Melody Akena.co.uk

The size of Care Homes

There are so many different sizes of homes in this country, by that I mean care homes, which offer a wide variety of opportunities. Some families feel better placing their loved ones in a home which is aesthetically pleasing, it gives them the idea that the home will do the best for their relative.

The choice to come into a care home can seem like a daunting one and I've had to place family members in a care home myself, so I know what it's like on both sides. I have to admit I found large establishments to be quite imposing. The rooms were beautifully done out, but nevertheless they were quite impersonal and so I've always, always favoured smaller homes.

Looking at things from an American point of view, a 'small' home is still a 100-bedroom facility! What I've always loved about the UK however, is the fact that small, means small. A care home with a small 'h' if you will. It was always one of my passions to create a care home with a small 'h'. In fact, why not just drop off the 'care' and simply have the home?

Let us make a home that our residents can feel they're able to relax and kick back in. We don't match the opulence you might well find in a large home, but I do know that each one of my residents knows me and I know them.

I know their families and know who they are, I know that my staff know them, we are a community. We're not really a care home, I think that's what gives us the edge. Small care homes can have a habit of never emotionally feeling quite 'good enough', just because there's another care home near you with a huge facility, don't be discouraged, don’t be disheartened, trust me, it's the small things that people value.

People, after all, like 'unique'. Why do you think we all fall over ourselves for companies such as The Little Cup Cake Company? Because we think to ourselves 'ooh isn’t that nostalgic?', 'isn't it well made and beautiful?'. We all want something unique. We all love the small Bed and Breakfast rather than the huge chain. Everywhere you look, people want to feel that; 1) that they're getting value for money and 2) that there's something unique and individual about where they're staying.

Whatever your quirkiness and whatever makes your home 'home', capitalise on it.

Don’t be discouraged, just look around you and ask yourself 'What makes my home a home?', 'What gives my home have the ability to stand out?'. There's bound to be something, you could find your answer anywhere!

Speak to the nurses who come into your home, speak to your staff, you'll be amazed at what they have to say. When I've chatted to our staff and said 'Oh, you know I think I need to do this or that', they'll say, 'You know, if you do that, you'll lose that or take away a bit of this?', they'll see something I haven’t, they'll have a different perceptive, purely because I've been looking at it from a different angle.

What I'd really love is to encourage you. It may look as though the landscape is forever changing, but your home has a place. There is a reason why people choose your home above anyone else. If you are a small care home then just capitalise on that and find out what your place is. In normal business that would be called a niche market, but for the sake of this let us just call it finding a place that people can call home and that is really your care home.

Care and the world of politics

After watching the political debates on television and hearing what the different parties had to say in their small segments regarding care. I could see that care was not really going to be at the forefront of anybody’s agenda.

The whole issue of care, who pays, what needs to happen, and the issues regarding the ever growing number of people who are living longer and healthier, but need some type of input in their daily lives, sadly, is not going to be touched upon. At the end of the day I think all political parties can safely say that deficit or whatever deficit there is, will have to be met from the public purse and that purse is ever shrinking. So the only way they can really see to do this, is by introducing this concept of people wanting to live in their own homes for longer.

Living in your own home as an older person, is fantastic, if you cope well with daily life and with report after report of how older people have suffered at the hands of an inadequate, poorly run care homes, the concept of living in your own home is appealing. Good care homes though are about choice, real choice. Choice is about having a selection of viable, appealing, well organised options available to you and choosing the best one for you. What if, the options available to you in a care home were superior to staying at home on your own?

If someone was really to turn around and say you know I think going into a care home is better for me than staying at home, what would the outcome of social services be? What would they decide to do?

I have recently been in the middle of a situation whereby I was contacted me regarding a resident who was living in a care home and was going to have to be moved out. It turns out that the home carried out a self assessment of that persons needs and realised that the person no longer needed care. That person though had been in the care home for as long as they could remember. They had got better under the help of the care home. They wouldn’t be where they were now if that home had not been a good care home, one that made a clear difference to its residents. I wish this wasn’t a catch 22 situation!

It is all very well talking about choice, but what choice really seems to means to politicians is 'what's good for the purse, when you don’t have your own funds and when there are no funds available'. It seems to be about what's good for the public purse.

Regardless of how much 'real choice' politicians say they want to give people, regardless of how much they want to say 'yes, choice is there', 'choice' comes down to one thing - money.

Even the star ratings care homes are given is all about the amount of cash homes are given. In different parts of the country, the same type of care, is available in homes who charge £450 per room, per week and those charging £1,500 per room, per week. The difference is not the star ratings but how much money a care home receives to provide the service. We all want a 5* service, we all wants a champagne lifestyle. Good care home managers do the best they can do with the resources they have, but people have to be realistic about those resources.

