What the best care homes all have in common

ver since I worked as a care assistant in the mid-1980s, care homes have been under pressure. The pressure, though, is growing more and more acute as our society ages. Our needs are growing, with more complexity, and our expectations are rising too. It is now time to be really honest with ourselves and recognise that we really need care homes and good ones too! But care homes wont be good by us just telling them or wishing them to be so; kindness and compassion cant just be demanded. Good care homes can only come from a good hegemony based on honesty, shared values and respect. My top ten below is aspirational and reects not only the attributes of a good care home, one where I would like to hear the bell toll, but also the attributes required of the society around it: care homes cannot be good on their own. They cannot be islands.

JOHN KENNEDY graduated from Manchester with a degree in economics. He has since followed a career in social care in both the private and voluntary sectors. As director of care services for the JRF and JRHT he is responsible for a range of services and manages a portfolio of research work on risk and regulation, loneliness, dementia friendly communities and recently investigating ipads for care.

Values must be held at the top

The culture of the provider organisation is crucial to the ability of the care home to be a good one. The views of the chief executive, expressed privately behind their oce door, must reect the fundamentals of integrity, honesty, mutual respect and humanity in relation to the management of their business. If head oce does not reect these values the care home is fettered from the start.

Qualities of the manager

A condent, empathetic, energetic, capable and kind manager is essential for the good care home. One who leads bravely and understands their own accountability and those of their sta. One who knows when to ask for help and is capable of pushing back when demands become unreasonable. One who is fully supported; practically and emotionally.

Sta must be supported

The sta in the good care home are its heart and model its values. They must be respected, supported, well treated and valued. Their emotional as well as employment needs should be recognised and understood. They must be fairly paid, at least the Living Wage!

Clarity of purpose
Good care homes manage risk,regulation and paperwork in an adult way. Crucially they never allow the system and bureacracy to become their main purpose, despite the pressures to do so. Relationships and human beings are their focus.

A community of people
The purpose of the good care home is around the people not the establishment. There is no such thing as a good 42-bed care home. There are however places where 42 individuals live well together, albeit with some ups and downs, and share some communal space, time and company. Food reects this and is tasty and a pleasure. Good care homes try not to refer to the residents as there is no such homogeneous group.

A home is lived in
The environment in a good care home is clean, tidy and well designed. People live there and it shows, it is obvious that individuals have control over their own space. Any tendency to look and feel like a clinic is resisted.

Engagement
Good care homes are engaged with their community. The local community takes responsibility too and encourages, cherishes and supports. Good care homes are welcoming and are easy and friendly places to visit.

Working with the health community

Good care homes have good relationships with the local health community. GPs, district nurses, hospital, consultants. They have respect for each other. They listen to each other, collaborate, understand each others pressures. Work together to nd solutions with the person at the centre.

Working with relatives

Relatives are condent in the values of the good care home. They are able to challenge when needed and to thank. They are able to be relatives. They can let the sta do their job with condence. They understand that the care home is not a babysitter, and that sta are people too and have their own relationships with the people who live there. Relatives too have an adult relationship with the people of the good care home.

No man is an Island, entire of itself . . . because I am involved in mankind . . . never send to know for whom the bell tolls; It tolls for thee
JOHN DONNE

Regulatory support
Commissioners and regulators trust the good care home. They engage in an appreciative way, supporting the care home as a valued part of the whole system. They share their knowledge, experiences and good ideas. They challenge and hold to account but they dont place bureaucratic and ineectual burdens on them. Especially when things go wrong!

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