Do You Escape the Gravity of Your Care Business
Your business possesses a gravity that pulls you in and is hard to escape.
But escape you must if you are going to address any weaknesses and risks in your business and threats from outside, as well as exploit your strengths and take your care business to where you want it to be.
Imagine floating in space high above the Earth.
As you gaze upon our beautiful planet, the glorious colours, the expanses of water, the swirls of cloud formations, you feel calm, relaxed and at peace. Your mind free of the hustle and bustle that is your life down on the planet.
With your mind free from the detail of everyday life you see the big picture.
But you know that whilst you gaze down upon our world, it is constantly pulling on you trying to drag you back to its surface, back down to the noise and clamour and assault on your senses.
Your business does the same; it possesses a gravity, a pull that keeps you IN the business, holding you down and challenging you to step away from it.
In my post at the end of last year I talked about it being a perfect time to step back, reflect on the year just gone and on the year ahead.
Read Post: Want 2024 to be Better? Here’s How
In this post I give some guidance as to how to identify what your business needs and how to make it happen.
The following two posts on how to set and achieve your goals is also worth a read.
Read Post: How to Set and Achieve Your Goals – Part 1
Read Post: How to Set and Achieve Your Goals – Part 2
In these posts I also give some guidance on how to step away and work ON your business not IN it.
Regardless of when your business year starts, if you haven’t yet thought about how you want the year to go, then it’s not too late, especially now, as your costs are about to increase even further when the National Living and Minimum wages increase on 1st April.
If April’s wage rises gives you cause for concern and you missed my recent post on the subject, please do check it out.
Read Post: National Living Wage 2024 – Why You Need to Care About This Now
Your first – and possibly your biggest – challenge to transforming your business is your ability to step away from it (to escape its gravity well) in order to see the big picture and create the kind of strategy that will propel it to the next level.
Being too busy in your business – not escaping its pull – is one of the biggest reasons a strategy doesn’t get created, doesn’t get implemented and why a business doesn’t move forward as planned.
It’s also too easy to do. We all have days of being reactive and of simply tackling one problem after another. But if that’s the norm for you then you could actually be hurting your business as you may have little control over it.
You need to escape the pull of your business and with practice you can.
Set aside a period each week like a Friday afternoon and spend the time doing something that isn’t an everyday task but a strategic action that will benefit your business.
This could involve learning something new like a new marketing tactic or reviewing how well an aspect of your business is performing and finding ways to improve it.
Turn this weekly practice, where you step away from your business for a few hours, into a weekly habit. Make it a norm so that not doing it becomes a rare occasion. The more you do this and pull away from the day-to-day, the easier it will become.
Being able to step away from your care business will benefit it and you in so many ways, including the increased control you’ll have over it and ability to keep it on course to achieve what you want from it.
If you are worried about the wage rises in April then download my free report, 5 Steps to Make Your Care Business Financially Secure.
To Your Success
Chris
7 Reasons Why You Should Not Accept the Care Fees Your Commissioners Want to Pay
If you’re not convinced that now more than ever you need to set and receive the care fees you need and not accept the fees your commissioners want to pay, here are 7 compelling reasons why.
1. Councils Are Running Out of Money
Let’s start with the overriding fundamental reason…their shrinking budgets mean they can’t afford to pay all care providers the care fees they need.
This is nothing new. For years you’ve been told about their budget cuts how “we need to work together” to find a solution that works, from which nothing changed.
But now, we know that many councils are facing the real threat of bankruptcy. “Nearly one in five council bosses believe it is “fairly or very likely” that they will go bust in the next 15 months…” The Guardian, December 2023.
Then last week we were told that at the end of last year the UK economy fell into recession. And yesterday (19th February) Birmingham Council were all over the national news because they have announced £300m of cuts they are going to have to make over the next two years in order to balance the books.
According to the BBC, these cuts include £23.7m from adult social care in the next financial year (which starts this April). And they will raise council tax by 21% over the next two years.
But with one in five councils heading the same way, even if you don’t fall under the Birmingham region, you still should prepare for the worst – that being your council being in a similar position as Birmingham.
Because of this lack of funding, getting the care fees that you need is going to get even harder as councils at best tighten their belts even more and at worst make huge cuts to services in order to claw their way out of bankruptcy.
And if for a moment you feel some sympathy towards councils and feel pressured to “work with them” which means accept lower fees, remember that you have a business to run and all the responsibilities that go with that towards your staff and clients and yourself.
Also, check out the Town Hall Rich List 2023 and see just how much council leaders and senior managers paid themselves in the fiscal year 2022 in your region.
The CEO of Staffordshire County Council (where our nursing homes are based) earned a salary of £211,743 and the Director of Health and Care earned a salary of £195,694 plus a bonus of £11,262. Plus more than £4.39 million was spent on ‘exit packages’ – cash paid to staff to leave their job – as part of a ‘restructure’.
Their top priority is diametrically opposite to yours. Achieving their priority harms your business. This is why you must set your fees – not let your commissioners set them for you.
2. Your Commissioners Don’t Know the True Cost of Care.
Your commissioners set fee levels and yet, they have no idea how much it costs you to deliver care.
Commissioners have previously openly admitted to me that they didn’t know the cost of care and how good it would be to learn, so they understood better what fees care providers really needed. I managed to disguise my shock.
Since the Fair Costs of Care (FCOC) initiative that took place in July 2022, the situation has become worse, because now they think they know your costs.
Councils across the country are using the results of the FCOC initiative to try and show that they know your numbers better than you do and that you should therefore accept the “fair” fees that they are willing to pay.
And they are succeeding.
Councils across the country are making big savings at your expense.
Here is a quote from Essex Council showing a cost saving of £510,000 on residential services for adults with disabilities alone.
It doesn’t matter that the costs are taken from a handful of care providers who may not know their own costs accurately, nor that the costs were taken from the financial year ending March ’22. Commissioners are still using this initiative and tool to negotiate fees down.
But the key point here is that local council aren’t succeeding to negotiate your fees down because they know what your costs should be.
They are succeeding because care providers don’t know their numbers well enough and hence don’t have the clarity needed to counter these challenges and defend the fees they set.
If you don’t know your numbers you will struggle to receive the care fees you actually need because you will struggle to justify the fee you have set.
In my report, 5 Steps to Make Your Care Business Financially Secure, I take you through how your commissioners are using the FCOC results to challenge your fee and how you can stand up to these challenges.