This new coalition could support an ailing care system by to telling people the truth. The coffers aren’t as full as we are making out, we have a problem, a crisis and everybody is going to have to contribute to ensure they get the type of life and the type of care they want in the future.

They should start talking to young people about the type of care they might need when they're older, it's too late talking to them when they're 90! When they're very young and still in schools, they should be educated about old age. Talk to them about putting money aside for care, a bit like a pension plan. A type of plan that helps the young put money aside in case their need critical care. The type of plan that provides them with options of how possible critical care plans could be delivered to them would be far more valuable in many cases than a simple pension plan.

At the end of the day when an older person becomes ill, they're not thinking 'oh my pension plan gave me this much, but it could only buy this much'. They want to know that all the major decisions are simply taken care of. You ask any old person today, they don’t want to look after individual budgets. They want to know they have enough money to buy the things they used to, to a certain degree, that's their generation. My generation might be completely different.

I've noticed that a lot of care homes are building and extending. They're striving to be bigger, 80, 90, even 100 rooms with lots of facilities, I keep asking myself 'What type of care home do I want to be in? ', 'Do I actually want to be in a care home?', 'Do I even want to be in a living well facility (which by the way, is just another name for a care home)?'

And I keep thinking 'Do I want to live in a large home?'. I think I'll always say a small care home and, surprisingly the majority of care homes in the UK (56%) are under 30 beds. You wouldn’t believe it though, the way bigger care homes make themselves known and dominate the market.

The little care homes don’t say very much. That's another issue. I've looked at all these big care homes and they're developing this site, renovating that site, but do those brash changes really count to their residents?

I would ask any of the politicians to determine care, not on facilities, not on whether the cushions match the chairs or the duvets match with the beds, but by the residents and how well they're looked after. Smaller care homes without those budgets aren't being recognised and instead are even penalised. Why should those doing a really, really good job be forgotten, when they're busy helping those labelled 'critical' and working with them to turn their lives around, why should they be penalised for that?

Getting organised Part 2

Ok, so you heard in my previous blog about my new PA. Well, the story continues. I've also discovered that I had various meetings planned over the last 4 weeks, which were affected by the ash cloud. When we realised various meetings couldn't take place, I asked 'Would you mind doing x, y z?' 'Could you fax it? E-mail it?'. No...apparently they couldn't receive email. It suddenly dawned on me, if the people I was dealing with had access to a computer, then their lives would be so much easier. The ash cloud didn't affect Internet connection, just affected the ability to fly. People didn't have the information they needed with them...of course, you don't leave the office thinking 'oh, I just get my stuff together in case there's an ash cloud, I'll stick everything on a USB stick!' (I have a tendency to lose those anyway!) None of that. The answer? 'Go to my PC' allows you to look at your computer from anywhere in the world. As long as you have internet connection, you can connect to a portal and see your computer back at the office. Now I'm not talking about limited access to files, I'm talking about USB system, and I'm not talking about things you've picked up and downloaded, I'm talking about your actual desktop...you'll be able to view it as if you were sitting in front of it.

You'll be able to access everything, send email, type, write reports, send them off and no one will have any clue where you're doing it from. They won’t need to get that panic stricken call that you can’t get back into the office, I've found it absolutely amazing.

So...so far, I have a PA on the other side of the world and I can now view my own PC from any computer, anywhere in the world. Well, combine that with having Xero Accounting Software and I suddenly realised that worries like where to use a computer, going global, worrying about information etc, all hinder our development in the care sector.

We are so reluctant to do things by computer, that what we simply create mountains of paperwork and we just keep getting buried under it. I really want to encourage you, even if it means taking a couple of days out...really look at your processes. One of the questions I keep asking myself is “Do I have to do this or can it be delegated?”. Believe me, if I can delegate out to my PA, I will. When you run your own business you can’t to it all! If I can delegate, it means I'd be free to do something I really need to do.

My next technical furore is to be going to www.meeting.com in which I'm going to see if I create virtual meetings. Apparently the feature allows me to do presentations, which would be absolutely fantastic. It will mean when I'm away, or if I get stuck anywhere in the world, I can get my team to log on too, we'll be able to get things resolved much more efficiently and effectively.

This is something that I've always wanted to do, I know you shouldn’t take your work with you, but you do and I do! I worry about my business, my residents and my staff when I'm away. Using every technological process possible to maintain that contact during my absence gives me peace of mind, because as it turns out, it's never the staff who have the issues, it's you!

