How I Moved From Being An RGN To A Registered Care Home Manager

"Being a Nursing Care Home Manager is a rewarding job providing you have the passion, knowledge, resilience and your actions are always based upon professional integrity."

With tips on how to succeed in both roles, Former RGN & Care Home Manager, Nolene, tells how she spent her childhood unwittingly preparing for a career in care, as she reflects on her career journey.

Topics covered in this article

Why I Wanted To Become A Nurse

How I Began My Career As A Registered General Nurse

What Are The Main Challenges of Nursing?

Why I Wanted To Change My Career

How I Became A Registered Care Home Manager

Which Skills From Nursing Were Valuable In My Work As A Registered Care Home Manager

What I Loved About Being A Registered Care Home Manager

What To Expect From Your Job As A Registered Care Home Manager

A Typical Day As A Registered Care Home Manager

Why Being A Registered Care Home Manager Is So Rewarding

Why I Wanted To Become A Nurse

You never realise how great your childhood experiences and challenges influence your decisions as an adult and your career path, until you do a deep personal reflection of past to present.

Here is my journey to becoming a Registered General Nurse and then a Care Home Manager.

I grew up on the beautiful islands of Trinidad and Tobago and both my parents instilled in me and my siblings the value of giving, caring, helping those in need and standing up for justice and truth.

From the age of five, my mum would take us to the “Home for the Age / Elderly”, “The Home for the Blind”, the Home for those unable to Hear and Speak.

Those living in these accommodations looked forward to, and enjoyed, our visits.

As first it was a bit daunting for my brothers and me being among people who appeared to have different skills and abilities from us.

We quickly learned from my mother that this is what the world is made up of and we all must do our part to help enrich the lives of others.

It was always great to see smiles on the faces of those we visited.

We also learnt a lot from them too – as they were highly creative and had such sharp senses and abilities.

As a kid, listening to the stories of the elderly was a fascination and highlight of my visits.

How I Began My Career As A Registered General Nurse

These childhood experiences stayed with me and my first real career passion was to become a lawyer so that I can fight for the rights of those that were unable to do so themselves.

Unfortunately, as this was too costly for my parents, at the age of 18, I migrated to the UK to do my Nurse training.

Being trained as a traditional nurse, my fellow classmates and I spent part of the time in the classroom and the rest of time “learning while doing” – gaining hands on knowledge and experience while working on the wards.

It was an eye-opening experience working on various specialist units.

It became apparent to me again, that someone that is ill, or unable to help themselves needed us as nurses to give care, support, advise and encouragement.

From the very beginning, I had incredibly good mentors who instilled in me good nursing practices, emphasising on areas such as the meaning of giving high quality personalised care, health and safety, infection control, nutrition, documentation etc.

I absorbed this information like a sponge and wanted to know more and more about how I can contribute effectively into supporting and empowering someone back to good health and independence within their constraints and limitations.

I began looking at nursing from a holistic view, and though it is part of a nurse’s remit to administer medication, I had a strong view that human beings can have good physical, mental, social and spiritual health by changing their behaviours and adopting good lifestyle routines.

What Are The Main Challenges of Nursing?

Throughout my training, I realised the one main challenge that some of my peers had was doing shift work, also working on weekends and nights.

This was particularly difficult for those parents with a young family.

I was always an early raiser and staying up all night never posed a problem for me.

During the quiet moments at nights, when all the patients were settled, it was a great time for me to use my time wisely to read and study.

Why I Wanted To Change My Career

On completing my Nurse training in December 1993, my passion to help those most vulnerable in society increased.

These were the elderly.

I quickly found a job in a nursing home teaching myself everything about elder care and how to best make an environment for them that promoted safety, comfort, quality personalised care, fun and love.

During this time, I enrolled onto a degree in Socio-Legal Studies.

My intention was to link the social aspects of Law and Nursing into my current field.

I was a quick learner, hard worker, determined and focus to go into Leadership and Management of a Nursing Care Home.

I was quickly promoted to Senior Nurse and Team Leader while at the same time doing my degree.

How I Became A Registered Care Home Manager

In 1998, my hard work, preparation and confidence paid off as I was offered a job to manage my first Nursing Home that was registered for Nursing and Dementia care service users over the age of 60.

This home was able to care for over 40 residents.

It was a great achievement for me as I was only 27 years old.

I started off on a salary of 25,000 per annum.

After five months I was head-hunted to join a cooperate company running one of there Nursing Care Homes for the elderly, accommodating over 50 residents.

My salary at this time went up to 28,000 per annum.

As time went on, I dipped in and out of Care Home Management to gain experience in other fields.

In my last job as a Care Home Manager in 2013, I had a pay package of £65,000 per annum.

This salary would have been a lot more if I did not move around on several occasions to gain additional experience outside of the care industry.

Which Skills From Nursing Were Valuable In My Work As A Registered Care Home Manager

There is great scope for career development within the Care Home Industry depending on the company size and the areas you may want to specialise in.

From a Nursing background perspective, one can enter the field of Quality Auditing, Wound Care Specialist, Operations Management, Area and / or Regional Director.

The larger the organisation, the more career opportunities there are to explore within this industry.

What I Loved About Being A Registered Care Home Manager

I loved working as a Care Home Manager.

It was my joy and passion.

My love for working with the vulnerable adults came from my early childhood upbringing.

