“The care of residents is put in danger by overloading the manager with demands that have very little to do with running a good care home,” says John Burton, the Head of the Association of Care Managers.
The manager of a care home has two main areas of responsibility - inside and outside: the best possible care for residents and managing the “boundary” of the home in order to enable good care to be given within it. These responsibilities are heavy and may be experienced as contradictory, pulling the manager in opposite directions. Both may need a little explanation.
To achieve the best possible care for residents, the manager must be present. She or he must know the residents, relatives and staff, and be around when things are happening. In a care home, this means being there with people early, late and during the night and at weekends sometimes. The manager should constantly “sample” the home by going to handovers, eating meals with the residents, stopping and chatting, and by noticing details. The catering team and the housekeepers are all important too. The internal management of a care home is a complex task. “Being there” takes planning and considerable discipline because pull of the office is powerful and perpetual.
However, care homes are also part of the wider society. Although they are small communities within themselves, they are still part of a bigger community. Like all communities they depend on their environment - the people, organisations, and resources around them. In order for a care home to provide a service, it in turn must receive services. The residents come from the wider society; the staff come in and out every day. The supplies for the home are delivered. Doctors, nurses and pharmacists come and go. Social services staff and countless other professionals have constant business to do with the residents and the home. Then there’s maintenance and there used to be inspection!
These “outside” functions are the second part of the manager’s key responsibilities. However, outsiders generally do not understand that if the manager is overloaded with work that is all to do with “outside” the home, the very essence of what a care home is all about - its “primary task”, the best possible care for residents - will deteriorate and die. The manager may look very efficient and busy, and will be there from 9 to 5, from Monday to Friday, and “outsiders” will be very happy with the attention and response that they get, but the residents and staff will be very unhappy because they will hardly see the manager, and the real work of the home will be a sham.
There is one other element in this inside/outside problem for the manager, and that is the work/home life balance. Of course, all working people have to face this one, but not to the same extent as a manager who is running a “home”. Managing a care home requires many of the homemaking skills, energies and emotions that running a family home does. All the core strands of homemaking and caring - nurture, comfort, love, compassion and concern - are needed in both settings. The sustained effort of balancing and managing - surviving might be a more appropriate word - all these three elements (inside, outside and work and home) takes a toll on the care home manager.
For good care homes to continue to prosper through reliable, committed leadership, outsiders must remember not to overload the manager. By all means offer services, support and resources that are helpful to the core task (the best possible care of residents) but let the manager do the loading! Remember, if you overload a vehicle, the steering, suspension, and brakes are all liable to fail; the engine labours and the clutch burns out, and you risk losing the whole cargo. Good managers are the key to good care. If you overload the manager, you’ll wreck the care home.
(Note to care home managers: THE NEXT TIME SOMEONE TRIES TO OVERLOAD YOU, PRINT THIS ARTICLE AND GIVE IT TO THEM TO READ.)
The Association of Care Managers (ACM) (www.caremanagers.org.uk) represents people who manage direct social care in the UK. ACM campaigns for the experience, commitment and ideas of care managers to influence policy. ACM supports care managers and shares good practice, but never defends bad practice.
managing care with integrity and commitment