Article Consulting recently surveyed the managers of care homes that had been rated Outstanding by the Care Quality Commission (CQC), to gain an insight into what makes them different to other managers, and how they have been able to achieve the coveted Outstanding rating.
The resulting In Our Own Words report gave these outstanding managers the opportunity to have their voices heard and directly contribute to the growing debate on what makes a care home Outstanding. The report provided a unique insight into the individuals who are members of what is still an all too exclusive club, by identifying and analysing the common values and behaviours these managers seem to possess. The report quotes managers extensively and looks at the challenge of achieving an Outstanding rating through their eyes.
The research generally reflected what we already know from other studies and reports about the managers of care homes: they are overwhelmingly female, aged between 55 and 64 and are likely to have been promoted from within the service. The majority have worked in the sector for over 20 years.
Benefits of training
Article’s research identified that the managers of Outstanding care homes had accessed significant levels of training and support in the last 12 months. This included:
- Networking (78%).
- External training (72%).
- Internal training provided by their group (72%).
- Accessing online information (61%).
Networking, both internally and externally, was the most useful source of support, development and guidance for managers, followed by internal training provided by their group.
Looking at the total number of formal training days received in the last 12 months, 44% of the managers surveyed said they had received between six and 10 days, whilst 28% of managers stated that they had received more than 10 days’ training.
If there’s a correlation between training and Outstanding services, Boards should be asking their chief executives how many days’ training and development are managers accessing a year? At the same time, perhaps chief executives should be asking operations and HR directors to bring forward training and development strategies for managers.
Added to this, organisations should beware of the manager who says they’re far too busy to go on training sessions or to seek out their peers and others to share knowledge and learning. To cement any correlation, perhaps as part of its inspection regime, the CQC should ask managers how many days’ training and development they have accessed in the last 12 months, in addition to ‘…are you supported by your manager and the organisation’?
And for those managers whose organisations do not provide six to 10 days’ training and development a year, they might want to ask for it.
In addition to their own training and support, the managers of Outstanding care homes highlighted investment in training and development for their staff as being pivotal in achieving their Outstanding CQC rating. This included the provision of mentoring and networking opportunities. Sharing learning and experience was also highlighted as being important as a way of embedding a culture of good practice.
Life inside the home
90% of the managers of Outstanding care homes who responded to the survey highlighted the importance of recruiting the right staff, valuing them and, as one manager described it, ‘Being willing to manage-out staff who shouldn’t be working in care’.
Alongside recruiting the right staff, managers also focused on creating a culture that is built on genuine care and compassion, one which puts residents at the centre of everything the home does. Managers also highlighted the importance of working in partnership with families, maintaining two-way communication and creating a supportive environment.
The qualities of an Outstanding manager
When asked what the top qualities that the manager of an Outstanding rated care home needs to have, those that were most frequently highlighted included:
- Passionate (71%).
- Caring (53%).
- Dedicated (41%).
- A ‘can-do’ attitude (41%).
The research showed that these managers have a clear vision and focus on leadership as much as they focus on what might be considered purely managerial tasks. Managers were also quoted as ‘doing whatever it took to get the job done’ by ‘working 24/7’, with one manager reporting that they frequently worked up to 100 hours a week.
Unsurprisingly, when asked what got in the way of achieving an Outstanding CQC rating, managers’ responses were consistent:
- Staffing, including recruitment and retention.
- Financial constraints.
- The increasing levels of paperwork.
- A lack of time.
- The unrealistic expectations of others.
What makes Outstanding managers different?
Not content with just gathering data about how managers of Outstanding services go about the job, the research sought to get under their skin and even in their heads. The intention was to understand what, if anything, makes them different to other managers.
The managers who took part in the survey were invited to take the Judgement Index, an online assessment of values-based behaviours in their working and personal lives. The results were fascinating.
Three of the main areas measured by the Judgement Index focus on a person’s capacity with ‘people’, ‘task’ and ‘strategic thinking’. Judgement Index research of frontline care staff has shown they have stronger ‘people’ and ‘task’ scores, and weaker strategic and lateral thinking ability. However, the outstanding managers had an even balance across all three.
Having achieved this balance means that when faced with challenges, they are more likely to place equal consideration to ‘people’, ‘task’ and the ‘strategic’ consequences of the decisions they make. It means that they can see the bigger picture.
When measuring the balance of value someone has towards ‘people’, ‘task’ and ‘strategy’ then combining this with three personal dimensions of ‘self-esteem’, ‘role in life’ and ‘self-image’, the outstanding managers had an even balance in all six key areas. This is very rare when compared with managers across other sectors. People with these six qualities tend to be self-assured and consistent in their approach, often displaying natural leadership abilities.
Another key area the Judgement Index measures is problem-solving, and a manager’s ability to understand, process and make decisions at pace. With an average group in any industry, it would be expected that only 15% would score ‘extremely capable’ in this area. These 15% would be able to problem-solve and come up with quality decisions quickly, often leaving others behind in their exceptional capacity. It is striking, then, that 75% of the managers of Outstanding care homes scored in this ‘extremely capable’ bracket – far more than we would expect to see.
The Judgement Index’s previous research identified that within the care sector, people score much better in ‘intuition’ than the average population. Intuition can include noticing and sensing subtleties in other people and their behaviour, but also in the environment. This is important in social care, especially when looking at compliance and risk. All of the outstanding managers profiled fell into the ‘strong’ bracket for ‘intuition’, solidifying the belief that outstanding managers have outstanding capacity for intuition, noticing and sensing.
Another area measured by the Judgement Index is around following directions accurately. 85% of the outstanding managers had the strongest possible score in this area meaning their precision and attention to detail is very high. As a result, they are likely to expect this same precision and accuracy from their staff and this may be a key factor in their success.
Worryingly, however, the Judgement Index assessment identified most of the managers had a susceptibility to burnout, probably due to their high motivation levels and strong work ethic. Whilst none were in the ‘danger zone’, it’s worth noting that it is common to see high performers, like these managers, experiencing burnout at some stage, especially when working up to 100 hours a week.
Perhaps the most striking result of all is that, when compared to other care managers, the managers of Outstanding care homes all fall into the top 10% when rated in strength across all areas measured by the Judgement Index. This is an exceptional outcome. It shows that whilst it takes a team effort for a home to achieve an Outstanding CQC rating, it’s clear that all Outstanding homes have an outstanding manager.
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In Our Own Words can be downloaded from Article’s website www.articleconsulting.co.uk