I am using care homes as an example but these can be swapped for any social care department or even most companies.
Just a quick peek into the forums, or at the job boards will show you all is not right. There is a monster lurking under the bed and its time we addressed the issue. We simply cannot continue to see the turnover of managers, and the glut of manager vacancies rising exponentially. Something has to change. This is one answer.
There is a universal truth….
A Care Home will ALWAYS reflect its manager. This is a hard truth but true all the same. I have seen it again and again.
The life of a care home is not a straight line. It has ups and downs, good times and bad times. Things can sometimes get a bit wobbly, and at other times all is right with the world. It will naturally go through stages.
Stage 0: Home is steady, Manager is happy, staff are happy. No concerns
Typical Response: Celebrate (and why not)
Stage 1: The home is steady, everything appears calm and settled. Most of the work is completed on time. Staff are generally happy. Sickness and agency use are low. Manager is tired but coping.
Typical response: Do nothing for there is ‘nothing to do’
Stage 2: The home is mostly steady but has occasional days when things go awry. Work is mostly completed on time although some reports can be missed for ‘genuine’ reasons. Staff sickness is generally OK but you are keeping an eye on it as there has been a slight rise. Agency use has increased slightly but appears under control. The manager has complained of feeling tired and needs a break.
Typical response: Allow the manager to have a days holiday and monitor the situation
Stage 3: The home feels a bit wobbly. Sickness is on the rise along with agency use, but still relatively low numbers. Reports are more often late than not and the manager is showing signs of struggling. They tell you they are having trouble sleeping. You see a small rise in staff and relative complaints.
Typical response: You are closely observing, perhaps telephoning more often than you would. You ask a support manager or one of the quality team to go and observe the service.
Stage 4: The home is precarious. The manager is complaining of stress, headaches, overwhelm and being unable to cope. Agency has hit over 100 hrs a week and sickness is rising. Safeguardings have increased along with notifications and the home is starting to come under the scrutiny of outside agencies. You are contacted by the Local Authority and / or CQC and asked what is happening.
Typical response: You send in ‘support’ who attend, see what is happening and leave a 3 page action plan for the Manager to work to. This increases pressure on the manager and is the final straw. They go off sick.
Stage 5: The manager is put on a Performance Improvement Plan, the home is inspected by LA / CQC and shortfalls are identified. A recovery plan is put in place. The manager resigns. Staff are unsettled and relatives dissatisfied. The home goes into embargo until issues are resolved. Staff leave, agency continues to rise.
Typical response: Recovery mode. Support teams are sent to get the home back on track. Advert for a Home Manager goes out but this time it is for a ‘Turnaround Manager’.
And before anyone suggests this is far-fetched or extreme examples, I have seen it, others have seen it. Why are there so many vacancies? Interim work is increasing, consultancy work is increasing.
There is an obvious cost to all this:
1. Cost of rehire (recruitment and processing costs)
2. Cost of support staff time
3. Cost of agency
4. Cost of staff sickness
5. Reputational damage
6. Emotional cost to staff, relatives, service users (and yourself probably)
7. Induction and training of new staff
8. And many more hidden costs
So what is the answer?
It is to recognise and support managers effectively. But when to intervene? Which stage is best?
A home can be at stage 4 before help arrives, but by then it is too little, too late. Stage 3 is probably going to be too late as well.
Identifying a manager at stage 1 can help you support more effectively, reduce manager turnover and stop the downward spiral. At stage 2 things can probably be rescued with a quick response.
I have a Facebook Group for Managers feeling overwhelmed. It has over 1700 members. In a recent poll of managers who were considering leaving 70% said they would accept an offer of coaching to provide emotional support to see them through a difficult period.
70%! What difference could that make to turnover rates? Obviously not all of those will be prevented from resigning, but if even half could be saved then the turnover would plummet.
It’s an absolute no-brainer.
A small outlay on coaching / emotional support early enough to make a difference.
Stage 4 / 5 followed by the costs outlined above.
I know what I would do, but then again I am a Social care professional who is also a coach. I know what can be achieved over 3 months coaching.
Martyn Dawes is a Coach, Social Care Consultant, and Author of The Overwhelmed Manager: What To Do When You Don’t Know What To Do