Should aged care leaders spend more time on the floor?

If you take a close look at the greatest leaders throughout history, the one common theme that links these people together is the shared understanding that what you do has a far greater impact than what you say. 

It has become abundantly clear that aged care facilities are struggling to meet the needs of those in their care, and whether you blame that on shrewd business tactics by some providers, a lack of Government funding, or a bit of both, the end product remains the same. 

Although conditions may not always be ideal, those that hold management positions within aged care facilities wield some of the greatest influence pertaining to the quality of care that residents receive. 

Gerontology Consultant, Nicole Smith, spent a number of years managing aged care facilities.

Throughout her tenure, she made a conscious decision to spend four days of each month on the floor to work alongside the nurses and carers that she managed while performing the same tasks as they did. 

Nicole sat down with Hello Leaders and shared her thoughts on what facility management can do to positively influence the culture of their workforce, and how changes in the selection criteria for management roles can have a big impact on care outcomes.

“I started out as a disability carer at the age of 18, but I didn’t get to university for nursing until I was 26. But I have had a vested interest in people for as long as I can remember,” said Nicole.

“By the time I started managing aged care facilities, I realised that the higher up I started to go in terms of job title, the more disconnected I felt from the issues that staff on the floor were facing, so I lobbied those above me to give me four days out of every month working on the floor.”

Nicole jumped straight back into hands-on care – changing pads, mopping floors, med-rounds, and spending more time with residents.

While she had a great relationship with staff beforehand, the initial reactions to Nicole picking up a mop and cleaning the floors were more shock than admiration. 

“When I started mopping floors again, the staff actually tried to take the mop off me because they felt I shouldn’t be doing that in my role. Which is not the mindset that I wanted staff to have,” she explained.

“Of course I wanted to help, but in reality, getting out on the floor stemmed from wanting to build a culture of teamwork with staff and letting them know that we are in this together.

“Personally, I think managers that don’t get out on the floor regularly are incapable of getting the big picture.”

Leaders or Followers?

There are a number of different aspects to managerial positions within an aged care facility that go far beyond the realms of overseeing the workplace practices of staff.

Managers are often expected to juggle a number of important responsibilities on any given day ranging from conflict resolution and general people management to the intricacies of meeting targets, staying on budget and dealing with issues related to occupancy.

As part of her role in staff recruitment, Nicole is called upon to gauge the suitability of prospective aged care facility managers and the semantics are not what she is looking at.

“I check a lot of resumes in my current role, and If I come across a resume from a Director of Nursing that is solely focused on their budgeting skills, and meeting targets, I throw it in the bin,” said Nicole.

“I don’t want to see a spreadsheet of financial accolades, I want to hear about their goals for delivering person-centered care and I want to hear about their ideas for potential programs for people living with dementia.

“If they don’t have that, I am not interested.”

 Although Nicole acknowledges that candidates need to have a wide range of skills in order to be suited to a management role, she also believes that there are some qualities that should hold a lot more sway than others which are not always at the top of the list for providers when recruiting. 

She said a manager in aged care needs to be more than what qualifications they have on paper and candidates should be vetted through an emotional intelligence test.

“ideally, it should come down to who has the most heart – and then you work backwards from there,” Nicole explained.

“I think that there are a lot of people in the aged care industry that take these roles for six months who collect their big pays and then leave because they don’t suit the role.

“But then, these same people get another job in the same role somewhere else and you end up with a cycle of managers in the industry who can manage spreadsheets and meet financial goals but aren’t necessarily great at ensuring their residents are having the best experience.

“We need to investigate new ways of employing leaders, because at the moment, the majority of aged care facilities only have bosses – and the current climate shows that this is simply not working.”