The tensions between care home managers and local authorities

Mark Redmond considers whether enough is being done to correct the misrepresentation of home managers and their interests in client care and professionalism.

Research points towards care home managers being motivated by being the best professional they can be. But this doesn’t tally with their experiences of Local Authorities, who they think view them as primarily motivated by commercial imperatives.

For almost 10 years care homes have operated in an environment that has hardly been friendly.

It has meant that we have had to make some tough decisions. Decisions that we wouldn’t want to make, and ones that have left us misunderstood by others.

This has affected our relationships with local authorities. Of course, neither side of that divide set out to be on opposing sides.

We all continue to share many goals and ambitions in the care of older people, but as the squeeze on fees has hit, and as costs of care have spiralled, a sense of mistrust and misunderstanding has taken hold.

Home Managers – keeping all the plates spinning

As hard-working home managers we are many things – financial wizards, management gurus, mentors to our staff, responsible for the care offered to those living in homes, and accountable to regulators, councils and families.

Here then, local authorities are just one of the many balls we keep in the air on a daily basis.

On the whole we do a great job of this, and we should acknowledge this. The fact that local authorities tend to think of us as being primarily motivated by commercial pressures is a key issue, not least because today that is precisely what are we are required to do (manage the commercial operation), and therefore part of what we have become.

Our decisions can affect not only the profitability of our home, but its financial, actual future.

We are continually sailing between continuation and closure, and the decisions we make can alter that balance.

The days of having enough money through local authority fees in order to provide good quality care are now long gone, and councils know that.

As managers we need to maintain the right balance between private and state funded residents, between those whose care is expensive, and those whose care isn’t.

Yet whilst councils have long relied on our private-paying residents to subsidise those they pay for, they continue to ask for more from us. It is in this gap that misunderstanding has grown.

In this misunderstanding it is easy to forget that when we follow CQC guidelines and maintain positive inspection reports, we will continue to have the upper hand in that relationship.

So, whilst the voice of councils remains important, we should understand that it is just one of many. Our voice as home managers, responsible for the high quality care of our residents is of equal value too! You can read this story from registered nurse to registered care home manager.

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