3. They Don’t Understand Business.
LAs and ICBs don’t know how much it costs you to run your care business. They are public sector organisations who haven’t got a clue about running efficient, cost-effective businesses that need to return a healthy profit. If they did, they wouldn’t be facing bankruptcy and we would still have council-run care homes across the country.
Neither do they know what level of profit a business needs to return in order to be financially healthy.
If they did, one LA would not have put this question out to providers in one of their surveys. Look at how many options are at 10% or below and only one above 10%.
Clearly they think 10% or less is an acceptable profit margin.
The lowest option is below 3%. They think it is reasonable for a business to make less than 3% profit. It shouldn’t even be an option.
Profit is not a dirty word – it is the lifeblood of a business. 10% is not a healthy profit margin – you need to be making around 30% to ensure long-term financial sustainability.
Only you know your costs. Only you know how much revenue and profit your business and therefore only you can set the fee you need.
You cannot take the fee a referrer pressures you into accepting if it does not return the level of profit your care business needs.
You must know how to calculate the right fees for each of your individual residents. How else will you know you are receiving the right fee to deliver a quality service and keep your business alive?
4. You Will Most Likely Have to Close Your Care Business
Accept the fees your commissioners want to pay and you will struggle to be financially healthy and will eventually have to close or go under as so many providers before you.
There is little more I can say here because if you’ve worked in this sector for any length of time you’ll know from experience that this is the case.
If you do normally accept their fees, even reluctantly after much pressure, then please take a step back and decide that this is no longer going to be the case.
Having made that decision, if the whole prospect of knowing your costs well enough to set accurate fees that you can justify makes you a little nervous, then read this report, 5 Steps to Make Your Care Business Financially Secure.
In this report I’ll show you exactly how to set, defend and receive the care fees you need. It covers how to set accurately calculated fees, how to use that information to defend your costs and how to counter the challenges you’re likely to face.
Click this link to download the report.
5. Commissioners are Under Very Little Pressure to Change.
The government and local councils should find themselves between a rock and a hard place – the rock being a lack of public money and the hard place being you, the provider, setting the fees you need.
But they are not.
They are between a rock and spongy place that easily yields to pressure. Rock on one side and soft stuff on the other – which is going to win? And because, for years care providers have yielded to pressure, there is little incentive for the government and local authorities to change.
Until you become ‘the hard place’ nothing will change.
The nursing homes of our sister company are ‘hard places’. They calculate and set the right fees and they receive them. And they are prepared to say no to a new client if a commissioner won’t pay the fee needed. In fact, after years of this, the commissioners know not to haggle and to either pay or go elsewhere and more often than not they pay.
You need to become the ‘hard place’ or nothing will change.
6. The Care Sector Will Never be Out of Crisis.
The care sector is in crisis. Fees are too low. Record insolvencies is the proof.
Only you and all other care providers can get this sector out of the crisis it is in. The only way to do that is to set the care fee your business needs.
If everyone stopped accepting low fees and instead set the fees they really need, then LAs would have to pay them and we could turn this sector around.
Your competitors aren’t other care providers – demand outstrips supply. Your biggest competitors are your commissioners and yourself.
The former is clear for the reasons I have outlined here. But you being your biggest competitor? If you accept the fees they want to pay then you are hurting your own business and so yes, you are one of your biggest competitors.
7. You Will Never be in Control of Your Business
The success of any business, including yours, is wholly reliant on its financial health.
Everything you do in order to run your business and to deliver the best of care possible costs money.
If you don’t receive the fees you need, you can’t be in control of your business.
Without the revenue and profit you need you will pinball from one crisis to the next as you struggle to…
• Have enough staff and keep them well trained.
• Pay for extra wellbeing events and activities.
• Expand your business.
• Get any kind of a loan because banks won’t loan to financially weak businesses.
• Cover unexpected costs, like the extraordinary rises in the cost of things like energy, food and insurance.
And, when you want to exit, you will struggle to find a buyer who will pay the price you want to sell your business for.
Accept the fees commissioners want to pay and you will always struggle financially.
Calculate the fee you need, eliminate the guesswork and take control of your care business.
To see how to calculate the care fees you need and how to then confidently negotiate for those fees, download the report, 5 Steps to Make Your Care Business Financially Secure.
And right now, as we approach 1st April’s rise in National Living and Minimum rates, review your current fees based on your increased costs from April.
To see more on that check out my previous post, National Living Wage 2024 – Why You Need to Care About This Now
If you feel daunted at the prospect of reviewing and setting the right fees, check out our Care Fee Calculator and try it for free.
This post was updated from 20th April 2023.
National Living Wage 2024 – Why You Need to Care About This Now
How much will April’s National Living Wage rise cost you?
In this post I will show you how to estimate this cost rise so you can see for yourself the financial impact it is going to have on your care business.
But first I’ll highlight why you should start to prepare for this NLW rise now, in order to minimise the financial damage from April.
Last April the NLW, for those aged 21 and over, rose 9.7% from £9.50 to £10.42.
This April, it will rise a further 9.8% to £11.44, an increase of £1.02.
For a 50-bed nursing home having an overall monthly staff bill of £200,000, an overall increase of 9.8% will take that cost to £219,600 and month. That’s an increase of £19,600 a month or £4,523 a week.
How many weekly care fees is that the equivalent of on average for you?
Of course, your numbers will be different and not everyone will see a 9.8% rise, but the principle is the same and, regardless of your actual numbers, it will be a significant cost increase.
Why You Should Care About This Now
If you’re thinking, “Chris, it’s early February so this increase won’t take place for a couple of months and I’m really busy so why should I worry about this now?”
Good question and I’m glad you asked.
The reason why you should start to look into this now is because there are a number of steps you’ll need to go through in order to minimise the financial impact that this rise will have.
You need to:
1. Work out how much your overall staff costs are going to increase to in April and divide that cost across your usual number of clients or average occupancy level.
2. Review your fixed costs if you haven’t for a while and spread the average extra weekly fixed cost across your usual client level.
3. Create new care fees for your current clients based on your newly calculated costs.
4. Review your current fees by comparing them with these newly calculated fees to see how your cost rises have affected your profit for each client.
5. Arrange a client review meeting for those client fees that are no longer returning a healthy profit.
The first four steps aren’t as trivial as they may sound and could take a couple of weeks of effort depending on how many clients you need to review.
