In this post
Introduction
According to the Office for National Statistics, there were an estimated 372,035 care home residents from March 2022 to February 2023, and the numbers are increasing. Care homes are fundamental in providing vital services, care and support to those who need additional help with day-to-day living and their families. They foster well-being, safety, and community for residents and relieve pressure on healthcare services, thus benefitting society.
Care homes come in all shapes and sizes and are home to various residents, such as older people, those with chronic health conditions, disabilities, learning difficulties and people at the end of life. Each resident will have unique needs and wishes, which care home providers must meet to ensure they provide person-centred care to promote health and well-being.
Managing a care home is rewarding but demanding and challenging. The environment is dynamic and fast-paced and requires those responsible for day-to-day operations to deal with multiple demands, including keeping residents, families and staff happy, healthy, safe and secure. They also have significant responsibilities regarding compliance, making the care home a success and enhancing outcomes for those living and working at the care home.
Effective care home management is vital, as it promotes a positive culture, ensures everything runs smoothly from day to day and enables managers and staff to provide the best possible care to residents. This blog post aims to identify and discuss the key skills and qualities necessary for successful care home management.
Leadership and Communication
Leadership is “a process of influence that occurs in a group setting towards the achievement of a common goal” (Health Education England). When leadership is strong, staff are encouraged and motivated, and everyone is connected by a common purpose and shared vision. Strong leaders build trust and positive relationships with their team, recognise their achievements and communicate effectively to foster a positive working environment.
Strong leadership is fundamental in care home management for the following reasons:
- It helps to make important decisions – there are a lot of decisions to make when managing a care home, some of which can be critical to its operation and the safety and well-being of staff and residents. Strong leaders have the right skills and confidence to make good, informed decisions regarding all aspects of care home management.
- It shapes care home culture – leaders can make or break an organisation. They set the tone of the culture, and people will naturally follow by example. Strong leaders are role models who lead by example and demonstrate the values and behaviours they expect from their team. Their actions can strongly influence and empower those around them and can boost staff morale, attitude and performance, leading to better productivity and enhanced care.
- It helps them to manage resources – whether it is staffing, finances, facilities, food, or equipment; a strong leader can help effectively manage these resources to ensure the care home is a success.
- It promotes continuous improvement – strong leaders strive to be the best they can and recognise and are committed to continuous improvement. They turn challenges into opportunities for learning and growth to ensure they provide the best possible care to residents and their families and a happy workplace for staff.
Leadership is a fundamental aspect of care home management, as it significantly influences the quality of service, staff morale and productivity and the overall well-being of residents and staff. Care homes that are rated as outstanding are typically managed by outstanding managers
Communication goes hand in hand with leadership and is a fundamental skill you must have as a care home manager. It involves delivering and receiving messages and information effectively through writing, verbal, non-verbal and visual means. You will communicate and interact with staff, residents, families and external stakeholders, such as health and social care professionals. Here are some examples of effective communication strategies:
- Assess your current communication strategies for effectiveness and identify what is working and what requires improving. Ask staff, residents, families and external stakeholders if they are happy with current communication channels and if they have any ideas for improvement.
- Consider using various forms and methods of communication, such as face-to-face, letters, emails and messages, to share information with those who need it. Be mindful of non-verbal cues, body language and tone when communicating in person.
- Introduce digital tools and technologies to make communicating easier and more efficient. Skills for Care has further information on using technology in social care here. It is important to note that people have varying communication preferences and barriers, e.g. some older people may find it difficult to use technology, so try and find ways to overcome these issues.
- Ensure that communication is clear, open and consistent, and tailor it to your audience, as it will foster trust and build positive relationships, e.g. avoid using jargon and technical terms when communicating with residents and families. Encourage ideas, suggestions and feedback to facilitate two-way communication channels.
- Actively listen to people, which means paying attention, listening with interest and without judgement or interruption, asking questions to clarify, acknowledging what they have to say and demonstrating their message has been received. Have an open door policy and set aside time to listen compassionately and empathetically to the concerns of staff, residents and families.
