Reflections on the last decade
Expectations of service delivery have been dramatically increasing. On shrinking local authority budgets, we are expected to do more with less, and many smaller providers are beginning to fall by the wayside – unable to sustain the demands of the Care Quality Commission (CQC) and commissioners. The focus has also changed to accountability and compliance, everything has to be evidenced, which is running the risk of stripping the compassion out of care and reducing it to a box-ticking exercise. It’s incredibly resource intensive and many small providers can’t sustain the number-crunching, in addition to their principal responsibilities.
At Bramley Health, when we were Glen Care, we ran a range of care homes and mental health services. In response to increasing pressure and the resultant homogenisation of the sector, we have focused on specialist provision in learning disabilities, neurocognitive disorders and for women with complex needs.
Projections for the next decade
The next few years look to hold more challenges, especially for small providers, around 40% of which are non-compliant under the new Key Lines of Enquiry framework. Many will disappear, and care will be increasingly provided by large, national organisations, offering magnolia services in a more consolidated market.
At Bramley Health, we will continue to develop our business model, continuing to focus on complex care provision and developing our position as a high cost, low volume niche provider.
I look on my role at Bramley Health as being a supportive one. I’m not a fan of top-down management, I believe in talking to staff and service users, finding out what hurdles they face and working with them to generate solutions. Of course, it’s my role to mitigate risk to the business through the rigorous governance framework, but I put the human element of the business first – and use it to guide and form the company’s strategic planning.
I would have to say, renowned neuropsychiatrist Dr Andres Fonseca, the Medical Director at Bramley Health has been a great influence. He has been invaluable to my learning and development, providing insights into the daily issues faced by clinicians and staff and the detailed workings of a healthcare provider.
Another key influence on me, although not a person, was the experience I gained when Glen Care encountered some issues with the CQC. The whole process changed me and the company for the better as we worked through the quality improvement processes. It instilled in me the importance of deep scrutiny, the central function of governance and prepared me for high-stress situations in the future. Whilst trust remains an integral part of an organisation’s ethos, it is equally important to have verification as a key principal of good governance.
The best lesson I have ever learned is to put service users first. Equally, I don’t believe that you should be totally driven by profit. Of course, Bramley Health is a business and, as such, it has to be sustainable, but profit will come naturally if you get the other fundamentals right and put the quality of service users’ care as the principal aim.
Respect and understand your responsibilities. Be accountable for what happens – right or wrong. Take responsibility when things do go wrong, don’t blame others and don’t hide. Also, make sure that you’ve got the right systems in place, so that you can sleep at night.
You see a lot of negative management, including people barking orders. It doesn’t really work. It’s far better to lead from the front and to deliver creativity together, so that everybody in the organisation buys into the objectives and gets behind delivering them.
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