I was recently “temping” as a part-time manager of a care home, while the home recruited a new manager. Since my last experience of directly managing a home, I have inspected many care homes and worked with organisations running them. I’ve trained and supervised managers; and I’ve spoken and written about the management of residential care. I have also had the responsibility of heading a voluntary organisation that runs care homes. But this has been a challenge and an education.
The home – for 15 older people – is run by a medium-sized charity. There’s a good mixture of residents: a few able to walk to the shops and see friends, and some very dependent on staff to help with almost everything. Apart from me, the staff are all women – aged from under 20 to over 60, and nearly all living locally.
To paraphrase the US defence secretary Donald Rumsfeld: there are things we know we know, and things we don’t know we know; then there are things we know we don’t know, and things we don’t know we don’t know. Geddit?
We “consultants” generally pretend we know it all, and we only ask questions to help other people to think. I know how to run a care home but it’s a long time since I’ve actually had to do it. I guess that, unless we’ve had good recent experience, most of us who make it our business to prescribe, regulate and advise how homes should be run, would struggle to do it even half competently.
That it is an extremely responsible, demanding and complex job is one reason why many of us keep well clear of such a test, but the overwhelmingly powerful disincentive is money. I couldn’t believe how little this manager was paid: £15,500 a year for a 40-hour week, usually stretching well beyond 45 hours (no overtime pay). And, of course, care staff are paid even worse – some just scrape past the minimum wage.
Good as it is in many respects, this organisation can’t pay its workforce properly or staff the home adequately because it receives as little as £266 a week in fees for council-funded residents; and that’s after they’ve contributed their pension.
So, the workers – including the manager – are overworked and underpaid, but they do a good job. It’s a local home, very much part of its community. The staff have every reason to be proud of the place.
As a temp you have to get stuck in quickly. I didn’t hang around. I turned up before 8am for my induction day with the outgoing manager, and an hour later I’d helped her with the morning medication and met all the residents. I tried not to get marooned in the office, not only because it was a windowless, stifling little cell on the first floor, but also because I needed to be out among people. So, I took reading material – files, records, procedures – down to the dining room.
Within a couple of days, it was evident that most of the team managed the day-to-day administration and care practice very competently. What took them minutes would probably take me hours. But it was also obvious that they simply didn’t have the time to manage the home in a more “strategic” way. The vital structural frameworks of good care were missing: supervision, keyworking and care planning. They were there on paper but not in practice.
I saw my main task as trying to build this structure without demolishing or undermining the excellent day-to-day work. I spent a lot of time talking with people and making myself useful in simple, practical ways – repairing, clearing, shopping, cooking, reorganising the office – thereby being a credible “worker” within the place, while discussing, promoting and demystifying ideas that staff had previously experienced as impractical.
I also spent time with residents. I always had lunch with them and we started lively fortnightly residents’ meetings.
Having completed my term as temporary manager, I’m going to spend half-a-day a week at the home to continue the work on supervision, keyworking and care planning, and to support senior staff.
I’ve enjoyed the experience and learned a few things I didn’t know… recalled a few I didn’t know I knew… and there are one or two I thought I knew, but now I know I don’t.
Name: John Burton.
Qualifications: Certificate in the residential care of children and young people; the Bristol University advanced course; the advanced consultancy course at the Tavistock Clinic; MA public policy; and a diploma in counselling. He is author of Managing Residential Care, Routledge, 1998.
Last job: Head of a voluntary organisation running care homes.
First job: Community service volunteer.
- Get to know people
- Make yourself useful to compensate for asking damn-fool questions
- Identify the things that people are already doing well, while you see where you can ‘add value’
- Ride in like the Lone Ranger and sort the place out
- Assume that you know it all and that current practice is poor
- Change everything