Leadership is critical in fostering a positive work culture and promoting teamwork, as it inspires, engages and motivates staff to work together and collaborate to achieve common goals. It also gives direction and purpose to their teams so they understand their role and responsibilities in contributing to a positive culture in their workplace.
Organisational Skills
Managing the day-to-day operations of a care home is no easy feat. It is a fast-paced role where you will deal with multiple demands and must adapt when the unexpected happens. Therefore, you will need strong organisational skills to succeed. When organised, you can prioritise, remain focused, manage time effectively and meet those essential deadlines. These skills will also help you set goals and delegate effectively.
An essential aspect of your role will be to manage schedules, staffing levels, and resources. To put those organisational skills to the test and ensure you manage these areas effectively, you could:
- Have effective schedules for each day and week, as it will establish a routine for residents and workers. The predictability can reduce stress and improve efficiency. However, do not be afraid to be flexible and change schedules where needed.
- Plan and implement a staff rota once you have decided how many staff you need. The rota should list your staff and contain other vital information, e.g. working hours, locations and their responsibilities. You can use technology for support. Skills for Care has further information on safe staffing here.
- Complete a risk assessment and have a contingency plan where staffing levels could negatively impact resident and staff outcomes and well-being, e.g. ensure there is cover for staff emergencies. There should always be sufficient qualified, competent, skilled and experienced staff (CQC).
- Have a plan for everything, such as staffing, food, facilities and finances. Effective planning can help you stay ahead of the game and organised.
- Use care home management software and other available technologies, e.g. apps and tools, to keep all the information in one place, which can help manage resources and schedules effectively.
Working in a care home with vulnerable residents requires excellent attention to detail. They will have various needs and routines, which you must accommodate to provide resident-centred care. It is also necessary to avoid mistakes potentially leading to safeguarding and health and safety issues, e.g. medicine errors.
The ability to prioritise tasks in a fast-paced environment is also necessary, as care homes are dynamic and unpredictable environments with a lot going on. It can help to put tasks and problems in order of perceived importance or urgency to enable you to adapt (Ludlow et al, 2020).
Staff Recruitment and Training
Recruiting and retaining staff is a significant challenge in the social care sector, but you must deal with it head-on if your care home is to be successful. Recruiting and training new staff is expensive, so you want to get right and having the following skills can help:
- Written communication skills – you will require excellent written communication skills. You may need to write engaging and accurate job descriptions and advertisements to encourage people to apply. You may also have to produce clear and robust policies and procedures for staff to follow.
- Verbal communication skills – how you verbally communicate, i.e. convey information using words and tone, with job applicants, new staff, and experienced staff is vital and can influence their opinion of you and the workplace. Communicating openly and clearly can build trust and positive relationships.
- Interpersonal skills – include the ability to communicate and how well you interact with others. These skills help you build and maintain positive relationships. If you are standoffish and unwelcoming, it is unlikely that staff will want the job or remain in it. Be approachable and friendly while remaining professional.
- Observational skills – observing what people say and do is important, especially when interviewing candidates. You want to attract people with the appropriate values, behaviours and attitudes. Ask yourself, would you ask this person to look after your own family members? If the answer is no, you will have saved time and money recruiting someone else. You can also use observational skills to gauge staff morale and productivity and make necessary improvements.
- Active listening skills – whether in interviews, in meetings or having conversations with staff, it is essential to pay attention and engage with what they are saying. If you come across as disinterested and dismissive, it can make staff uncomfortable and they will be unlikely to raise concerns in the future.
Staff must be properly trained and have the correct knowledge, experience, skills and personal qualities to carry out their roles effectively and safely. If they do not have appropriate training and are not competent, it can lead to errors, poor care and even harm to residents in worse cases. An elderly resident died when she fell from a hoist, and one of the causes was that carers had no training in how to safely use the sling (SHP Online). Mistakes can be costly, leading to enforcement action, prosecution, reputational damage and even care home closure.
