Do you struggle to step away from the day-to-day problems in your care home? Does your day start, continue and end with problems that only you seem to be able to solve? Are you interrupted by people needing your guidance?
Do you complete your day having not achieved all you wanted?
Do you feel like a hamster in a wheel?
If you could eliminate the vast majority of the problems that land on your desk, how much time would that free up for you?
In this post I’m going to show you how to do just that.
There are two types of problems: those not of your own making and those that are of your own making.
Problems Not of Your Own Making
Of course, problems happen outside of your control. I don’t think for a minute you can be blamed for the Coronavirus pandemic but you have still had to address it. The same goes for other issues like new government legislation, or a key manager in your business becoming ill and needing time away.
Even though you have no influence regarding the occurrence of unexpected problems, there are things you can do so that your care home is better able to manage them.
From a broad perspective, the stronger your care home business is – the stronger it’s foundation – the more resilient it will be to these problems and the smaller the impact will be on your care home.
Coronavirus has had a massive impact on care homes. Even if you haven’t tragically lost a number of your clients to Covid-19, all the tests and checks you have to carry out has cost you at least 10% of your revenue.
Recently one of our nursing homes had to carry out daily staff LFTs because of a positive test, which increased the cost to 20.49% of revenue for that week as shown in the image below.
A care home that only makes around 10% profit will have lost all of that profit to Coronavirus and is almost certainly making a loss.
The mitigating factor in this case is to have a care home that is financially healthy. Healthy businesses make profit margins of around 30%+.
The 10% profit margin many councils expect you to earn, is unhealthy enough in good times never mind the awful year we’ve been through, and makes your care home financially vulnerable to any increases in costs.
A care home that runs well with good systems and processes in place can quickly adapt to the added burden of a new piece of legislation.
A care home that has a strong management structure and a system for bringing people up through the ranks, will handle the loss of a key person much better than a care home which doesn’t.
So, you can mitigate for, and better handle, the unexpected by simply having a strong, strategic care home business.
Problems of Your Own Making
Problems I define as ‘of your own making’ are problems that didn’t need to happen – they could have been prevented. These problems you face most often, which is good simply because over time you can do things to ensure they don’t, or rarely, happen again.
Here are 8 reasons for these types of problems occurring.
- You didn’t thoroughly assess the possible hazards ahead and one of them becomes a reality.
Strategic leaders face fewer problems because they carry out risk assessments.
You should carry out a risk assessment of your care home business every year. Identify the possible internal risks – such as high staff turnover, being too reliant on a key person in the business, needing a very high occupancy level to make ends meet and standards dropping that could threaten your CQC rating – and potential external threats such as changes in legislation, new contracts, new local competition and the strength of the economy.
Identify as many internal risks and external threats as you can and prioritise them according to probability and impact on your business. Prioritise the big ones and make sure you have a mitigating plan in place.
I get my clients to list the risks to their business, which in itself can be a large exercise, and then give a score between 0 and 5 for the probability of it occurring and a separate score for the impact it would have if it did. 0 is negligible probability or impact and 5 massive. Multiply the numbers together and the higher the score the more important it is to address it before it happens.
Create mitigating pans for the risks and once in place carry out the test again and see that it has reduced to an acceptable level.
Asking ‘What If?’ is a powerful way to help you identify these risks and threats. I talk more about this in another article – click here to open this article in another tab.
- You assume the person knows what you are talking about when in fact they really don’t.
You might think you’ve been clear with your instructions or with an explanation but when you know your stuff it’s easy to assume that the other person gets it.
We all suffer from something called the “the curse of knowledge”. Lee Ferver’s book, The Art of Explanation, describes this communication problem and how to overcome it.
We’ve all had conversations with people who are experts in their field and talk to you like you should be too. Whether it’s your GP throwing in a term they use daily, but you hear rarely or a builder talking about getting a building to ‘PC’ (‘Practical Completion’ in case you didn’t know) or a car mechanic telling you your big ends gone, your immediate reaction is to switch off from what they’re saying whilst you panic inside wondering whether to stop the person and ask them to repeat but in layman’s terms.
Actually, because I’ve been in this position quite a lot, I sometimes pre-empt a discussion by admitting that I have little knowledge or experience in this field and ask that they use layman’s terms and avoid acronyms. I then find it easy to stop the explanation when an acronym slips in.
Basically, if someone doesn’t ‘get’ what it is you are explaining or an instruction you are giving, then that’s your fault not theirs. When you’ve finished always ask if they understand and if you’re not convinced ask them to repeat what you said.
- You didn’t make your expectations clear and hence didn’t get the result you wanted.
In addition to clear explanations, your expectations need to be clear too. I’ve heard plenty of leaders in my time give an instruction and then later chase in frustration because they’ve not received anything back.
In reality they can’t complain because they didn’t say when they wanted it back or in what format or if disappointed with the results, what outcome they were looking for.
When do you want a task completed? Do you want to see the results? If so, in what format? Does the task need to achieve a certain standard? How do you want that demonstrated? Set your expectations and as far as possible make them measurable.
“I want that report emailed to me by Friday lunchtime and to include these points that I want you to address and justifications for any decisions you make that are outside the expectations I have set. Call me if you have any doubts or questions.”
- You changed your mind.
If you haven’t fully thought through what you want doing and how you want it implemented, then you could change your mind and waste time and effort.
Make sure you’ve fully mapped out what it is you want doing so that you can more easily spot potential problems that could arise.
- You didn’t fully delegate.
It’s awful for the person being given a task to then be watched over, critiqued, and instructed at every turn. The person you are micro-managing will feel de-motivated and may well do ‘just enough’ so that she can get, what’s become a chore, off her plate as quickly as possible.