From requesting a review meeting to actually having one, the last step alone can take up to three months so chances are that, even if you begin the steps today, you’re going to be into April and the NLW cost rises before you can have client reviews with your – local authorities or ICBs.
This is why you really should start working through these steps now.
Let’s briefly look at the work involved for each step.
Step 1: Staff Cost Increase
What will your staff costs increase to when the new NLW kicks in?
You need to review all of your staff hourly rates and salaries because, as well as those on £10.42 increasing to £11.44, you have staff on other rates which will also need to be increased.
For those 18-20, the NMW rise will be 14.8% to £8.60, 21.2% to £6.40 for 16 to 17 year olds and a 21.2% rise to £6.40 for apprentices.
Those on higher rates will then need to have their rates reviewed and increased in order to maintain the pay gaps.
Having done this, you need establish a staff profile so you can work out the cost of staff on each rate (from April) based on their average weekly working hours.
While you’re at it, work out your staff costs based on your ideal staffing level, not on the number of staff you currently employ.
Because of the pandemic and recruitment challenges, if you are low on staff numbers then your average monthly staff will come out lower. If you then carry out a successful recruitment drive, your staff levels and hence cost will increase.
How receptive will your local council be to your need to increase your fees because your staff costs have increased? You know from experience that they won’t be.
You should set fees that will cover the staff levels you ideally need for your usual client numbers and client types. And that means you need to calculate your staff costs based on ideal staffing levels.
This table shows a possible staff profile for the care team in a 50-bed nursing home.
Notice that I have set NLW carer rate at £11.44 rather than the current £10.42 and more senior staff have had their hourly rates increased to maintain the gaps.
Your hourly rates will also need extra employer costs added. This is On-cost and Cover cost, which could easily add an extra 20% or more to your hourly rates, which is significant.
For example, the senior carer on £12.85 an hour, could easily have a true cost to you of £16.69 an hour. A carer on £11.44 an hour could well be costing you £14.86 an hour.
From this staff profile you can work out how much your staff will cost each week and divide that total across your usual number of clients or residents.
You will then need to establish new average hourly rates (including agency rates) in order to accurately work out how much care delivery is going to cost from April.
Like I said, this is a fair amount of work, but it is the only way to get an accurate cost for what is by far your largest cost and the biggest financial burden on your organisation.
To help you work out your costs, like I’ve shown here, I’ve written a report, 5 Steps to Make Your Care Business Financially Secure, which you can download for free by clicking the link – the title of the report.
In this report I take you through steps like these but in far more detail and give you a roadmap for setting and winning accurate care fees.
I also show you a tool designed to help you set the fees you need.
Getting this right has never been more important.
In the face of local councils grappling with the threat of bankruptcy, your commissioners are going to work even harder to get you to accept care fees that are way too low. And if you do, you’ll end up being dragged down with them.
So, click the link and download, 5 Steps to Make Your Care Business Financially Secure, and follow my roadmap to setting and winning accurate care fees.
This is the same roadmap our sister company uses for their nursing homes and they receive the right fees to ensure financial stability.
Step 2: Review Your Fixed Costs
Your fixed costs (everything else outside of staff costs) have increased so if you haven’t reviewed them for a while please do.
Knowing your fixed costs is simply a matter of recording them weekly or monthly using a spreadsheet or a tool created for this specific purpose.
Hopefully this tool will also show a rolling monthly average for these costs.
If you don’t record your costs to this detail, please start now.
Meanwhile, for the purpose of setting an average fixed cost now, use your annual reports to estimate an average monthly cost and ideally go back to October 2022 when the cost of living was at its highest.
I highly recommend that any tool you use includes the ability to add monthly budgets so you can see how the actual monthly spend compares with these budgets.
There are three key benefits to knowing your costs.
1. You can better control your costs and address areas of overspend by setting budgets.
2. You will be able to set more accurate fees.
3. You have all the detail you need to justify the fee you have set.
Completing a tool like this on a weekly basis is a relatively easy admin exercise that should only take a few hours depending on the size of your operation.
The control and clarity you gain from being able to better manage your extremely high costs and see where savings can be made is well worth this relatively small effort.
If you don’t have a financial tool that will give you the detailed information, you can of course create a tool like this in a spreadsheet.
But if you aren’t a spreadsheet whiz then take a look at our tool, The Running Cost Calculator.
Initially created for our nursing homes, I’ve developed an online commercial version that you can now use for your own care business, regardless of the type of care service you provide.
Once you have your average monthly fixed cost, divide it into weeks and across your usual client/occupancy level, to see a weekly cost per client.
Step 3: Create new Fees for Your Current Clients
With your accurate costs, including accurately calculated average hourly rates (with extra employer costs), you can create accurate fees.
You can accurately work out how much care each client is entitled to daily as part of your care (and nurse) costs and the cost of extra individual care a person may need.
What’s key here is that because you have accurate costs and average hourly rates you can eliminate any guesswork.
I’m not going to take you through how to do this here but again point you to my report, 5 Steps to Make Your Care Business Financially Secure, where I take you through this step-by-step.
Step 4: Review Your Current Fees
By comparing your new fee with your current fee for an individual person, you can see how much profit (or loss) you are actually making on your post April costs.
If you run a nursing home you may think the weekly fee of £1200 for one of your residents is ok. But you won’t know unless you actually know your costs and calculate accurate fees.
I have worked with care providers to help them review their fees and they are sometimes shocked to see just how little profit they are making and how many fees they are in fact making a loss on.
I cannot emphasise enough how important it is that you create new client fees for your current clients as I described and compare them with the fees you are receiving.
Again, I go through this in more detail in my report 5 Steps to Make Your Care Business Financially Secure.
Step 5: Arrange Client Review Meetings
Now you know what fees you need and have compared them with the fees you are receiving. You can now see which clients, if any, are returning a profit that is too low or in fact returning a loss.
You can prioritise these clients and arrange client reviews. Of course, the sooner you do this the better because as you know, it can take a while to finally get a date out of your local council.
But once you have that meeting you have to convince them that your fee needs to be increased. So, the more detail you have the better.
But your commissioners will do all they can to find holes in your argument.
They will:
• Question your costs such as how you calculated your average hourly rates.
• Try and trip you up on detail like Cover cost.