Regulations, standards, technology and equipment are ever-evolving, so ongoing training and professional development are important to ensure staff are competent and provide the highest quality of care to residents. It will make staff feel valued, as you are investing in them, making it more likely they will want to stay. It is also a legal requirement, and regulators will look at staff training during their inspections.
The social care sector is stressful, and your staff will face various challenges. The working hours, residents and families can be demanding, and the work is fast-paced. You have a vital role in providing support, direction and guidance to staff members to enable them to succeed and make it more likely they will want to continue working for you.
Further information
Resident-Centred Care
Resident-centred care is essentially the same as person-centred care, and it means providing care home residents with personalised and holistic care that meets their needs and respects their wishes. They are all unique individuals with different physical, medical, emotional, social and spiritual needs, and their interests and preferences will vary. Therefore, it is crucial to tailor care plans to ensure:
- Each individual is placed at the centre of their care and support.
- The care and support match the needs of the individual rather than trying to make a person fit existing routines or ways.
As a care home manager, you have an essential role in promoting dignity, respect, and autonomy for residents in your setting. You will need to get to know and understand them and their families and respect their views, choices and decisions. You will involve residents in decisions about their daily routines, activities, and care and empower them to actively participate. You will also ensure residents can live as independently as possible and balance their independence with safety and support. It will help you set an example for your staff to follow, which can enhance residents’ well-being and outcomes.
Resident and family involvement is the cornerstone of resident-centred care, as it enables them to become active participants in decision-making and care-planning processes to ensure the care and support meet their needs. Here are some examples of strategies for involving residents and their families:
- Create a supportive environment where they feel welcome, valued, cared for and respected. Take time to get to know them, even if it is a small chat, and be approachable and friendly.
- Complete an initial assessment with a new resident and ensure they and their family are involved. It can help you identify and understand their needs and use the information in a proposed care plan.
- Ensure everyone agrees to the care plan and involve residents and families if and when it requires reviewing. Keep them well-informed about their care and invite them to care planning meetings and reviews.
- Use various means of communication and get feedback from residents and their families. Actively listen with compassion and empathy so they know their opinions and feelings are valued.
- Provide easy-to-understand and accessible information and avoid jargon, which can confuse. It should be simple enough for residents and their families to understand their options.
- Involve residents in activities in and around the care home, e.g. could they show new staff around, plan activities for other residents and help with gardening, food preparation and cleaning? Also, encourage families to be involved and attend events.
- Comply with the law if a resident lacks mental capacity and cannot make all or some decisions. They should still be involved to some extent if possible, and their dignity, privacy and respect preserved.
Shared decision-making ensures the process is inclusive, where residents and their families engage more, benefitting them and your care home.
Further information
Budgeting and Financial Management
As a care home manager, you must manage finances and budget to ensure the care home is financially viable to provide the best possible care and support. It goes without saying that you will need some maths and numeracy skills to work with numbers. However, you will also require specific skills, such as:
- Creating and monitoring budgets – you will create budgets, allocate resources, monitor expenses and manage income streams in the care home.
- Financial analysis – you must be able to analyse the financial health of the care home to make good budget decisions, which involves data analysis. Therefore, analytical skills are a must.
- Forecasting – you will need to look at what could affect the care home finances in the future, where the money will come in and where additional expenses could arise.
- IT – effective budgeting and financial management requires computer skills, whether you use spreadsheets or specific software.
If you are new to care home management, familiarise yourself with the terminology used in financial management and budgeting. Nurses.co.uk have further information on managing finances here.
Finances and funding can be a significant challenge for care homes, so maximising revenue, controlling costs, and ensuring financial sustainability are essential. Here are some strategies that can help (this list is not exhaustive):
Increase efficiency – you can reduce and control costs by making the care home more efficient, for example:
- Adopt energy-efficient practices, e.g. switching off non-essential appliances and replacing equipment with more energy-efficient options.
- Streamline administrative processes.