You're always the one saying “Is this ok?”, then writing them a 5 page report and that's when I'm only going up the road for half an hr!

So you see how, finally, now, I'm really watching for how it can take time out, see what I can cut out and how. Read the book, there are so many great examples, it even talks about ways of adding to your income streams, how to work out your dreams realistically and how to take them ahead. If there's one thing I realised, it's that the only thing limiting me, is in my mind, and I would encourage you to explore.

Back to blogging - getting organised part 1

I've spent the last 8 weeks not blogging. Not doing very much actually except trying to sort myself out! You might ask “Oh gosh I thought you were super organised”... well maybe I'm pushing that, because but what I found 4 weeks ago, was me, in a horrible position. I had my blackberry going 20 to the dozen, emails piling up and at one point I had 695 emails in my in-box! I had so many different things going on and I thought 'This is getting over up and beyond a joke! I can’t possibly be effective!'

I'd be lying awake at night, getting up and tackling a few things, then I'd come in early in the morning, thinking I'd get more done before the phones started to ring. I'd leave late at night (after the phones had stopped ringing!). Eventually what you find, is that you're working 24 hrs a day, seven days a week and you don’t understand why.

In the midst of all this, I'd call my friends and bemoan my life, bemoan the fact I was in this situation and then one of my friends just out of the blue said “Look Melanie, this is what you need to do”, and she sent me a book called The 4 hr Week.

'Great' I though, 'another book that's going to tell me you don’t have to work like this and you don’t have to do this and you should do that!. 'Just what I need!' was running through my head.

My book shelf is full of self-help books, some advice I'd I had applied, some I hadn’t and I didn’t need another book, but she said “Just read it!”. All I can say is I am not usually one to advocate books, but The 4 hr Week was a brilliant book.

Not only did it transport me to a lifestyle where I thought 'oh yes, this could definitely work' and 'I would love to be living a lifestyle like this', but it also allowed me to explore pure escapism. One of the major tips was in the section marked 'Alternation' where it talked about outsourcing. Now right now I type this blog,  have a 'policy and procedures' document being completed by my PA. My PA is not in my office, she's not even in my building, she is in fact on the other side of the world.

I've only been working with her for a couple of days but I can tell you is my to-do-list is getting shorter! I'm outsourcing to her for a price that's right for me. I bought 160 hrs with my PA for £643.98 – that's a task every day.

I'm using one of the companies I discovered while reading Timothy Ferris’s book. They provide me with a PA who does all the word processing I could possibly need and then some. I found that it's the typing and updating that needs to be done that takes me away from developing my core business and capitalising on opportunities that came my way. So to have that outsourced now? I can't tell people how brilliant it is, it has absolutely changed my life. There's no National Insurance to pay (because she is outsourced), if I buy 160 hrs and I don’t use them, I can come back when I do need the hours and start again, I can spread the hours or a number of days or weeks even.

You could also buy time just for a specific project. I like to know what's going on with my competitors for instance, to see if they've just launched anything or anything has changed. I now get her to do all of that and she just calls them up, gets all the information and I get it back in a nice little report. I'm so happy; you cannot imagine how happy I am! Back to blogging, so come back soon for the next instalment.

Finances for Care Homes - Part 4

Use a spreadsheet!

I'm not talking about bells and whistles here. I'm talking about a basic spreadsheet where all you have to do is to input numbers and it calculates all the figures for you. You can see what you need to change and where. This helps you in forward planning if you're looking to implement a project a little further down the line for instance, you'll see when it would be feasible.

If you've recently reduced your bed numbers, how would this impact on your all your other projects longer term? What if resident numbers fell? What if the boiler broke down and you needed to find £100 or even £200 to fix it? A spread sheet allows you to understand how to do that. It allows you to look at every situation and every eventuality.

I know it all seems time consuming and you're probably thinking 'I’m not a number person!'. What I have found useful (and my local college helped here) was to go on a Basic Bookkeeping Course, rather like 'Book-keeping for Dummies'. I've actually got this book, it's very interesting, opened my eyes to a lot of things, and definitely helped me get a grasp on my business.

Care is changing. I know I keep saying it over and over again but you need to know when you can move. If you're a small care home you have innovation on your side, you have size on your side, being small means you can respond almost immediately to changing circumstances.

Whether you're financially sound, or standing on the edge of a financial quagmire, finding a way to get out of it means knowing the type of quagmire you're standing in at the moment! If you're sinking fast, you need to know when to latch onto a strong footing and build a strategy to get out.