• Use the results of the Fair Cost of Care initiative to try and tell you your numbers are wrong. My report covers this and shows where the inaccuracies in the Fair Cost of Care initiative are and how to confidently defend your numbers against theirs.
Hopefully, you will have set your new fee to give you a 30% or more profit. But because you know your costs you also know the minimum fee you can accept and still return a profit (say 20%) that won’t be low enough to hurt your business.
You can then set a profit margin that you won’t go below.
But if your commissioner refuses to pay this fee then you should serve notice.
I know this is a last resort and such a hard thing to do because you may have built a relationship with this person.
But you run a business and if you can no longer afford to keep that business going then all of your clients will need to be found other providers and your staff, who need your employment, will have to find other jobs.
At the risk of sounding like a stuck record, another reason to download the report is that I talk more about negotiating with commissioners and the things you can challenge them on should they refuse to increase your fee.
Last Word
Even though the rise in NLW won’t happen for another couple of months. I hope you see why it’s important that you start this process now.
Building a successful business in this sector is so challenging. And arguably the most challenging aspect is to make it financially strong enough to succeed.
All that you need to do, from compliance and training to delivering quality care, costs money, a lot of money.
Being financially stable should therefore be your top priority and reviewing your current fees, based on your costs from 1st April, is the best thing you can do now to ensure your business is financially strong.
And to do it successfully you need to plan time into your busy schedule. If you want some pointers on that then check out my previous article, How to Set and Achieve Your Goals – Part 2.
Meanwhile, download my report and set aside say 40 minutes to read through it. Then start to set aside time in your calendar or diary to follow the steps to receiving the fees you need.
Download: 5 Steps to Make Your Care Business Financially Secure.
Finally, if maths isn’t your thing, please don’t let the steps I’ve outlined here and in the report, put you off. All the calculations and images shown here and in the report come from two tools we have created and which are used buy our sister care business.
The Running Cost Calculator I’ve mentioned in this article. The other one, which will help you calculate the right fees is called the Care Fee Calculator.
Please do check them out and try them for free.
How to Set and Achieve Your Goals – Part 2
Setting the right goals is one thing but successfully achieving them is quite another.
Most goals aren’t successfully achieved. But because in the previous post we looked at how to identify and plan your top priority goal that could transform your care business, this is one goal you really want to achieve.
In this post I’ll take you through steps you can take and tools you can use to achieve your goal and transform your business as planned.
In my previous post, I laid out a blueprint for goal setting. If you haven’t read it, I strongly recommend you do before you read this post.
How to Set and Achieve Your Goals – Part 1
Planning and executing a plan to achieve a goal is no easy thing. You and your senior team are extremely busy and now you need to set a plan and execute the tasks detailed in it and ideally in the timeframe you’ve estimated.
This isn’t going to just happen, so here’s some guidance on how to make it happen.
Your Mindset
Your mindset is critical when it comes to effort like this, and it needs to be in the right place.
It’s too easy to stay in our comfort zone and do what we normally do and put off work that we’re not used to doing.
We need to get into the frame of mind that we’re going to set aside the time needed to put the plan together and, along with your team, execute it.
Ask yourself “How much do I want to achieve this goal?” “Am I motivated enough to carry out the actions?” “Do I want to do the actions required to achieve the goal?”
To help you answer these questions take time (1, 3 to 5 minutes) to visualise what you and your people need to do and the commitment you need to make to achieve your goal. Visualisation is a very powerful way to motivate yourself to kickstart yourself into action. If, from answering the questions and visualising the effort required, you feel positive then cement this feeling by visualising what a successful outcome will look like and mean to you and your business.
If you are not feeling motivated, then visualise failure. How does failing feel? How terrible will you feel? What are the consequences of not achieving the goal?
Visualising this feeling of failing and still being in the same situation you don’t want to be in is another highly motivating method to get you to take action. This is because imagining failure will recruit hormones like dopamine which is known as the molecule of motivation and is associated with pain and stress.
Help your willpower and tenacity by saying things like, “I absolutely will start/do this today. Nothing is going to stop me from starting/doing this.” Likewise, if you want to do something but know you shouldn’t say, “I absolutely won’t…” There is a box of Lindt chocolate in our cupboard left over from Christmas and last night I had to say “I absolutely won’t open that cupboard tonight and reach for the chocolate.” Before I went to sleep, I also said, “I absolutely will get up at 6:30 and have a workout.” And it did help me do just that.
The more willpower you demonstrate over time the more willpower you build and carry forward which will help you do (like exercise) or avoid (like chocolate) things you throughout your life.
Set Aside the Time and Distractions
Having resolved to set your top priority goal and turn it into a reality, how are you going to do this?
As I said earlier, the effort needed won’t just happen. The first thing you need to do is set aside time needed to identify the goal and create the strategy plan as I set out in the previous post.
Setting aside the time to do this and any important task is one of the most important actions you should take. Get strict with yourself.
When do you do your best work? We have a natural rhythm – a daily rise and fall of attention and motivation.
Generally, attention and focus is at its highest around 30 minutes, 3 hours and 11 hours after waking. Research has shown this works around our 24-hour circadian cycle and relates to hormone levels like dopamine.
I wake around 6-6:30am and really like that quiet time at the start of the day to walk the dogs and think about the day ahead or exercise or relax with my first coffee of the day or usually a combination of all three. (Walking the dogs is always in there – the looks I get if I don’t are tough to bear.)
But this isn’t a rule so don’t constrain yourself if you happen to do your best work at other times of the day. If you have other things you need to do that day and so doing pushes this work back to the afternoon, still do it if you can, as completing it will make you feel better than missing it altogether.
I do my creative work first thing which fits in with the 3 hours after waking.
When working on your plan:
• Set a specific time to work on this project or set a constraint like you will work on it between 9am and 11am or you will spend an hour or two hours on this every Tuesday to Thursday before midday.
• Let people know that you aren’t to be disturbed unless it’s an emergency.
• Turn your phone to silent and put it face down or better still put it in the drawer.
• Don’t start up your email software unless you need an email to carry out the work itself. I usually check my emails two or three times a day for half an hour and rarely before 11am. Emails are the biggest grabber of your time and attention so keep switched off as much as you can.
Block out this time in your calendar and make it sacrosanct. Unless there is a real emergency, this time is your time to set your goal and strategy plan for achieving it.