- Embrace technology, as it can be quicker and more efficient.
- Look out for government programmes and initiatives that could help.
Negotiate with suppliers – see if you can negotiate lower prices, bulk discounts or extended payments. There may also be options to sign longer contracts to lower prices.
Preventative maintenance – ensure the care home premises and equipment are regularly maintained. Not only will this prevent them from breaking or malfunctioning, but it will also save you money in the long run.
Invest in staff training – if you properly train staff and ensure they are competent, it will enhance the care provided to residents and reduce the likelihood of errors and accidents, which can be costly.
Utilise local volunteers, charities, businesses and community organisations – they may be able to offer services and support free of charge or at a reduced cost, e.g. a local company may be able to offer free activities for residents. There may also be options to form alliances with local companies.
Fundraise – you can raise money for the care home by fundraising, but be clear about what the money is for, e.g. new equipment or activities.
To ensure a successful care home, you should recognise the importance of transparency and accountability in financial management practices. Being transparent requires accurately recording and reporting financial information and detailing how and where resources are used. Accountability requires you to accept responsibility for your own actions and outcomes. These are essential to build trust and credibility with stakeholders and to ensure legal compliance.
Regulatory Compliance and Quality Assurance
Care homes provide an essential service and look after vulnerable people. Therefore, they are subject to various regulatory requirements and quality standards. The following are laws that set out the minimum legal requirements in England:
The Health and Social Care Act 2008
- It establishes the Care Quality Commission (CQC) as the regulator for all health and adult social care services.
- It details the duties and enforcement powers of the CQC and the requirements for registration.
The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
- They define the registration requirements for activities and services.
- They specify the standards that health and social care providers and managers must comply with.
- The CQC has further information here.
The Care Quality Commission (Registration) Regulations 2009
- They apply to all regulated activities and set requirements for providing or managing a regulated activity.
- They detail the process of CQC registration.
- Makes provision for the registration and regulation of care homes and other types of health and social care establishments.
- It also covers offences and penalties.
- Sets out how adult social care should be provided.
- CPD Online College has further information here.
The Care Homes Regulations 2001
- These are made under the Care Standards Act 2000.
- They cover registered persons, care home conduct, fitness of premises, management and children.
Care Quality Commission – The fundamental standards
- These are the minimum standards of care you are expected to provide.
There are different legislation and regulators for Wales, Scotland and Northern Ireland. For further information, see:
Wales
- Key legislation (social care) | Law Wales.
- The Care Homes (Wales) Regulations 2002.
- Guidance for providers of care home and domiciliary support services | GOV.WALES
- Care Inspectorate Wales.
Scotland
- Legislation protecting people in care | Care Information Scotland.
- Care Inspectorate.
- National Care Standards – A Guide.
Northern Ireland
- Legislation, Regulations and Rules – NISCC.
- The Regulation and Quality Improvement Authority.
- Care standards | Department of Health.
There will also be other legislation to consider when managing a care home, such as health and safety, fire safety, food safety, mental capacity, finances, data protection, safeguarding, buildings/infrastructure, etc.
As a care home manager, you must know and understand the legal requirements and standards applicable to you and your care home. You will be responsible for the day-to-day running of the care home and have a crucial role in ensuring compliance with regulations and standards and maintaining high standards of care. You will need to ensure that regulatory activities, such as medicine administration and personal care, are conducted within the regulations.
To ensure the care home and care provision remain legally compliant and high standards are maintained, it is vital to conduct regular audits and assessments, which can be internal or external. These are important, as they enable you to assess the effectiveness of your processes and systems and identify any gaps that need to be addressed. You can then take the necessary actions and make improvements, which will assist you in your CQC inspections.
You should strive to go beyond the minimum legal requirements, which is why quality improvement initiatives are important. These involve approaches, methods and tools to continuously improve service provision and quality of care for residents, which can result in better outcomes. Skills for Care has further information on why quality matters here.
