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  • 08 May 2019
  • 3 min read

Should I look for jobs managing small care homes or large ones?

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In this blog, Liam defines the difference between working in small and large homes so you can see what one will be best for you to work in.

Are you stuck on what size home you should be working in? Read Liam's blog to find out what kind of care home you belong in.

What are the differences between managing a smaller care home, mid-size to large home?

Firstly,  let’s define these sizes – some care homes for specific specialities can be as little as five beds so let’s be clear; by small, I mean around 35 beds, medium 36 to 55 beds and large 56 to 80 beds.

The key thing that changes in the size of the home is the size of the staff budget (hours).

This has significance for the home manager – in the smaller services, it may be expected that the home manager works on the floor providing care, giving out medication, helping in any other way needed – housekeeping to cooking.

In some instances, if a staff member calls in sick, the manager needs to cover it themselves.

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It may be occasional or habitual if there is a staff vacancy – it is something to quietly explore at an interview.  

The same goes for nursing homes, if a nurse calls in sick and the manager is a nurse, the manager may be required to cover that shift.

You can see how this needs to be well managed and expectations clear.

The key thing for the home manager is to build capacity and flexibility into their staff team to reduce their level of personal responsibility in covering shifts.

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It's harder to work towards a "good" CQC rating in a larger home

One other dynamic to consider is that with managing a large home (as defined above) typically it is harder to get a CQC rating of “good” and above.

Many of the services rated “outstanding” are smaller services with 10 to 20 residents.

This is more complex than it looks – to get a CQC rating of 'good' to “outstanding'” requires the feeling of 'home', the registered manager demonstrating a deep knowledge of their residents and team and when the inspectors speak to staff or residents, all conversations reflect confidence in the service, a responsive service, for a start.

This is easier to achieve in a smaller service where is there is a natural sense of connection with the manager as you see them all the time.

When the resident group and staff team gets larger, the home manager assumes a great sense of leadership and will likely be less hands-on.

This requires a different profile of skills, including the ability to develop subordinates, delegate and achieve outcomes through leading well, rather than by doing it yourself.

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About the author

Liam Palmer is the author of 3 books on raising quality standards in care homes through developing leadership skills. In Oct 2020, he published a guide to the Home Manager role called "So You Want To Be A Care Home Manager?". Liam has been fortunate to work as a Senior Manager across many healthcare brands including a private hospital, a retirement village and medium to large Care Homes in the private sector and 3rd sector. He hosts a podcast "Care Quality - meet the leaders and innovators”.

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