Inside Track Q&A: Vicky McDwyer, MD, Esker Lodge Nursing Home, Cavan

Vicky McDwyer is managing director of Esker Lodge Nursing Home in Cavan, a specialist dementia care and general nursing home established in 2002.

McDwyer places an emphasis on dignity, choice and independence for her 70 residents, 60 per cent of whom have some form of dementia. She employs 90 staff.

What sets your business apart from the competition?
We spent a lot of time designing the dementia-specific environment to make it domestic in style rather than institutional.

In 2010, when we were extending the building, we sent our architect to Stirling University, a centre of excellence in terms of dementia care and design. Our staff are also truly committed and dynamic people.

What was the best piece of business advice you have received?
Trust your gut and don't sweat the small stuff. I have 90 staff, 70 residents, 150 next-of-kin, the ambulance service, HSE, suppliers and Hiqa to work with each week . . . it can be difficult to keep them all happy all of the time.

It is also difficult to control what they think about your business. I might be doing something because it is best practice, but that might not be immediately clear.

I have learned to only focus on what is best for residents and staff. I have also done a lot of recruiting and my gut has never been wrong in 10 years.

What is the biggest mistake you've made in business?
Lots of little things rather than one major mistake – things I could do better perhaps in terms of how I communicate, or over-thinking things. If I was doing our extension again, I wouldn't change the design in the middle of the project.

You learn by experience though, and what really matters is not making the same mistake twice.

And your major success to date?
Winning Nursing Home of the Year in 2007 (an Excellence Ireland Quality Assurance & Nursing Homes Ireland award) and winning a special recognition award from Ulster Bank Business Achievers in 2012 – we didn't quite fit all their existing criteria but they were so impressed with our work that they felt that they had to recognise what we do.

Whom do you most admire in business and why?
I don't really do "heroes" but I've just finished Steve Jobs's book and I love his drive, passion and perfectionism, and that he never took no for an answer. I admire Norah Casey for her dynamism.

She is impressive in terms of creating opportunities for herself and in her ability to pick herself up after personal tragedy.

Based on your experience in the downturn, are the banks in Ireland open for business to SMEs?
They are talking to people but it is protracted and it requires stamina. Your business plan has to be very clear, tight and concise. They are being very cautious and they do not have the resources to process that level of detail quickly. Everybody is more cautious but it's probably better in the long run.

What one piece of advice would you give to the Government to help stimulate the economy?
The number of people over the age of 85 is going to increase rapidly over the next few years. A national strategy within aged care provision to meet this demand is needed.

There is an opportunity to plan and put infrastructure and care services in place which, as well as meeting the care needs of older people, could create thousands of jobs and support rural communities.

What has been the biggest challenge you have had to face?
Trying to juggle everything constantly – spending time with residents and staff, meeting all the different regulatory requirements and planning for the future.

The nursing home sector is highly regulated and rightly so, but there is a huge amount of work that goes along with that if you are doing it well. In our business, if it’s not written down it didn’t happen, so paperwork is a necessary evil.

How do you see the short- term future for your business?
Really exciting. We are constantly working on continuous improvement and are a bit ahead of the curve in terms of what we do. We have one of the few newly qualified registered nurse prescribers, who can prescribe medication and help with assessments, thus improving healthcare outcomes for residents.

We are currently looking at rolling out new services to help those living with dementia in our local community.

What is your business worth and would you sell it?
It's worth a lot to me because of the hard work to get where we are. Would I sell it? Not now, I'm enjoying it too much.

eskerlodge.ie. In conversation with Ruth O’Connor