Problem-Solving and Decision-Making
You will need various skills to be a successful care home manager, and the following are particularly important regardless of the size or nature of the care home you are managing or will manage:
- Critical thinking – the ability to analyse and interpret information and facts and form reasoned judgements. It is a skill that will enable you to look at the care home you manage, critically examine practices, solve problems and make improvements to ensure you provide the best possible care to residents.
- Problem solving – the ability to identify and analyse problems, overcome obstacles and implement effective solutions. It is a skill that will help you deal with the numerous challenges associated with running a care home and identify solutions to deal with them.
- Decision-making – the ability to use intuition, reasoning or both to help choose the most appropriate solutions to challenges. It will enable you to make prompt decisions in the best interests of residents, families and staff.
These three fundamental skills are connected and will help you tackle the many challenges in a care home environment. Here are some examples of the common challenges that you can face:
Complying with CQC standards
You must ensure the care home complies with the necessary regulations and CQC standards. You will be subject to regular inspections by the CQC, and an ‘inadequate’ or ‘requires improvement’ rating could have negative impacts and even deter residents and families. Some strategies you could adopt to address this include:
- Understand the laws relating to your care home and get advice if unsure.
- Stay ahead of any changes in regulations to ensure ongoing compliance.
- Familiarise yourself with the CQC standards and what they will look for during inspections.
- Ensure staff training and education and administrative processes are up to date.
- Conduct regular audits to ensure processes are effective and there are no gaps in compliance.
Funding
Social care is a sector plagued by funding pressures, and it can have a knock-on effect on recruiting staff and providing good quality care. Some strategies you could adopt to address this include:
- Learn to manage finances effectively, including budgeting and resource allocations.
- Engage the residents, families and the wider community, which can help drive publicity and help with donations.
- Identify fundraising ideas to make money for the care home, e.g. cake sales, sports, crafts, dances, etc.
- Make savings through efficiencies.
- Embrace technology, which can help keep track of finances more easily and help navigate rising prices (Care Home Management).
Staff recruitment and retention
Many care jobs are unfilled, and there are significant issues with recruiting and retaining trained and experienced staff in the social care sector. The demand for care workers is high, but budgets are limited, so it can be hard to balance. Some strategies you could adopt to address this include:
Recruitment
- Have robust recruitment procedures.
- Write engaging, clear and concise job adverts.
- Advertise in the right places.
- Offer a decent salary, especially above the National Living Wage, benefits and flexibility.
- Recruit the right people whose values align with the care home.
Retention
- Have a thorough induction process to help new staff feel welcome and understand their role.
- Build positive relationships with staff through regular communication.
- Have an open-door policy where staff feel comfortable approaching you to discuss things.
- Provide suitable and regular training to staff and show you are committed to their professional development.
- Conduct regular surveys to identify staff issues and gauge satisfaction.
Some further strategies are on the Department of Health and Social Care here.
Safeguarding
Safeguarding is a significant issue in social care, and every resident within the care home has a right to live in safety, free from abuse and neglect. Safeguarding challenges are numerous and can include maladministration of medication, poor nutritional care, rough treatment and abuse (SCIE). Some strategies you could adopt to address this include:
- Have robust safeguarding policies and procedures, including one for whistleblowing, and regularly review them for effectiveness.
- Have arrangements for identifying, reporting, responding to and managing safeguarding concerns.
- Provide staff with safeguarding training and refresh it to ensure their knowledge and skills are current.
- Have a safeguarding lead.
- Keep thorough records.
Emergencies
There can be numerous emergencies in care homes, such as medical crises, injuries, fires, etc. You will need to think and act quickly to ensure people’s safety. Some strategies you could adopt to address this include:
- Identify any hazards that could harm residents, staff and others on the premises, assess the risks and put appropriate precautions in place.
- Ensure resident’s care plans are robust and strictly followed to prevent emergency situations, e.g. providing incorrect meals to food allergy sufferers.
- Have emergency procedures and test them regularly.