Start as soon as you can. Having read this and assuming you have a big, transformative goal you want to achieve or want to carry out, the first step is to get you thinking about this.
So, block out the time now.
Seriously, stop reading this post and set at least an hour in your calendar or diary to carry out the first step of the blueprint that I set out in the previous post.
I hope you entered later today, or first thing tomorrow or as soon as is possible. Now visualise sitting down at your desk with an A3 sheet of paper and pen and starting the process. Visualisation is a powerful technique and doing this will help cement your commitment to doing this.
When you do sit down and identify your big goal, you’ll hopefully be motivated to carry on and start the next step in this blueprint. Also use this time to set the next session, and ideally the next few sessions, in your calendar or diary.
When you block out time try to be specific as to what you are going to do in that time. So rather than 2 hours defined as ‘strategy plan’ put in those two hours the specific work you intend to do. Or reversely, know what you want to achieve that day and set it in calendar with a time estimate.
There is a technique with regards to using your calendar effectively for all of your tasks called Timeboxing, which is worth checking out.
Set Clear Expectations and Deadlines for Others
Set clear expectations if you delegate tasks to others. Too often expectations are not clearly communicated, and a task has to be repeated because the person hasn’t delivered what you need.
The last thing you want is to have to chase for the results of the work you’ve assigned and then not get the outcome you need. Be very clear about what you need them to do and the outcome they need to achieve.
Ask If they understand and if necessary to repeat back to you what you want them to do. Have them commit to the task and timescale and allow them to voice any concerns or doubts they may have.
Monitor and Review
Having set measurable goals, objectives and the actions that need to be taken, it should be clear as to what information you need to monitor and review in order to know if you are on course or not.
You’ve set yourself deadlines and have been specific about the measurable results, so you can decide how often you need to monitor the progress being made.
The tasks should be granular enough that you can monitor the progress on a weekly or fortnightly basis.
For example, in the previous post’s example – goal of making your care business financially healthy by setting and receiving the right fees – one key milestone is to review all of your current fees by comparing the fee you would need to set for each of your clients, to return your target profit, based on your latest costs (including the increased staff costs that will happen this coming April) against the fee you are receiving.
Broken down further this means creating new fee quotes, based on latest costs (a previous task already completed), for all your current clients.
You may have delegated this task and know that, based on how many clients you have, this task will take 3 weeks to complete. But don’t wait three weeks to check.
Let’s say you have 30 clients to check. You can monitor weekly and check at the end of the first week that 10 up-to-date fee quotes have been created and another 10 the following week and so on. You could monitor daily and check that 2 new fee quotes have been completed each day.
There is a balance between monitoring regularly so you know things are on course and micro-managing. That’s your call but the sooner you know you are drifting off course (new fee quotes haven’t been completed for a day or two) the sooner you can act and get this execution phase of your strategy back on course.
You know that in 3 weeks you can review all your fees and move on to the next stage of the process. A review of this task should therefore already be set in your calendar. Of course, you may have allowed some leeway and so the person has a month to carry out this task and you carry out a monthly review.
However, often you monitor, a monthly review of the whole project and actions being carried out is a good idea to see if all is well or areas of the plan need to be adapted. Again, these monthly review sessions should be set in your calendar and in those you wish to attend.
You could establish the need for a short weekly report or update and only meet with those who aren’t hitting deadlines. For efficiency and effectiveness, create a template of the key information you want to see, so that there is no ambiguity, and you only receive the data you need.
Ideally, you should do this for all your managers and their responsibilities and not just for this plan.
Every quarter, a major review of progress should take place. If you have been carrying out regular monthly reviews, then this quarterly review will essentially be the third monthly review of the quarter and a top-level check of the plan.
Tools to Help You
How you set out tasks and timelines and monitor and review progress is of course your call, and you may have your own methods.
Here I want to highlight some tools that help me with my strategy plans and that you could find useful.
For brainstorming I create mind maps, whether on paper or using a mind map tool, I find they help the creative process and give you a good visual overview of your goal broken down into objectives and actions.
Here’s a simple mind map example taken from simplemind.eu
Once I’ve created this complete picture, I then want to align the work needed into a cause-and-effect flow. In other words, to achieve a major goal or objective, certain things need to happen in a particular order. The way the objectives and tactics are arranged shows the order in which actions need to be implemented and milestones reached.
The ‘fishbone’ image shows how objectives and tactics line up along a timeline towards a goal.
One objective may have more than one level of tactics as Objective 1.1 shows or as Objective 1.3 shows you may have a lower level of objectives under which lie tactics. The numbering system can be useful to track hierarchical paths, but this is down to personal preference.
Having set the flow, with the objectives and tactics, depending on the complexity of what you’re trying to achieve, you may want to separate out the individual objectives into manageable workflows.
These flows would show the actions or tasks that need to be carried out, when they need to begin and be completed and where one would be dependent on the completion of others in order for them to start.
Gantt charts are a powerful way to see if a project or part of a strategy is being implemented according to schedule.
You can create Gantt Charts in Excel or use a commercial Gantt Chart tool.
Here is an example of a Gantt Chart taken from Gantt.com.
Vertex42 has a free simple Excel-based Gannt Chart template that is pretty good.
Another way to monitor progress is to use Progress tables.
Progress tables show the objectives and tactics for each goal and are an effective way to make sure all is as it should be. You can create progress tables that suit your business so long as they clearly show the objectives and tactics relating to a particular goal.
For example, in this image you see a top-level goal (GF1) and beneath it the list of objectives and tactics (or means) that need to be carried out.
You also see how a numbering system is used to link, in this case a Financial goal, to its objectives and tactics
In the next columns, define the actual objective or tactic, the person responsible for its achievement, how success will be measured, what the target is and a date for completion.
Objectives and tactics can be further broken down and ownership given to others to complete a particular task. This is particularly useful for managers assigning tasks to their team.
At the end (right-hand side) of the table you have the Status and Trend columns. I like to use traffic lights in the status column to give an easy visual indication of how well the task or objective is progressing. The traffic lights are based on a number range such as between zero and ten.
The final Trend column shows an arrow to indicate the trend that the status is taking. For example, you could be on schedule (yellow) but from your review meetings feel that you could soon be behind schedule. This gives you an extra level of visibility of progress beyond the Status indicator.