Another thing - my bank manager loves the fact that I know what's happening and that I can get reports to him on a timely basis. I don’t have to say 'Let my accountant get back to you on that'. Before the end of the month I send a report to my bank manager which shows I'm in command of my business.

It gives me peace of mind too, it's always been an area I've been concerned about. Now I can strategise this year, keep a firm grip on my financial situation and my financial planning for the future. I have a better understanding of my finances...I think you should too.

Finances for Care Homes- Part 2 & 3

The second thing you need to have is a good accountant. They are like gold dust and I am lucky to have a good accountant Nick........from Nick Callen Associates. They are in Bath where I was based originally. I send him all my stuff and it works brilliantly. I know it's a long distance relationship, but we have got phone, email and blackberry to be able to correspond and the best thing is that a good accountant and good bookkeeper will talk to each other. Encourage openness. It really does work and if you don’t quite understand why something appears in a certain section of your accounts then your book keeper or accountant can explain.

The third thing which I think is very important, is having a really good electronic accounting system. Nick introduced me to Xero. I cannot tell you how good Zero has been for me. As a small business owner I don’t work normal hours (even though I now try to work 8 – 5, I still take a peek at 11 at night to see what my accounts are doing, what my bank balance looks like, things like that!)

Get your book keeper to use it, everything is uploaded in real time so there's never a time when I don’t know what's happening to my accounts. There are never any surprises any more, I have a clear idea of who I owe what to, I can track invoices for expenditure and create ongoing invoices.

I have a little marker in my diary that tells me today is Thursday 15^th - you need to make sure you send out your invoices. All I have to do when the invoices are created automatically on the system is to print them off and send them out. It’s fantastic - they do 7 day or 14 day trials and I would suggest if you don’t have an electronic accounting system, use Zero for easy access anywhere.

Finances for care homes-Part 1

Knowing where you are is the key to knowing where you're going.

Financial strategy is one area in which I have always been challenged. I think it's because I'm not an accountant; I have never pretended to be. Accounts generally mean “What's happening to my bottom line, "Oh crumbs I need to do something about it” and then I'd try to delve into it further only to find out out I'm doing the very thing I shouldn’t be doing!

I've sought advice on my accounts far and wide; I've spent ludicrous amounts of money on what I considered to be the best scheme, the best person, I even bought my accounts in-house at one point thinking that was the best way to go because, so I was so worked up about them, but finally I can actually say I have got it!

I can’t say it will work for everybody, I can’t say it will be perfect, but what I can say in these times when strategy is important, is that financial strategy, is even more important.

Burying your head in the sand (and I have done that!), is not the way to go. You’ve got to stand up, sit yourself up in the chair and say to yourself “I have to face this head on”. If you can face it head on, you can devise a plan, you can take positive action.

What do you want to do? Where do you want to go? What are you looking to achieve in 2010 financially? What opportunities are out there? What can you reasonably spend your money on, improving your business, multiplying turnover tenfold or even twentyfold?

You won’t know any of these things until you have actually got a clear understanding of where you are financially. You can’t just leave it to your book keeper, you can’t just leave it to your accountant because they just do their job - they get the information, they configure that information and get it back to you. You have to be more aware of what you're reading, you have to be more aware of where you're going wrong, what you need to change, what you need to cut down on, where you can increase and what you can do to create a contingency fund.

As in previous blogs, I now have four tips that I'm happy to share with you...here is the first:

You need a good bookkeeper. You can do this yourself if you feel you have the ability. I never dared because I know I don’t have the time to do it to the way it needs to be done, but you can do it yourself if you have the ability.

If you realise that is not your calling employ a good bookkeeper. I’m not saying it works for everybody, but there are book keepers I would recommend, first of all, The Local Bookkeeper who offer a bespoke accounting service, with advice thrown in as well if you want, without the function going through the roof, there's also Mazuma Money, they do everything from basic book keeping to payroll right up to management accounts. Why do I like Mazuma? Well...ok...I love the colours and the person I spoke to is really professional but these two things alone, makes accounting exciting to me. A colourful world in a world of accounting that can be quite boring to be honest.

Now you've found your book keeper, the best thing you can do for them is to be organised in how you present your information to them. When they come in to see you, don’t have everything in a muddled heap and hope to god they'll be able to understand your handwriting or your little notes, the post it notes that are now a multicoloured pile of neon signs posting to the various aspects, or the explanation of expenditure that doesn't quite make sense because the receipt can’t be found as the last time you saw it was on the kitchen table, when you were trying to speak in between a major incident. NO.

Having it all in organised order will help you and it will help your book keeper. You can answer any questions they may have almost immediately and you can ask them questions. Try and get your book keeper to come in house once a week, even it's for a short time, or try and have time set aside to talk to them on a once a week basis. It is easier to remember stray receipts week by week than it is to remember stray receipts at year end. Believe me I have been there.

