Homecare managers and leaders are pivotal to influencing how homecare workers feel about their job, how they interact with the people they support and if they choose to stay working in that role. Equally, for these leaders to best support their teams to thrive, they need to feel this support too, with opportunities for development, consideration of their wellbeing and having their own peer-support network in place.
My Home Life England works with registered and branch managers, deputy managers and care co-ordinators at homecare services through regular professional support and development programmes. Leaders set aside time to discuss, understand and share with peers what is working well, what the challenges are and the things they struggle with. Many identify this as a unique place of safety, one that they may not have realised was so needed. While there is significant overlap with leadership across other areas of the sector, there are some specific challenges within homecare, as well as brilliant examples of responding to them.
These insights have informed a new report, which shines a light on what good leadership looks like. In addition to reviewing data from 44 homecare leaders who participated in one of My Home Life England’s leadership programmes, we also undertook 46 interviews with branch managers, care co-ordinators, care staff and training team staff across 12 branches of a large homecare provider. We then combined this with a scoping review of the literature and identified six components of good leadership, before testing these out at a workshop with eight homecare leaders.
The six components are:
- Managing teams to feel safe, supported and valued.
- Clear communication, collaboration and belonging.
- Creating a positive culture of practice.
- Clarity of roles and responsibilities, processes and policies.
- Strong quality assurance and customer service.
- Sustainability, growth, development and community engagement.
The focus here is on the first three of these, which focus more on the role of homecare leaders in supporting and developing their teams, particularly the care workers who support people who are living at home.
What draws people to homecare leadership?
Homecare leaders are motivated by the positive impact their organisations have on others, a sense of being able to make a real difference and every day bringing something new. They spoke about the importance of supporting their care teams, their satisfaction from ensuring their organisations ran smoothly and their pride in being able to grow their businesses. One homecare leader said, ‘[I most enjoy] meeting customers, new business, enabling and developing carers so they are happy and excel, embedding everything that we do to be excellent, pro-actively using “lessons learned” to bring in improved initiatives, training staff.’
What are the challenges?
The homecare leaders we spoke to were aware of what a difficult job frontline homecare workers do – responding to many varied situations – and how autonomous they need to be, with relatively little support. Leaders identified everyday challenges that they themselves face. These included managing unrealistic workloads and unpredictable demands, with frequent references to ‘spinning plates’ and ‘fighting fires’.
While their work is dynamic and engaging – certainly none were bored – constant recruitment, staffing pressures and limited strategic headspace away from daily operations to address commercial pressures can lead to overwhelm and burnout, especially without strong support from the wider health, social care and housing system.
Managing teams to feel safe, supported and valued
Given the challenges of delivering homecare and the isolation that care teams can feel, homecare leaders must convey a strong sense of value and support to their teams. The managers we spoke to describe trust as essential, and that it needs to be two-way – trust by managers that work by care staff will be carried out independently to a high standard; and trust by care staff that they can rely on the support of their manager when needed, that their working environments are safe and that what is expected of them is realistic.
Homecare leaders explained how they build trust through consistency and by being present and engaged. Facilitating shared decision-making, encouraging feedback, considering suggestions for improvement without defensiveness and voicing workers’ concerns to higher management, as well as access to appropriate training, can also foster a culture of openness and psychological safety. One homecare worker said, ‘We can openly voice concerns, there is good comradery, [branch manager] asks for views, we all talk about it, there is no browbeating, we have “always here to help each other” in our minds.’
Care leaders described ways they tried to ensure their teams feel appreciated, such as birthday gifts, Carer of the Month awards and regular acknowledgement of their positive impact. One homecare leader said, ‘Carers are gold dust. We show appreciation [for example] Maltesers Monday, Fudge Friday – going out to surprise carers on their shift to say thank you with chocolate.’
Communication, collaboration and belonging
Connecting with teams remains probably the biggest challenge within homecare, given how dispersed teams are. With opportunities limited, there is an even greater need for all communications to be effective in modelling the organisation’s culture and values, plus appreciation of managers towards care staff. Homecare leaders were conscious of ensuring they did not solely focus on complaints or problems, instead putting an emphasis on positive feedback. One homecare leader said, ‘As a manager, always providing the personal touch to carers, e.g. I ring them if I hear some positive feedback, so they receive lots of praise…’
Linked to this was honesty and openness, and not avoiding having the more difficult conversations, but approaching them in a caring and respectful way. Care leaders described how they actively seek and support communication when time is limited. This included sending personal notes of thanks, managing WhatsApp groups, thinking creatively about ways to get the team together and inviting staff to help design the perfect meeting. One homecare worker said, ‘[One of the best things about my job is] the great relationship I have with carers, e.g. if I send a text out RE help, masses reply.’
In terms of fostering a sense of belonging, having clarity around job roles ensures that homecare workers always know who to go to for support and advice. Internal mentoring schemes can also help people to establish vital connections, especially when geographically dispersed.
Creating a positive culture of practice
The relationship between homecare leaders and homecare workers has a direct impact on the relationship between homecare workers and the people they support. One homecare leader said, ‘We’re not micro-managed and so we feel empowered, we are a kind team.’ The other homecare leaders we spoke to recognised this and described the positive values and behaviours they wanted to enable within their care teams.
These included:
- Helping teams to connect with the positive difference that they are making, helping them feel a sense of joy and achievement when working with individuals.
- Recognising deeply that the ‘carer role’ is about a relationship with another individual, not just about delivering a list of tasks.
- Seeing themselves as supporters, with a vital role in helping people to stay living at home.
- Developing and maintaining a culture of celebration, curiosity, support and appreciation with a focus on noticing positive practice.
Some of the ways homecare leaders achieved this was:
- Modelling avoiding language that objectifies people – e.g., ‘doubles, feeding or toileting’.
- Giving people time to get to know each other as individuals, ensuring homecare workers have good background information on the person they are supporting, not just a list of their care needs.
- Providing reasonable flexibility in how homecare workers support individuals, promoting a person-centred approach.
- Asking homecare workers how they feel about people they support, including what they find hard.
- When a person dies, attending to what matters – the person, the carer and/or any family members and providing carers with emotional support – rather than focusing on the loss of ‘the care package’.
Support for homecare leaders
The six interwoven elements of good leadership we identified revealed key aspects of positive management within homecare and practical examples of how homecare leaders seek to achieve this. However, the demands on homecare leaders are considerable, and the dangers of burnout are high, risking a negative impact on their teams too. For homecare leaders to enable their teams to feel safe and supported, they need to feel this too.
Participation in My Home Life England programmes enabled care leaders to feel this sense of support and safety, and in conversation, they highlighted the importance of ongoing professional support or coaching. Homecare leaders reflected on how important it was to have a group that they could share their concerns and achievements with and be supported by – something they felt they did not have enough opportunities to do.
With time to understand and develop their leadership skills, consider their own wellbeing and support needs and ensure their own support network is in place, homecare leaders can enact strong leadership, with a positive ripple effect on their care teams and throughout their organisation.
You can read My Home Life England’s homecare leadership report on its website. Then, feedback on this feature below or join the conversation to share your thoughts.
Dr Rebekah Luff is National Programme Manager at My Home Life England. Email: [email protected] LinkedIn: @My-Home-Life-England