19/08/2024
Down Memory lane -A Day in the Life of a CQC Registered Manager: Striving for Excellence in Health and Social Care.
To all my valued followers, I have not forgotten you. My series of Down Memory Lane is still live and kicking. Only that I had to focus on the books that I am writing.
But today, I take a departure from the grind of writing about Leadership and Management within the healthcare sector to reminiscence of my days as a registered manager. *A Day in the Life of a CQC Registered Manager: Striving for Excellence in Care* Down Memory Lane takes me back to my days. I worked as a CQC registered manager for people with Multiple and Complex Learning Disabilities for about 14 years.
Some of you may relate to what I am sharing. But they say, sharing is caring. . Please feel free to share your experience as well.
This was a typical day: One day in 2014:
5:30 AM: Morning Routine and Reflection
I awoke to the soft chime of my alarm. As a CQC Registered Manager, my days were busy and filled with responsibility. Before diving into my demanding role, I made it a point to start my day with a brief meditation and a cup of tea.( I had acclimatised to the British culture). This morning ritual allowed me to centre my thoughts, reminding me of the immense impact I had on both my staff team and the residents under my care. Today, like every day, I was determined to uphold the highest standards set by the Care Quality Commission (CQC), and my employer, ensuring the well-being of those in her care facility.
7:00 AM: Arriving at the Care Home
I arrived at the residential care home early, well before most of the staff. I liked to walk through the quiet halls, greeting the night staff, who were preparing to hand over their duties to the morning team. This was M my opportunity to assess the environment—were there any unusual noises, lingering odours, or signs of distress? My eyes scanned each room with the precision of a leader committed to maintaining the ‘Safe’ and ‘Well-led’ standards required by the CQC.
After a brief conversation with the night supervisor, I reviewed the handover notes. No significant incidents were reported overnight, but I noticed a few minor details—one resident had been restless, and another had refused their medication. I made a mental note to follow up with the nursing team to ensure these issues were addressed promptly.
8:00 AM: Morning Staff Briefing
At 8:00 AM. sharp, i convened the morning staff briefing. The team gathered in the staff room—nurses, care assistants, kitchen staff, and domestic workers. I believed that effective communication was key to running a successful healthcare service, and this daily meeting was my chance to set the tone for the day.
“Good morning, everyone. Thank you for your continued hard work and dedication,” I began. “Let’s go over today’s priorities.”
I discussed the care plans for residents, highlighted any special requirements, and reminded the team of the importance of person-centred care. I also emphasised the need to document everything accurately, a critical aspect of meeting CQC’s ‘Effective’ and ‘Caring’ criteria. I always ended these briefings with an open floor, encouraging my team to share concerns or ideas for improvement.
9:00 AM: Resident Rounds
After the briefing, I joined the nurses on their morning medication rounds, visiting each resident. For me, this was more than just a managerial duty; it was a chance to connect with the people whose lives I was entrusted to improve. I knew every resident by name, their personal histories, and their preferences. I took time to chat with Mr. XYZ, a resident with early-stage dementia who loved to reminisce about his days as a journalist. My attentive listening not only made Mr. XYZ’s Day also provided valuable insights that would be incorporated into his care plan.
During my rounds, I noticed that one resident, Mr. P seemed more withdrawn than usual. I discreetly asked the nurse about his condition and learned that he had not been eating well. I decided to have a one-on-one conversation with Mr. later P, knowing that emotional well-being was just as crucial as physical health in the CQC’s ‘Responsive’ domain.
11:00 AM: Administrative Duties and Compliance Checks
Back in my office, I turned my attention to the mountain of paperwork that came with role. ( Unlike these days, those days, use of electronic recording was in its infancy). Ensuring compliance with CQC regulations required meticulous record-keeping. Today, I was updating care plans, reviewing incident reports, and ensuring that all staff training was up to date.