The Trend arrows are also based on a number, say between zero and ten; zero being a drastic downturn which needs to be addressed urgently and ten showing progress moving forward at a healthy pace.
As I said earlier, what methods and tools you use is up to you and has got to work for you. You don’t want to over complicate the process but establish a system to be able to set your plan and monitor and review progress that works for you.
Conclusion
At the time of publishing this post we’re halfway through January. So, if you want to change your care business this year, please set aside time in your calendar now or just go ahead a grab a piece of paper, write out all your goals and circle your top priority.
If necessary re-read the mindset section and tell yourself that you are absolutely going to do this. Don’t overthink the process – grab an A3 sheet of paper or head over to your whiteboard (if you don’t have a whiteboard please invest in one) and start to write down how you want your care business to be different this year and beyond.
Highlight the one top priority (others may be valid and need to be addressed too but stick with the one big one for now). If you’re using paper get a clean sheet and write that priority as a goal in the centra and start to break it down into smaller chunks as I described in the previous post.
If you’re using a whiteboard, take a picture of it and then clean it off and write your top priority in the centre and so on.
Break the goal down into actions and time and measurable milestones and allocate who will do what. Stay at a high level for this initial brain dump and don’t go down into too much detail.
Sit back and look at what you’ve done, let it soak in and refine it over the next day or so and think about who will do what and how you will allocate your time and theirs to get the tasks done.
Doing this will overcome inertia and get the juices flowing and help you get this important project started.
Achieving your goals requires a combination of dedication, focus, and strategic planning.
By setting aside dedicated time, eliminating distractions, staying motivated, delegating effectively, and regularly monitoring progress, you set yourself up for success.
Implementing tools like Gantt charts adds an extra layer of organisation, making your journey smoother and more manageable.
Remember, success is not just about the destination but the journey you take to get there.
Keep pushing forward, and watch your goals transform into reality.
Throughout the previous post and in this one too, I’ve used the example of setting and receiving the fees you need to be financially healthy because, if you are struggling financially, this is by far the most important goal you should focus your energy on achieving.
If you want to see the steps for achieving this goal in more detail along with the methods needed and tools available that will help you, then download my free report, 5 Steps to Make Your Care Business Financially Secure.
If you have any questions or wish to discuss how to go about achieving your aims then contact me on chris@qualityofcare.co.uk and I’ll come back to you as soon as I can.
How to Set and Achieve Your Goals – Part 1
We’re in that period of New Year resolutions and planning the year ahead. Setting goals is a crucial step towards achieving success.
How you set a goal will impact the probability of successfully achieving it. In this blog post, we’ll explore the importance of establishing one priority, breaking down longer goals into manageable milestones, and the significance of specificity, measurability and time in goal setting.
Priority Not Priorities
One of the key elements in effective goal setting is prioritisation. but there can be only one priority.
You may well identify multiple goals to improve your care business this year – more profitable, lower staff turnover, higher occupancy. While it’s tempting to pursue multiple goals simultaneously, spreading yourself too thin can lead to burnout and diminished results. Identify the most critical goal that aligns with your overarching objectives and concentrate your efforts on it.
There can be only one priority.
Having one clear priority allows you to focus your energy and resources, increasing the likelihood of success.
To choose your one big priority, write down all the goals you want to achieve this year for your care business and circle the most important, the one that will have the biggest positive impact on your care organisation. That’s the one to go with.
Of course, don’t forsake other important goals – just identify the one priority goal that must be achieved come what may.
For example, for a care home owner or manager maintaining a high occupancy level and reducing staff turnover and reliance on agency are absolutely valid goals. But if that care home is struggling financially because their fees are too low then receiving the fees, they need to be financially healthy would be my number one priority.
If your care business isn’t as financially robust as it needs to be then straight away, I would say make receiving the care fees you need your top priority because all you would like to do will depend on you being able to afford to. And down the line the very survival of the business is dependent on its financial viability.
Is it Challenging?
Research has shown that if a goal is too easy, it’s more likely that you won’t achieve it because it doesn’t arouse the brain enough.
It needs to be challenging enough that you think you won’t achieve it but not too much to be deemed impossible. The challenge needs to make you uncomfortable. It needs to result in likely failures, anxiety and frustration along the way.
That way it will trigger neural activity – neuroplasticity – in your brain which will create new neural connections that will result in improvements that will stay with you when presented with future challenges.
It’s the same process as learning a new skill. We struggled to drive when we first sat behind the wheel and now it’s second nature.
If learning to play the guitar you won’t improve unless you try techniques and styles that challenge you. I wasted about five years just learning songs that sounded good but weren’t overly challenging. In the last year or so I have focused on learning new techniques and songs that would take me weeks to learn instead of a few hours. Because of this I am a much better player, which helps me to learn new techniques and difficult songs much quicker and which has improved my confidence and the way I play.
Going back to the goal of receiving the right fees for all your clients.
Is it a challenging goal? Well considering your non-private customers – your local councils and ICBs – will do their utmost to pay the fee they want to pay rather than the fee you need, who are often very late payers and who have less money with more heading towards bankruptcy, I would say, yes this does constitute a challenging goal.
But is it impossible? No. If it were then all care providers would be struggling and going under, but they aren’t. And you don’t need to be a big corporate care provider who make enough revenue to manage on low profit margins. Our sister company’s two nursing homes for example, set and receive the right fees for all their clients and only around 3% are private.
Be Specific
Goals must be measurable with regards to what success looks like and how long they should take to achieve. They therefore need to be specific with quantifiable actions.
A new year goal to be fitter this year or lose weight or play the guitar better isn’t a specific enough goal and is very likely to fail as most new year resolutions do in the first six weeks.
A goal to be fitter by going to the gym Monday, Tuesday, Thursday and Friday for an hour which will comprise at least 50 minutes hard work, 70% weight training and 30% cardio training is far more likely to be achieved. How will you measure success? The end measurable outcome could be a weight target, a fitness test or before and after images showing your physical improvement.
Back to the vital care specific goal of receiving the fees you need to deliver great care and return a healthy profit…your goal could be to receive the right fees for all your clients within six months.
And to be more specific, each fee needs to return a profit margin of between 25% and 30%. You have also decided that you will be prepared to serve notice if necessary if a council refuses to increase a fee. (You may well want to include the sub-goal to get the outstanding fees that the council or ICB may owe on you and set time limits.)
