to help us, the listeners, to get to know you a little bit?

Jeremy:

So, I was actually born in the north of England but spent most of my adult life up until 1996 in London and the south-east.

If you asked me at school what I wanted to be, the answer would have been I'd have been wanting to play cricket for England. Sadly that wasn't much of a possibility.

I think at some stage I was seeing myself as being someone that would have worked in a profession.

I didn't realise what I really wanted to do until 1989, when I was sat on top of a mountain in the Himalayas, recognizing that what I did for a living, which essentially was to work for a manufacturer of cars, wasn't really going to be a marvellous thing for the world and long-term.

And actually; that was the moment I realised that I wanted to do something that would make a difference.

I had no idea it was going to involve Middleton Hall or social care or anything like that, but I did realise that I wanted to run my own business that provides real value and makes a difference to people.

So, I guess that's where some of my values stuff comes from. And the reality is you can't quite separate business from your own sense of values.

So, I've always had a strong feeling that I never want to have to cross the road because of doing someone a disservice and that would come from my parents.

Middleton Hall Retirement Village wins award!

My father was very dedicated as an accountant, was always very, he never would have seen it as being customer-focused, but he would never want to let somebody down, and I think I inherited a fair bit of that from him.

So, in running a company like Middleton Hall, of course, that's some of the ethos that you bring, because that's part of my personality.

In the same way, I have great concerns about what us humans are doing to the planet at the moment.

" the reality is you can't quite separate business from your own sense of values"

So, it's no surprise that one of our values of the organization is about sustainability, and indeed we have a fantastic group of sustainability champions that look at how we are using energy, how we are recycling, and yeah, I can't pretend that that's a coincidence that it's about my personal beliefs that have somehow slipped into the organization when I wasn't looking.

Liam:

And it in terms of, obviously prior to care, doing the other management work, I mean what makes up your values as a manager and leader?

Can you talk to us about that a little bit?

Jeremy:

Well, certainly in my early career work for two organizations in the automotive sector, one who I won't name who taught me everything about how not to run a company - very big company worldwide, essentially because they had no understanding of what empowerment was about so nobody can make a decision.

I then worked for a very different type of smaller organization, European car manufacturer, and learn much of how to run a company through them. So, although I would suggest that working in the Automotive sector has nothing to do with social care. I probably did learn one or two things.

Liam:

And obviously in terms of empowerment, so how would you describe, because I've seen it myself, but for those listening to the podcast, how would you describe the culture of working here?

Because like you said this is in some ways an extension of your values. How would you describe the culture here?

Jeremy:

Well, I think this comes from one of the essentials for this type of organisation, which is having a very clear vision.

And I think if you ask any of our employees, and indeed when recessed or investors in people, they do ask our employees, everyone stands what we're here for and we're consistent in how we understand that, in that none of our Managers from myself as a managing director, none of our managers would operate any differently without understanding what our vision of values is about it.

So, we do demonstrate how we expect everyone to operate, and that shouldn't mean that when one of our residents has a question about something or challenges something they might want, there's a clear understanding that we should be able to do that because that's what we're here for.

"The Chief Inspector of the CQC was speaking to Jeremy about getting the overall rating of outstanding and asked how he felt about it. Jeremy said he had mixed feelings as it could lead to complacency, and I thought that was just a great example of a sense of humility in leadership in my experience quite rare and certainly inspirational."

So we try and be consistent at all times around focusing on the customer, and yeah appreciate social care, that's very much about being... Personalised care and everything but ultimately it's just about making sure that we understand what a customer actually wants and then letting people be able to take those decisions, because there's no point in someone working in one of our care services or working in front of house or work in the gardens having to question things all the time.

You need them to be able to make those decisions.

So, one of our gardeners had the idea about a few years ago, about whether he talked a few residents found they're interested in birds. Next thing you know, next thing I know, is we've got bird hide and a wildlife area.

And yeah, we did a bit of okaying to it, but yeah, that wasn't my decision.

It was somebody who had spotted something that would benefit our residents and would fit with our vision so easy, all gone, all done.

