Inspiring care home managers?

I worked in care for many years but only once did i have any respect for a manager. I think it was in the 70's and a new manager came in. One of the first things she did was to insist that for one hour every afternoon the tv's in all the lounges went off. All staff including cleaners stopped what they were doing and went in the lounges. Then it was over to us to get the residents talking etc. Of course they grumbled at first but they soon got used to this new routine. I will never forget the two ladies who had sat side by side for 5 years suddenly discover that they used to be in the same class in junior school. This sounds old hat nowadays but in the 70's it was a daring thing to do.

I have worked in care homes as a qualified nurse for almost 20 years now. I have worked in numerous homes and spent 10 years working for a nursing agency, so I've been around

The one that I am currently employed in, is run by a charitable organisation and is probably the best of the bunch. The others have been very depressing to work in, and the managers totally uninspiring and many of them totally unsuited to working in elderly care.

The main problem is staffing levels. You simply cannot provide a decent standard of care with the staffing levels that most care homes have.

I am currently working on an early shift as the sole nurse with five care assistants and on the late shift with only three carers - that is to care for 31 frail elderly residents, many of whom require a great deal of care. The nightstaff have one nurse and only two carers. If people were not helped out of bed at 6am the daystaff would be on until lunchtime helping people up People are helped into bed mid afternoon and fed their tea in bed because it takes so long to help 30 odd people to bed and the nightstaff would be on until past midnight if everyone started going to bed at 8pm. To be fair, many of the clients are very tired by mid afternoon or need pressure area care, and bed is the only option.

No matter how inspiring or decent a manager you have, you cannot provide a good standard of care with these staffing levels. The care assistants barely have enough time to provide the basic levels of care and they are constantly running here and there trying to get everything done.

I am expected to: administer the drugs, supervise the carers, deliver personal care, answer the phone, sort out problems, deal with GPs/other health professionals, deal with visitors, do the dressings, make phone calls, update notes etc. Sometimes, I'm not able to get everything done. I hardly have any time to talk to the residents properly or give them my full attention I'm constantly having to do two jobs at once and my mind is constantly on the next problem to be solved.

People think that the care assistants don't actually care, but they do. However, it's exhausting working in that job 5 or 6 shifts a week receiving only minimum wage and absolutely no thanks, either from the manager or the clients/relatives. Many of the carers suffer from chronic health problems that they are struggling to cope with, and some have sick relatives that they must care for after work.

Working conditions are often poor and one woman I am currently working with has had to work whilst suffering from an injury sustained within the home (she was not at fault) because she simply cannot afford to go 'on the sick'.

My carers care a great deal, but I watch them struggle sometimes and tbh, I don't know how they work full time. I only work part time and that's enough for me, but full time is tough.

Shorter hours and better pay would improve things enormously for people working in this environment.

The managers in these places have very little say in how much staff are paid or how many hours they work.

Please don't think that we don't care because we do, but it's such a tough environment in these places. A good manager can help, but what is needed is more money, equipment that works and shorter hours.

Oh hidden - I do so sympathise with you. I too have worked in several care homes and also on hospital wards as an auxiliary nurse/care assistant and they do vary so much. I know from experience that the carers and staff are all doing their best and there is no way that current staff levels, coupled with the lack of proper equipment etc allow them to give the care that is needed. It is so frustrating and although I obviously would never condone it, I can fully understand why carers occasionally lose their rag and walk away from a patient because they just haven't got the energy to cope.
As an agency auxiliary I was sent to a nursing home one day and I had hardly got my coat off before I was told to go and 'put the lady in 4 to bed' - that was it! I had no idea whether this lady could stand or walk, no idea of her mental state. Fortunately I managed but I never went there again!
I would like to pass on something I learned three years ago when my Mum decided to go into residential care. For a couple of years prior to this Mum had gone into a local residential home for a week or so twice a year when DH and I had a break on the respite scheme. The home was great - she always had a good room and apart from the obviously feeling of not being 'in her own home' Mum was quite happy with her stays. When the time came for permanent care it was obvious that the home she had been into several times for respite care was the one to go into permanently.
BEWARE! the permanent room wasn't a patch on the respite room, the care was nowhere near as good and there was no encouragement to socialise etc. She was in a temporary room but a permanent room never seemed to be available. When you think about it with a respite patient you want them to come back whereas permanent is permanent- they're stuck there.
We eventually moved Mum and found the most wonderful home. Only seven residents so the staff knew them all and knew all their little crafty ways etc! It was like one happy family, Sadly Mum died 18m ago but the care she received was second to none - so much so that DH and I still call in regularly to see the staff (yes still the same staff!)and residents that we met when Mum was there. They have two 100yr old and a 105yr old! Mum was as happy there as she would have been anywhere other than her own home and most importantly, she wasn't 'shipped out' when her health deteriorated - they cared for her right to the end and also cared for us.
My admiration goes to all who work as carers whether trained nurses or as untrained help - God bless you all!

My mother was in a wonderful home (nursing, not care) for the last few weeks of her life. It was small (16 residents), run by a husband and wife team and all the staff had been there since it opened 12 yrs previously. And hey, guess what - it was forced to close a couple of years later because the building it was in couldn't be adapted to include en suite bathrooms (most of the residents couldn't get to the bathroom unaided anyway). It seems TLC is way down the list of 'facilities' required when such places are inspected.

I have also worked in care homes. Most of the staff care very much but they are overworked and underpaid. I worked in one where the residents told me that they were glad when agency staff were on as they would get better care. (it has since closed.) I have made my daughter in law promise me that if I have to go into a home to make sure I have my own knickers and deodorant. (don't fancy sharing)