Remember, goals need to be challenging – don’t reduce your aim or vision just because you think it may be out of reach – you may not succeed in receiving the right fees for all your clients in the six months because your council is playing hard ball or dragging their feet to attend a client review meeting.
But if by that time 50% or 75% of your clients are on the right fees and the remainder still on-going, that’s still a massive achievement and going to make your care business far more financially stable.
This is where strategies and goals need to be flexible and adaptable and your strategy plan reviewed and amended as necessary.
Break Down the Goal in Actions and Time
Long-term goals, can span a year or even three to five years and can be overwhelming if not broken down into manageable pieces.
For example, you might have a major goal to open a new care home in a year’s time. If you think through the steps needed to achieve that goal or strategic destination, you see clear milestones/goals that need to be achieved along the way.
A goal, and the milestones along the way, needs to be broken down into measurable ‘how’ steps. How will you go about setting and receiving the right fees for your clients and how will you measure that success?
Those ‘how’ steps or objectives will then need to be converted into actual actions or tactics that you and your team need to take to achieve them.
For example, with regards to receiving the right fees, what ‘how’ steps – objectives to achieve the goal – would you need to take and when?
First you need to know your latest costs – your latest average monthly fixed and staff costs and your latest average hourly rates for your care and nurse (if you have nurses) teams. You also need to know your On-costs and Cover costs percentages so you can calculate true hourly rates not just the hourly rates you pay your staff. (These are real employer costs that can easily add 10% or more to your hourly rates and make a significant difference.)
Next you need to review your current fees against these up-to-date costs so you can see in reality how much profit you are making on each of your clients. I’ve carried this exercise out with providers to find their dismay that they’re actually making a loss on some and next to no profit on others.
I would do this exercise with costs that are going to come into force in April when the NLW rises from £10.42 to £11.44 because you won’t be able to do this exercise now, then repeat it after your staff costs increase by thousands of pounds a month.
Next you need to make sure you have detailed, accurate new care fees that you can fully justify. Then arrange client reviews so you can present these detailed fees.
How will you carry out those actions I just outlined? Who will carry them out? How long will this take?
With regards to time, splitting goals or projects into quarterly cycles feels natural. Achieving a goal in 3 months or having a 3-month milestone towards a bigger goal works well. Each quarter becomes a major checkpoint, allowing for adjustments and refinements to your strategy as needed.
For example, you could create a milestone that at the end of March you’ll have reviewed all your current client fees, have new detailed care fees worked out and have contacted those customers – LAs, ICBs – to arrange client reviews. (The next quarter would be focused on having those review meetings and negotiating for the fees you need so you are receiving them by the end of June.)
These 3 months then must be broken down into months (with smaller monthly reviews) and weeks.
Once broken down into measurable weekly actions and targets, you only need to make sure you’ve achieved what you set out to do for that week and that you have what you need in order to carry out the required actions the following week.
Going back to the receiving the right fees example…how long will the above actions take? How long to review your costs and current fees and so on?
This detailed approach transforms abstract goals into concrete, achievable tasks. By focusing on smaller, manageable steps, you build momentum and gain a sense of accomplishment, making the larger goal less daunting. Consistency in your weekly actions also fosters habit formation, which is a key component in sustainable success.
How Much Time Each Week Will the Tasks Take?
When you have an estimation of how long a task will take, how does that translate into number of hours each week and each day? There is no point in setting targets that aren’t achievable because there simply aren’t enough spare hours in the day.
If an estimated time for a task requires that you or another needs to spend 2 hours a day on that task but only an hour a day is realistic then that estimated time to completion needs to be doubled, which will then have a knock-on effect on the following tasks.
This is where your strategy needs to be flexible. You ideally want to achieve the milestone in 12 weeks but if you feel the time required each week is a challenge too far then don’t set yourself up for failure from day one and push the milestone out as far as needed.
Keep it challenging but not impossible.
What are the Risks and Threats to Success
Don’t assume that what you set out to achieve will go according to plan. You will encounter obstacles and hurdles. The more of these internal risks and external threats you can identify that may knock you off course, the better prepared you will be should one occur, and you may even find a way to eliminate the obstacle altogether.
For example, do you or relevant members of your team have the tools and knowledge required to set realistic average costs and accurately work out hourly rates with On-cost and Cover cost and use this information to set accurate, detailed, justifiable fees?
If you have delegated a task to another check that they know exactly what it is you need them to do along with the outcome expected and time frame and that they have the capability and resources to do it.
Give them the opportunity to highlight any concerns they may have such as a pending holiday or their ability to carry out the task. Ask directly and reassure that it’s better to say now, than find they haven’t completed the task satisfactorily in a month’s time.
Is getting a meeting with the council going to be a challenge that means you need to contact and arrange sooner in this process? Can you pre-empt and hence try to eliminate the barriers and objections you think they will put up?
Identifying potential risks and threats so you can mitigate, avoid, or eliminate them is crucial if you are to achieve your goal as planned.
Be SMART
What I’ve described above can be defined as a SMART goal.
It is Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) and provides a framework for crafting effective goals.
Specificity clarifies what needs to be accomplished, measurability ensures progress tracking, achievability balances challenge and feasibility, relevance aligns with what you want to achieve for your business and time-boundness adds urgency.
Applying these criteria ensures your goals are well-defined and strategic.
Conclusion
In the journey of goal setting, having one clear priority, breaking down longer goals into quarterly milestones, and incorporating the SMART criteria are essential strategies.
Combining these approaches with a realistic assessment of your time commitment creates a powerful framework for success.
The next big challenge is to make it happen – to execute the strategy and achieve the goal as planned. 80% of strategy plans fail at the execution phase.
In the next post I’ll talk through how to increase the probability of executing your plan successfully.
Throughout this post I’ve used the example of setting and receiving the fees you need to be financially healthy because, as I said earlier, if you are struggling financially, this is by far the most important goal you should focus your energy on achieving.
I outlined some steps to take. If you want to see these steps in more detail along with the methods needed and tools available that will help you, then download my free report, 5 Steps to Make Your Care Business Financially Secure.
Want 2024 to be Better? Here’s How.
The end of the year is the perfect time to pause, take stock of accomplishments, reflect on the challenges you have faced and to think about what you want next year to bring your care business.
In this post we’ll explore how to identify what you want to change and how to make it happen.
