Registered Managers Should Be Given More Support To Run Care Homes Effectively

Registered Managers should not just be left to get on with it and then blamed when things don’t work. They should be allowed influence and not held to account for things they cannot control.

Sometimes it is believed that the Registered Manager is actually responsible for everything running perfectly - if it isn’t, it is exclusively their fault.

This is unfair.

It’s easy to see how we ended up here.

From 2008, care homes were required to have a “Registered Manager”.

From that point on, the Registered Manager became, rightly or wrongly, the single person with ultimate accountability for managing the service.

This was done with good intent – to promote a culture of accountability. However, the unintended consequence in some providers was to make the Registered Manager universally responsible for everything to work within the service without error.

That is: marketing, governance, P+Ls and so on.

This ‘top-down’ approach is unrealistic and puts too much pressure on a single individual.

It will also ignore a raft of potential issues across the service that may well be outside of the Registered Manager’s sphere of influence.

Remember, the majority of Registered Managers RUN the service, they didn’t DESIGN the service, or choose the location.

Furthermore, typically, they didn’t hire all the staff, set pay rates, determine the budget, set out resource allocation or create governance.

They simply run it.

It’s a little like hiring a chef to make your restaurant a thriving business without giving them autonomy to write the menu.

The metaphor isn’t perfect but, in many services, it is not far off the mark.

So, to address this, the Registered Manager’s role should be provided with effective and wide-reaching support from above.

An efficient care home is one where the provider looks at their support processes, their governance systems, their audits, and even their Registered Manager support structures.

A correctly run service makes sure the Nominated Individual or Operations Director is proactively helping the Registered Manager achieve what they need to - not to simply hand them the keys and leave them to it.

That leads to mistaken strategies.

It is easy for providers to simply change the Registered Manager when there is a problem. But that is blinkered thinking - hopeful and wrong.

It would be more insightful to focus on the specific needs and challenges of the service, and to seek input from the Registered Manager on this too. And improve things by working together. Allow them that influence.

It is also tempting to think that more senior managers within the organisation (even if they don’t work at the site) understand the issues at a site better than the Registered Manager. In my experience, this is rarely true.

In CBT terms this is called “magic thinking.” And, again, in my experience, this is still too common in social care.