By all means, for larger projects, set milestones and the need for regular updates but leave them to get on with it, assuming that you have given them all they need to be able to carry out the task of course.
- You abdicated and relinquished responsibility instead of delegated and kept responsibility.
This goes to the other extreme of not properly delegating. You pass not just a task but complete responsibility to another without checking progress.
Too often I see senior managers and directors blame others who report into them for a poorly or never completed task or project. When in fact, all they’ve done is pass on an instruction, walked away and forgotten about it.
“I asked you to do [task] 2 weeks ago. Why wasn’t it done?” Say, it would have taken a day or so to sort out. Maybe it was a safeguarding that was reported and needs investigation. You didn’t set expectations and didn’t chase and you now have the safeguarding team chasing you because they’ve not received your report and it’s become a bigger problem.
- You keep expertise and knowledge in your head and are therefore always advising, guiding and resolving when things are not done correctly.
This is a common problem and one that takes time to resolve. There has to be a process of decanting what is in your head and getting it in a format that can be understood and replicated by others.
A care provider asked me to help her expand her business from one care home to multiple. The first major task was to make her dispensable. At the time her staff panicked when she went on holiday because she was the oracle who sorted out their issues.
This is a key part of systemising a business and to having it run smoothly without you, in it everyday resolving issues that in reality others should be able to sort out.
- You are a bottleneck.
Clearly you are a bottleneck if much of the expertise is in your head and your advice and guidance has to be regularly sought. You can also be a bottleneck if you restrict responsibility.
For example, if a department doesn’t have a budget and a ceiling item spend, then it has to come to you for approval even to buy a relatively low-cost item. I knew of a care home kitchen that didn’t have a potato masher because they had to get sign-off from the registered manager who hadn’t got round to it. Crazy.
These are causes of problems that should be a quick fix. There are of course less day-to-day causes of problems that can come your way but which never should with better training, and having a more effective systemised business but this is bigger ‘strong foundation’ stuff that isn’t for this post.
So, rather than fix a problem and then have to go back and fix again, and again and…here are some things you can do to eliminate the problem before it arises.
5 Ways to Eliminate Problems Before They Arise
- Identify and Eliminate Bottlenecks
Where in the process of running your business are the bottlenecks? Map out how your business flows and the key processes within. What’s required for that flow to work?
When you’ve mapped out how your business flows, look at where the flow slows down or temporarily stops because it needs input from elsewhere, including from you. I used the example previously about needing your authorisation for minor purchases. In this case, giving a budget and single item spend limit would open up that bottleneck.
How your business flows is a big subject which I introduce in this article.
- Create Rules and Boundaries
Every game of rugby or chess can be unique. The players can do what they like to achieve their aims provided they remain within boundaries and adhere to a set of rules.
By setting clear rules that work within well-defined boundaries, people will know what they can and can’t do and be empowered to do what’s necessary within these boundaries and rules.
As a result, fewer problems (and bottlenecks) will occur and people will feel more confident, be more motivated, will learn more and could reveal themselves as future leaders.
Kitchen – your overall budget is £x a month and you can spend up to £50 on a single piece of equipment without needing to check. I want an itemised report of all your spend with totals on the last Friday of each month. (No more managing without a potato masher. You are no longer a bottleneck.)
Care Manager – I want everyone up, received personal care and had their breakfast by 9 am. I’ll leave it with you to decide how. Let’s meet Friday at 10 to update me on how it’s going and the challenges you’re facing. Don’t forget that you could get the night shift started on this for the several early birds we have. (Clear expectation and delegation but not abdication.)
- Be Clear
When delegating a task, put yourself in their shoes and try to see if, from their point of view, you’ve given them all they need to know to succeed.
If necessary, ask them if they understand and reassure that it’s ok if they don’t get it because you’d rather they fully understood than head off in the wrong direction and waste time and effort.
How best does the person assimilate information? I for example, don’t process aural instructions or explanations very well. Pictures do it for me every time.
If it’s a larger project that you want to delegate, then map it out first and think through the steps to make sure you’ve covered everything so that when you delegate you don’t miss out an important element.
- Educate
Many problems can be eliminated with the right education and training. I recently worked with a company whose new employees were struggling and making mistakes and some leaving within days of being on the floor.
I went through their initial induction program and saw a 2-day, jam-packed event. Talking with new staff it was quickly apparent that there was so much to take in, these people were over-whelmed, nervous and had retained little of what they’d been taught.
We studied the problems and identified what upfront guidance should eliminate them. We also took on board how the new staff felt and, with a core team of managers from across the company, the 2-day stressful induction program became a 5-day inspirational and educational induction program.
New staff were better prepared and more confident, mistakes were fewer and the staff stayed.
- Create Clear Process Flows
A simple one-page process flow can often replace a procedure comprising pages of text. Identify key processes in your business and create process flows that are easy to read, to understand, to learn and to remember.
Here’s a process flow for destroying medicine.
You want your care home to flow like a system. For more, see the Systems Building Block article.
I worked with a care home owner on this and we had department heads identify the key processes that, if understood and followed, would reduce mistakes and discord amongst peers.
A person was assigned to create these process flows and now each department has its own set of processes that all are taught and tested on. Now there is no ambiguity in how to accomplish tasks and mistakes are far fewer in number.
Take away the ambiguity and show people step-by-step how to accomplish key tasks.
Last Word
If you are struggling to step out of your business, eliminating problems before they land on your desk will go a long, long way to help.
Do this and you can step away from your care home and be the leader it needs you to be – driving it forward in the right direction and keeping it on course.