Identify the Changes You Want to Make
What is the one big thing you want to be different in 2024? A more financially robust care business? Expansion? Exit?
Whatever your top goal, now is the time to step back and think how you are going to make that happen.
Be Proactive
The first step to making the biggest positive changes to your care business is to be proactively decide that you are going to make this happen.
Make a strong commitment in your head that you are going to do this and not let everyday issues and demands drag you away. If it helps put notes up to remind you or create a mantra that you are going to make 2024 a much better year than 2023 or the last previous few years.
Follow this up by setting aside time in your diary or calendar to do this. Make this time sacrosanct.
Because we are so busy, it simply won’t happen if you don’t carry out these initial steps.
And please don’t hope things will be better because they won’t. Be proactive – strategic – and not reactive and don’t procrastinate.
Take a moment now to cement in your head that you are going to purposefully make positive changes to your care business.
Having done that, get your calendar or diary out and pencil in when you are going to do this. Even though you don’t know how long this process will take, pencilling in a few hours between now and the end of the year is a good start.
Identify Your Top Successes and Challenges
Before diving into goal setting for the upcoming year, it’s essential to reflect on the challenges and triumphs of the current year.
What worked well? What didn’t?
Answering these questions is a good start. Often what didn’t work well is easier to start with because these are the areas that will have stressed and frustrated you throughout the year.
If all areas worked well then you are looking at how to improve on this year, whether reducing costs and inefficiencies to increase profit or expanding your business.
However, it’s a rare business that has no areas that could be improved on enough to make a significant difference and this is especially so in the care sector where you have so many challenges thrown at you.
With that in mind, grab an A3 sheet of paper and write down the key areas that didn’t work for you. If you are going to do this with your management team then get them to use Post-it notes and write one big issue per note and group the common challenges.
Choose the biggest, most common, say top three areas that didn’t work, based on the impact on your business, and delve down to establish why. If doing this on your own with an A3 sheet of paper, circle each main issue and then branch off. If as a group repeat the Post-it exercise for each common issue.
Doing this will not only help you gain valuable insights into the strengths and weaknesses of your business but it will also help you see how to improve those areas.
By delving down you also get to the root of the problem that may actually be different what might seem obvious.
For example, it might seem obvious to performance manage out a poor manager who is having a detrimental effect on staff and the organisation.
But delve deeper and you might discover that this manager’s behaviour isn’t because they have a crappy attitude but is down to being overworked and stressed because they want to do a good job but aren’t receiving the support they need to be able to, without putting in extra hours and always playing catch-up.
That support could be needing more staff or needing better trained staff or better systems and processes to help them achieve all the things they need to do.
If because of low staff numbers, is there a recruitment drive to address or is the cost of taking on more staff too high? If poor training, why aren’t staff trained as they need to be – is it too costly? If lacking effective systems and processes, is that because of the cost of implementing these systems (like Digital Social Care Records)?
Do you see a common theme in those examples?
As you delve deeper you will find common causes to these issues.
And without doubt the highest issue amongst care providers is the financial struggle they face because of low fees.
Most providers don’t receive the fees they need in order to return the vital profit needed to invest back into the organisation and afford the training needed or pay the rates to keep staff or address the myriad issues that making enough revenue can address.
If you have followed me for a while you know that my overriding message is that your top, number one priority must be the financial health of your care business.
Nothing you will do to try and improve things will matter or be sustainable if your organisation is struggling financially. Everything you want to do will cost money.
On top of that, the challenges the government and your local councils throw at you increases the financial pressure on you. For example, the latest move regarding the new immigration policy and the massive impact on you regarding recruitment may well be the straw that breaks the backs of many providers.
Keep delving down to reach the real causes of your top challenges and if your business isn’t financially robust then this will be one of those causes if not the main cause and should therefore be your biggest challenge to address in 2024.
Assuming that addressing what hasn’t worked rather than improving on what has worked will have a greater positive impact on your care business, next you need to plan how you’re going to fix these problems.
Address Your Top Challenges
Having identified Identify specific areas that require improvement and delved down to find their root causes, establish realistic, measurable goals that will fix the problems.
From a top level, consider the following steps:
• Prioritize goals based on their impact on your business.
• Break down larger goals into manageable, actionable steps.
• Assign responsibilities to team members and ensure alignment with their skills and expertise.
• Set clear deadlines for achieving each goal.
• Invest in the necessary resources, training, or technology to support your objectives.
Creating and executing a coherent strategy is a huge subject – here are some articles that will help you if you’re unsure how to proceed.
• Where Do You Want Your Care Home to Be? Your Strategic Destination.
• How to Get to Where You want to be – Strategic Priorities
If your care business is not financially healthy, then rather than costly inefficiencies in your organisation, I’ll bet it’s because you aren’t receiving the care fees you need.
This therefore is the first thing you need to address.
Instead of taking you through how to do that, please download my report,
5 Steps to Make Your Care Business Financially Secure.
In addition to seeing exactly how to work out your costs and set accurate fees, in this report I also introduce you to a couple of tools that will make controlling your finances and setting fees a whole lot easier.
And if you are receiving fees that are too low then start to review these fees as soon as you can because if you do need fees increasing you know that your local authority or ICB won’t simply accept what you are saying. If you do this then base your staff costs on next April’s the new hourly rate and the increases you’ll have to make for those earning above the NLW.
If you are a rare provider who doesn’t have huge issues in their care business and you wish to improve and build on what you have then think outside the box and embrace innovation. The most significant changes often stem from a willingness to do this.
Challenge yourself and your team to dream big and envision the business you aspire to lead in 2024. This might involve adopting emerging technologies, exploring untapped markets, or redefining your brand identity.
Take these transformative steps:
• Embrace technology trends that can enhance efficiency and customer experience.
• Explore new revenue streams or partnerships that align with your core competencies.
• Foster a culture of continuous learning and adaptability within your organization.
• Communicate your vision clearly to inspire and align your team toward common objectives.
• Encourage creativity and risk-taking to drive innovation.
Conclusion
In the fast-paced world of business, taking the time to intentionally plan for the future is a strategic advantage.
Use the end of this year to reflect and identify what you need to do to take your care business forward and especially to eliminate the big challenges you have faced this year and will face next if not addressed.
By actively shaping the future you desire, you position your company for success and create a roadmap for growth, resilience, and lasting positive change.
Don’t just hope for a better year—make it happen.