• 09 May 2019
  • 5 min read

Do Nurses make the best Home Managers?

  • Liam Palmer
    Registered Home Manager

They're both able to efficiently manage homes, but who does it best - nurses or non-nurses? 

Who makes the best nursing home manager? A generalist or nurse manager? (A generalist shares their experience)

In my experience, this question is part of genuine ongoing debate in UK care home leadership, where residents with nursing needs are involved.

Chiefly, who leads best and in a time of increased rigour with the new regulator's framework (CQC), who has the most complete skills to a CQC rating of "good" or beyond? I write as a generalist who has been challenged by some former clinical colleagues claiming that only a nurse / clinical manager can "really" do it.

Clearly, there does need to be strong clinical leadership but is there always an advantage in that person also being the home manager? I explore below;

I greatly respect my nurse colleagues for the level of responsibility and skill they have, however, in my view, the skill of nursing is a profession in its own right, as is a Head Chef or a qualified Facility Management professional.

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• Which kind of institution should I work for as a Home Manager?

Peripatetic/ Operations/ Regional Managers and Operations Director - what's the difference?

Which kind of institution should I work for as a Home Manager?

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

Their jobs are organised with documentation, records, reporting protocols for legal and corporate governance and (in my experience) usually robust recruitment tools in place to ensure duties and responsibilities are clearly understood.

The Home Manager has oversight of reporting, standards, audits and takes appropriate action as needed and leads by example, listening and supporting.

For my part, I have been determined to show that the distinction between the 2 disciplines is overstated.

For example, no one would say that a clinical manager can't learn the theories of management science and leadership, in the same way, there is no reason why a professional and skilled general manager cannot learn the fundamentals of the clinician.

In my own small way, I have tested this.

After 18 months, I have finished my Diploma in Clinical Science with a Higher Merit.

Was it challenging? Yes!

Understanding "peak flow, urticaria, oncogenic theory and target diastolic blood pressure" was as a foreign language to me!

However, I discovered that the fundamentals are not so hard to grasp as there is a sense and structure to this body of knowledge.

In fact, fear was my greatest challenge over and beyond the technical complexity. In conclusion, I think a better question is - how can we develop clinical home managers to strengthen their general management/leadership skills?

Secondly, how can we develop the clinical knowledge of generalist home managers?

Whilst we consider this, I believe we need to respect the complementary strengths that each approach brings.

In my view, there is no "perfect" care home manager, there is just you and me, learning, growing, doing our best every day and drawing on the teams around us.

Inevitably we'll all always be stronger in some things than others and after all, running a home is a team effort. I am more comfortable to leave it that. 

Can a generalist manager (non –nurse) secure nursing home manager positions?

Yes, they can.

There are a number of reasons why a provider may be open to having a non-nurse lead a service.

One that I have come across a couple of times is where;

A former nurse manager may have lacked general management skills / under-developed leadership behaviours and as a consequence allowed the culture to become too hard (dictatorial) or too soft (the leaders are their friends/boundaries are blurred) which can be unsettling for the wider staff team.

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This can lead to friction, team factions and ultimately poor care outcomes.

On that basis, the provider may feel a manager with deeper general management experience may be more helpful for the service.

It is a broad question to consider whether nurses make better home managers versus non-nurses, (I explore more fully below) it depends on the individual and the needs of that particular service.

In my experience, each brings their relative strengths and perspectives to the role and often others to balance their experience with complementary skills and perspectives.

A non-nurse will often run a nursing home where there is a strong and dependable deputy / clinical lead to support them.

What now?

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About the author

  • Liam Palmer
    Registered Home Manager

Liam Palmer is the author of 2 books on raising quality standards in care homes through developing leadership skills. The 2nd is called "Leadership Secrets of Care Home Managers” inspired by several meetings with the Chief Inspector of the regulator, the CQC. Liam has been fortunate to work as a senior manager across many healthcare brands including a large private hospital, a large retirement village and medium to large care homes in the private sector and 3rd sector.

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  • Liam Palmer
    Registered Home Manager

About the author

  • Liam Palmer
    Registered Home Manager

Liam Palmer is the author of 2 books on raising quality standards in care homes through developing leadership skills. The 2nd is called "Leadership Secrets of Care Home Managers” inspired by several meetings with the Chief Inspector of the regulator, the CQC. Liam has been fortunate to work as a senior manager across many healthcare brands including a large private hospital, a large retirement village and medium to large care homes in the private sector and 3rd sector.