He sorted it all out and within a matter of weeks it was there, and residents were using it.

The peaceful setting that residents of Middleton Hall enjoy.

Liam:

It's quite a broad question, but if you had one piece of advice for someone looking to purchase a large care or nursing home, someone that would dream of the sort of CQC ratings you've got, not knowing kind of what's in store at all, what advice would you have for them in terms about to make that decision and what advice would you give them?

Jeremy:

I think my advice to start with, be in it for the right reasons, because if you're there purely for financial reasons, you will find it a challenging, you'll find it challenging in terms of quality.

"my overall view would be if it's purely for financial motivation this might not be quite the sector for you"

We're very much a quality driven organization. And our focus is fundamentally on our residents and our staff.

So, I think my overall view would be if it's purely for financial motivation, this might not be quite the sector for you.

Liam:

Okay, superb.

And something that we talked about briefly when we were not on air as it were, did you want to just explain about those three priorities, because I thought that was really encapsulated your approach really nicely?

Jeremy:

Yeah. I mean, we've always, the business has always been run on the basis that residents of customers come first, employees come second, and the financial performance comes third.

Now obviously, we all need to generate a profit in a sector to reinvest, but those are how we make many business decisions.

So customers first, employees and then financial performance.

And mysteriously, what we found is that financial performance follows the first two rather nicely.

Liam:

Thank you. And lastly, you talked briefly when we're off air about this sense of engagement with the detail and you were kind of explaining that that's part of your successes.

Do you just want to explain your thinking a little bit more there?

Jeremy:

Yeah, I think for many of our residents they take it for granted that they're going to get a nice apartment or a nice room, that they're en-suite's going to work, that you know, they're going to get a menu choice etc. etc.

"it's the level of detail that they notice"

Very often it's the small details that make a difference. It's the fact that when they walk into the spa they're addressed by name, its the fact that when they're in our orangery someone actually knows that they like their coffee made in a particular way or that they don't like onions or whatever it might be, because that's the level of detail that they notice.

Liam:

Fabulous. Thank you so much, Jeremy. I think we'll wrap up there. And thank you for your hospitality, and I hope everyone who listens to this thoroughly enjoyed Jeremy's conversation. Thank you.

To conclude...

Liam:

Thanks again to Jeremy Walford there for this candid and I think insightful interview.

I wonder what stood out for you. For me, it was his skill with finance, it was his importance placed on customer service, it was that sense of obsession about getting it right.

What also came across strongly was the sense of staff empowerment and staff engagement.

And finally, Jeremy shared an anecdote with me in between recordings, which I think I think speaks for itself.

The Chief Inspector of the CQC was speaking to Jeremy about getting the overall rating of outstanding and asked how he felt about it.

Jeremy said that he had mixed feelings as it could lead to complacency, and I thought that was just a great example of a sense of humility in leadership, in my experience quite rare and certainly inspirational.

And so if you want to contact Jeremy go to his website. That's Middleton Hall Retirement Village, Darlington.

You can find them if you Google him.

Also worth a day out if you want to go and see what Excellence looks like with a retirement village setting.

Give Jeremy a shout and you may be lucky and he'll give you a show round.

What's next - Episode 2

So my next guest on the show is Samuel Barrington.

Samuel is the CEO of Care Improvement Associates. He's a Pioneer and innovator in the care consultancy space.

He's big on LinkedIn and an influential voice in social care.

A really interesting and insightful entrepreneur and social care professional. I'm sure you'll love the interview and get a lot from it.

And finally, I'd just like to thank you for subscribing.

Thank you for listening. There's more great content to come. Comments, suggestions and feedback are always welcome.

Bye, for now.

I'd like to close by thanking my sponsor, the provider of the popular job websites Nurses.co.uk and also at Socialcare.co.uk.

The guys behind the business work hard to make the very best social care jobs accessible, with lots of useful free content about how to navigate the social care job market and how to get on.

So, whether you're looking for a new Social care job or wanting to advertise one, they're well worth a look. 

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