It was my desire to always ensure each person was treated as an individual, giving them always the love, care and respect that they deserve.

My motto was, “Treat each one as we would like to be treated”.

What To Expect From Your Job As A Registered Care Home Manager

Though one may have passion and it could also be your calling, it does not make the job as a Care Home Manager easy.

It can be a highly stressful and lonely job.

Firstly, it helps greatly to have a nursing or medical background in this role.

However, there are companies that take on Care Home Managers without a nursing or any kind of medical background.

To compensate for this, the company will have a Head of Care or Clinical Manager who overlooks the nursing aspects of running a Nursing Home, while the General Manager (Care Home Manager) focuses on Management.

Secondly, there are lots of governmental regulations, company policy and procedures that one needs to know at the back of their hand or needs to know how to access the information quickly if needed.

Thirdly, to be a successful Care Home Manager, you need to know, believe, practice and promote the importance of documentation.

I always emphasised to staffs that if it was not documented, that means it was not done.

Document everything – my saying, “Fail to Document, Prepare to Fail”.

Document, Document, Document!

I cannot stress enough how important this is.

My detailed and meticulous documentation had gotten me out of some sticky jams in the past.

Care Homes are highly regulated and deeply scrutinised, and rightly so.

During regular inspection visits that are conducted by either CQC or other external, or even internal, stakeholders, documentation are rigorously checked.

One simple omission of time, date, signature, amount, frequency etc can turn a Care Home from a good performance rating to a Care Home that needs improvement.

In this sector, there is nothing like over-documenting.

Other areas involve in the role of a Care Home Manager are the Marketing of the Care Home, dealing with its Budget and Finance, and Training and Development of all staffs.

The Care Home Manager is usually given support and training as required in fulfilling these aspects.

Based on my experience, two of the most important aspects of the job for Nursing Care Home Management are:

1. Safeguarding of Vulnerable Adults

2. Recruitment, Retention and Training.

I put them together as I personally believe that they go hand in hand with each other.

Without the right staff in place, managing a Care Home can easily fall apart.

It is the Care Home Manager’s role to ensure that she/ he has the right people recruited for the right position and that the staffs fully embrace the company’s mission and vision.

Having staffs that are committed to looking after the elderly, fully trained, open and willing to learn and exchange ideas is what every good Home Manager seek to attain.

Having the ability to retain staffs that have fully captured and practice the essence of safeguarding the residents adds to the epitome of having an Excellent Care Home.

A Typical Day As A Registered Care Home Manager

On a typical day at work, I always tried to be in the office between 7.30am and 8am.

This gave me to opportunity to meet with the night staff and to listen in to the shift hand- over.

The night staff would also have this opportunity to inform me of any of their concerns both personal and professional and voice anything untoward regarding the patients or other members of the team.

This would be a chance for me to do appraisals or supervision meetings with allocated night staffs so they would not have to return during the day for this to be done.

At this time, I would also be informed of meetings with stakeholders or reviews regarding patient care.

Here I would decide whether I need to accompany the Nurse in Charge at these meetings to give extra support.

My decision would be based on the complexity of the case, the resident, relatives attending and external parties.

I enjoyed visiting the residents to say a quick hello and finding out if they had a good night and have any concerns.

Here is a chance to cast my eyes quickly on their personal care, surroundings and documentation.

Any queries I may have will be directed to the nurse in charge before making assumptions.

After checking that there is a good staffing ratio on duty, I would head to my office to have a look at emails and my “To do” list.

Anytime between the hours of 9am – 11.30am, I would hold a quick Head of Departments Meeting.

It is important for all Heads and me to be fully informed of what is happening daily.

They can then share the information that is appropriate with their teams.

The day speedily goes by if I have to go to the hospitals to assess or re-assess a patient before they come into the care home, or before they are re-admitted into the care home.

There are usually daily, weekly and monthly internal audits that needs to be completed.

Some of these audits would be delegated to someone and then I would check and countersign.

Others, I need to do myself.

The frequency of certain quality audits and Key Performance Indicators can vary slightly depending on the company policy and other factors.

Why Being A Registered Care Home Manager Is So Rewarding

A day in the life of a Nursing Care Home Manager can go by quickly.

There were days when I forgot to have a lunch break.

I always enjoyed knowing that each day would be different.

The bigger the Care Home, you can be rest assured that there is never a dull moment.

Having said this, it is imperative that you maintain a good work/life balance.

Remember that you cannot effectively care for others if you are not caring for yourself.

Healthy eating, exercise, meditation, spending quality time with friends and family outside of the work environment and doing overtime only when necessary, are a few things that can be practiced managing your emotions of this job and to remain highly functional and efficient in this environment.

As the Registered Manager, you are the person responsible and accountable for all aspects of the running of the Home.

It is important to maintain professionalism and openness.

Communication is key.

I always maintained an open-door policy but there were times, I had to shut myself off for an hour or two to meet an important deadline.

Do not become too friendly with staff otherwise this can easily become a problem when drawing the line and can create tensions or jealousy among others at the workplace.

Keep your distance but be friendly and approachable at the same time.

This can make the job lonesome, but it saves you lots of unnecessary long-term problems.

Being a Nursing Care Home Manager is a rewarding job providing you have the passion, knowledge, resilience and your actions are always based upon professional integrity.

Always lead by example.

Let me know in the comments your thoughts on working as a Registered Care Home Manager and what I've said about my journey - let's chat there!

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