I prided myself on running a service that met CQC’s ‘Well-led’ standards. I conducted regular audits to ensure that all policies and procedures were not just on paper but actively practised by the staff. This morning, I reviewed the results of the most recent medication audit, noting a few discrepancies that required immediate attention. I promptly arranged a meeting with the nursing team to address these issues, reiterating the importance of medication safety and adherence to CQC guidelines. The nursing team informed me that their main challenge is lack of time. So sometimes they would give medication, hoping to sign later, but then get overwhelmed. This on its own was poor practice and was against medication guidelines as one should sign for administered medication as soon as they finish, and before moving on to the next person.
1:00 PM: Lunch with the Residents
I always made time to have lunch in the dining room with the residents. I believed that my presence reassured both staff and residents, showing that I was accessible and genuinely cared about their well-being. Today, I # sat with a group of residents who were engaged in a lively discussion about their favourite films. I joined in, laughing and sharing my love for Nollyhood movies and open-door cinema. This informal interaction was also an opportunity for me to observe the quality of the meals being served, ensuring they met the nutritional standards required by CQC.
2:00 PM: Family Meeting and Care Planning
I had scheduled a meeting with the family of a new resident, Miss. T, who had complex needs including frequent seizures. The family was understandably anxious about the level of care their loved one would receive.
I welcomed them into my office, offering reassurance and outlining the comprehensive care plan that had been developed in collaboration with my team. I explained how the service followed NICE guidelines and CQC standards to provide high-quality, individualised care. The meeting was emotionally charged, but my calm, empathetic demeanour helped to ease the family’s concerns. By the end, they were confident that Miss. T would be in good hands.
4:00 PM: Staff Supervision and Training
Staff development was a priority for me. I believed that a well-trained, supported team was essential to providing excellent care. This afternoon, I conducted a supervision session with one of the senior care assistants. We discussed her performance, areas for improvement, and career development goals. I also took this time to remind her about the importance of safeguarding and the need to adhere strictly to CQC guidelines, reading company protocols and how to report any concerns.
Later, I led a training session on leadership and management with all Team Leaders, emphasising the need for compassion and patience. I used real-life examples from the service, making the training practical and relevant. My commitment to staff development ensured that my team was always prepared to deliver the highest standard of care, aligning with the ‘Effective’ and ‘Caring’ domains of the CQC.
6:00 PM: Reflective Practice and Preparing for Tomorrow
As the day wound down, I took a few moments to reflect on the day’s events. I reviewed my notes, ensuring that any unresolved issues were addressed, either by myself or delegated to the appropriate staff members. I also made a point of writing in my reflective journal, a practice I had maintained since becoming a registered manager. This not only helped me to process my day but also served as a tool for continuous improvement—both personally and for the service I managed
Before leaving, I made one final round through the service, checking in with the evening staff. I knew that leadership was about visibility and support, especially in a 24/7 environment like this place.
8:00 PM: Heading Home
By the time I left the service, the sun had set, and the first stars were visible in the sky. I was tired but content, knowing that I had made a difference in the lives of the people we supported and my team. As I drove home, my thoughts were already on the next day. There was always more to do, more to improve, and more to learn. But for tonight, I allowed myself a moment of satisfaction, confident that I was fulfilling my role as a CQC Registered Manager to the best of my ability.
Conclusion
The life of a CQC Registered Manager is demanding and multifaceted, requiring a delicate balance of leadership, compassion, and compliance. My day reflects the dedication and hard work that goes into ensuring that a residential care home not only meets but exceeds the standards set by the Care Quality Commission. Through my commitment to continuous improvement and person-centred care, I uphold the dignity and well-being of the people we support while also fostering a supportive and well-trained staff. My story is a testament to the crucial role that Registered Managers play in the health and social care sector, ensuring that every day, the services are places of safety, comfort, and excellence.
Obviously, this was then, the environment in a residential care home is different for Domiciliary Care, which is punctuated by constant round the clock efforts to cover shift, dealing with commissioners, safeguarding, risk assessments, staff conflict, especially the mixture of international and local staff. That is a story for another day !!!!!!!
Godfrey MushanduCare Quality Support and Ultra Healthcare Solutions Health and Social Care Providers Network
