- 02 November 2018
- 6 min read
How Home Managers can balance bureaucracy with personal care
If we approach administration creatively we will be able to spend less time in the office, and deliver more personalised care in our nursing homes.

Whatever the size of a care home, and irrespective of the background of the residents, every day we are required to complete a stack of paper work for CQC, local authorities, health colleagues, and families etc.
The demands of filling in the same old forms, completing care plans and risks assessments sometimes makes us feels that it gets in the way of doing what we all want to really do – deliver good quality care to those we look after.

The demands of paperwork and admin
Paperwork sits on shelves and in filing drawers. Its mere presence can breed resentment - demanding our attention and condensing a human job into text and forms.
Yes, the potential outcome of paperwork and administration generally is that it may make home managers less attentive to the human demands of the job. And the volume and detail of work that the administrative demands of the job calls for can be a major problem too, increasing the chance of managers taking shortcuts.

Forms forget that each care receiver has unique, human needs
One of the biggest ironies with all this form filling is how we try to balance a personal service tailored to the needs of individuals by using standardised forms and processes for everyone.
All too often we find that the needs of those we care for don’t easily fit into a form. People become round pegs in square holes, where forms become incomplete or partial pictures.
Personalised care should demand personalised forms
The truth is that personalised care only goes in hand in with a personalised forms.
But what if this were attempted? The pressure would mount as even more time is taken up devising something new.
We would be glued to our computers for even more time, divorced further from those we are there to support.
More time in the office means less time spent with residents, staff and families. So, how can we reconcile all of this?
Stop doing what we have always done - old habits die hard
There are successful routes to making care personal and to document that care in a creative way that demonstrates real personalisation.
In many instances these do not require or always necessitate paperwork at all. It is simply that we have got into the habit of doing it that way.
An old colleague of mine used to make scrapbooks with the dementia patients she cared for, and every day they would be filled with photographs of the things they had done that day.
Not only did this act as a mnemonic device for the patients, it provided a discussion focus for loved ones. In fact, just a few days ago I came across a Tweet by Helen Sanderson where a care organisation actually used photographs as part of a care plan.
In one example the photo illustrated how the resident wanted pillows in their chair to be organised, so as to make her comfortable. Such a simple thing, yet really significant for the person concerned.
Creative personalisation of care - replacing forms
It really got me thinking about how photos can be used as a great way of ensuring personalisation, and could be used for dressing and brushing hair; for ensuring food is mashed to the correct consistency; and for showing how creams might be applied in the correct manner.
Here then, photos could even be replaced by videos, where the individual and loved ones might actually make their own contributions, expressing wishes, preferences and desires.
Replace the written document with other media
And it shouldn’t stop there. We focus our administrative time on the written word. Why not harness other media, since it’s so readily available. Instead of sending written minutes around we could share videos of staff meetings, shared on the company intranet.

Other ‘paperwork’ could be transformed into videos or audio that are similarly held online.
A dashboard could record which staff members have viewed the file electronically and triggered a ‘signed’ to acknowledge receipt. Watching video is quicker and more appealing than reading documents - saving time and ensuring it actually gets consumed by staff.
So, as we shift and adapt how we do things, evidencing good care might actually become the means by which high quality care can be delivered, and when we involve others the content has more meaning for those concerned. Turn dry administration into something more tangible
My tip then, is wherever possible turn the chore of wading through paperwork into a more human process.
Take time to transform time into a more personalised care function. This will mean we’re spending more time with the people we want to be caring for, and in a more personalised way.
Thinking creatively about how we share and consume internal documents will reduce the time we spend away from frontline care, and make administration less dry and unappealing.
Senior Lecturer Health & Social Care, University of Gloucestershire
About the author
Senior Lecturer Health & Social Care, University of Gloucestershire
For more than 30 years Mark has worked across higher education and adult social care in practice, research and consultancy settings. He is passionate about thinking about ‘doing’ social care differently, and creating new structures that maximizes opportunities for all involved in the care exchange.
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