These are just some examples of the challenges you may face. Care home environments are dynamic, with residents and staff with various needs, and circumstances can change quickly. Things do not always go according to plan in any workplace, especially social care. Therefore, you must be adaptable and flexible to respond effectively to any changes to continue to provide the best possible care and working environment.
Crisis Management and Conflict Resolution
There are likely to be crises and conflicts in care home environments. As a care home manager, you must be equipped to manage these issues effectively and having the following skills is crucial:
- Problem-solving – to identify the causes of the issue and find appropriate solutions.
- Negotiation – to help reach a compromise to resolve conflicts.
- Communication – to use the most appropriate forms of communication for the situation and to de-escalate tense situations.
- Active listening – listening intently without judgment or interruption and asking questions to seek understanding.
- Empathy – to put yourself in other people’s shoes, see things from their perspective and understand their needs and wishes. It will help you find common ground.
Care home environments can be stressful places. There may be staff problems, residents will have various health issues and needs, and some families can be tricky to deal with. At times, there may be tense situations requiring de-escalation to diffuse conflicts, and you may also face challenging behaviours from residents, their families/carers and even staff. You could de-escalate tense situations and manage challenging behaviours by:
- Assessing each situation. Never put yourself in harm’s way. If, at any point, you feel unsafe, it is vital to step away and/or ask a colleague or mediator for help.
- Listening to what the person has to say and showing that you are interested. It will make them feel listened to, valued and respected.
- Letting the person know you have heard their concerns and try to understand their perspective.
- Maintaining appropriate eye contact and being mindful of non-verbal cues, such as body language, gestures and facial expressions.
- Keeping a calm and neutral tone, even if the situation is emotionally charged, and avoid becoming defensive or argumentative.
- Providing alternative ways for the person to communicate their needs if they have any issues.
- Working towards a compromise that is suitable for everyone involved.
Promoting a culture of collaboration and teamwork can prevent crises and conflicts in care homes, enhance resident’s quality of life and boost staff morale. To do this, you must:
- Lead by example and model the behaviours you want your team to exhibit, i.e. if you are in constant conflict with others, it will not set a good example.
- Establish open and clear communication channels so staff, residents and families can discuss any issues and actively listen to their concerns.
- Set a shared vision, values and common goals for everyone to work towards and communicate them to the team.
- Use positive reinforcement, which is rewarding desired behaviours and addressing undesired ones. Celebrate achievements, no matter how small.
- Establish clear rules, expectations and standards regarding behaviour and conduct, and ensure everyone understands their roles and responsibilities.
- Foster an inclusive workplace where people feel valued, respected, supported and accepted, regardless of background or identity.
- Listen to people’s ideas and feedback and act on them accordingly. Also, provide regular and effective feedback to others.
Remain calm, empathetic, and solution-focused when difficult situations arise. It will help you think more clearly about what to say and the actions to take and will prevent situations from worsening, which could lead to further issues and even harm if left unresolved.
Further information
Conclusion
Being a care home manager requires particular skills, as it is a challenging role with many responsibilities. You must have excellent leadership skills to inspire and motivate staff and ensure your care home runs smoothly. You also need effective communication skills to interact with residents, families, staff and external stakeholders.
Having organisational skills is essential, as it is fast-paced and there are multiple demands to juggle. You will manage many aspects, including staff recruitment and training, budgeting and financial management, and regulatory compliance and quality assurance. Therefore, you must manage your time effectively to meet goals.
Providing resident-centred care is the key to a successful care home, and you must meet their various needs and preferences. You have a vital role in promoting dignity, respect, and autonomy for residents in your setting and ensuring they and their families are involved in shared decision-making.
You will face many challenges, unexpected and inevitable, such as crises and conflicts. Solving problems, making critical decisions quickly and de-escalating tense situations are skills you must possess to be a successful care home manager.
Effective care home management ensures the safety, well-being and satisfaction of residents, staff, and stakeholders. Whether you are an aspiring care home manager or are currently managing one, it is vital to continuously develop and refine your skills to meet the evolving needs of the care sector.
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