Stay tuned for Tip two to follow!

 

Contingency

My third tip on Strategy is Contingency

This is so important! We as Care Home Managers already know that Government placings are being reduced and if it continues, what would you do? If, suddenly, something unexpected happened, what are your contingency plans?

Never thought about a contingency plan? It's time to and it stops the fear of things going wrong. Answer me this, 'What's the worst thing that could happen?'. My next question is 'How would you manage that?'

That's the question I ask myself. It's not something we all want to dwell on but the idea is to look at the worst case scenario and then put a plan into place for if it happened.

What would affect the running of your home for instance?

What would affect you and your income?

Look at your answers and then work out how to lessen the impact, should a worst case scenario actually happen.

For example, if you know that your revenue is being reduced, are you still spending the same in every area of your home? Have you looked at staffing levels? I know that 's probably one of the first things you'd look at, but where else can you reduce costs? What other areas can you make changes in?

I would also suggest that you start to save 10% of your income. How do you find 10% of your income to spare? Try doing it as a game and be creative. Adjust your thinking. Rather than thinking I'm going to cut out everything, simply imagine what you'd do with a slightly smaller income. For instance. Say you're working with an income of £20,000 a month, what would you do if your income had only ever been £18,000 per month? What could you do without?

I know there was a university that did that – it went around all of its departments and said to them, 'If you had to lose 10% of your budget, what would you do?' The University did this at the start of the Credit Crunch. Each department started making changes and when departments had to become tougher, the various areas had money, a contingency plan and everything else in place to meet their needs.

Remember, be prepared and you'll take away the fear.

Second tip towards Strategy

Ok, my second tip on Strategy is Marketing. Below you'll find a few questions that it would be worthwhile considering. You may already do your marketing, but how could you improve it? Have this in the back of your mind as I take you through the questions:

How are you currently marketing your home in this environment?

When something big or major happens in your home, do you get out there and try and get it into the papers?

Do you take every opportunity to shout about your home?

You have to market your home and think about where you're reaching the public and what you are telling the public. For instance, what do your staff and residents think of your home? Could their comments be really helpful for others to hear? How would you communicate those comments to the public?

What do people in the community think of your home?

How community focused are you?

One of the most important parts of marketing in 2010 is blogging. While traditional marketing methods such as newspapers, flyers, leaflets, brochures, radio are all valid, don't forget your on-line audience. People use the internet to research Care Homes so it's not enough these days just to stick with a website that you created years ago. Keep it current. Do you Twitter? Are you on Facebook? For the Care Home Managers amongst you on LinkedIn? Don't forget that your customer isn't always the person who'll come to live with you, it'll be their daughter, son, granddaughter or grandson, they could be in business, they could love blogging, be stay at home parents – either way, your on-line presence should be as strong as your off line presence.

So – what could you do today?

Steering the Ship

What I want to talk about today is 'Strategy'.

I mentioned in my last blog as one of the 3 things 2010 will incorporate – Change and Leadership were the other two.

Strategy is a very, very important aspect in the current care landscape. Care home managers across the UK realise that long term care placements are changing. Governments are no longer placing people in long term care, they're looking for other ways of meeting care needs - mostly in the community and beyond. So, if our landscape is to change, we need a strategy to deal with that challenge.

For many care homes, their only source of revenue is the home itself. There's often nothing else attached to that Care Home. This is where I urge Care Home managers to take their heads out of the sand and look at what is really going to be needed. It's easy to pretend nothing is changing rather than sitting up and taking notice but this is exactly what you need to do. You need to make changes, look at your business and notice how you can add value to it. You can no longer be reliant on one revenue stream, instead look at ways you can create greater opportunities.

The last snow storms in the North East of England have now died down but I used that time to really take a long hard look at Clara House. We're a small care home, we don't have all of the revenue that larger care homes have, and certainly have to look at our budgets if we are to continue the standard of care that our residents have come to expect from our home.

So what I decided to do, was break this down into 5 key areas and I'll be giving you one area per week. First of all Revenue:

1 Revenue

Think about how you can improve your revenue. What added value can you give? What makes your care home stand out? Can you offer something that no-one else in your area does? To my mind it's absolutely vital to expand your private market. We did this at Clara House and the first thing we did was to ask people in the local community what they wanted. Once we found out what they wanted, we matched what we could provide and then told them we provided it!

Honestly, don't assume you know what people want. First step towards increasing your revenue then? Look at diversifying but ask what your audience wants first.