• 21 April 2021
  • 3 min read

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

  • Liam Palmer
    Registered Home Manager
    • Mat Martin
    • Richard Gill
    • Laura Bosworth
    • Aubrey Hollebon
  • 2
  • 605
"It's easy for providers to simply change the Registered Manager when there is a problem. But that is blinkered thinking"

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.

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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.

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About the author

  • Liam Palmer
    Registered Home Manager

Liam Palmer is the author of 3 books on raising quality standards in care homes through developing leadership skills. In Oct 2020, he published a guide to the Home Manager role called "So You Want To Be A Care Home Manager?". Liam has been fortunate to work as a Senior Manager across many healthcare brands including a private hospital, a retirement village and medium to large Care Homes in the private sector and 3rd sector. He hosts a podcast "Care Quality - meet the leaders and innovators”.

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  • Liam Palmer
    Registered Home Manager

About the author

  • Liam Palmer
    Registered Home Manager

Liam Palmer is the author of 3 books on raising quality standards in care homes through developing leadership skills. In Oct 2020, he published a guide to the Home Manager role called "So You Want To Be A Care Home Manager?". Liam has been fortunate to work as a Senior Manager across many healthcare brands including a private hospital, a retirement village and medium to large Care Homes in the private sector and 3rd sector. He hosts a podcast "Care Quality - meet the leaders and innovators”.

  • 2 Comments
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    • Jonathan Clarke 3 months ago
      Jonathan Clarke
    • Jonathan Clarke
      3 months ago

      Registered Managers are nothing more than operational managers in care. You're completely right, Liam. They're not (necessarily) CEO's and they're ... read more

      • Well put Jonathan. I've often argued that all qualities do not exist in one person - life shows you that doesn't it? You are right it is a flawed unrealistic expectation underpinning this. CEO level? ... read more

        Well put Jonathan. I've often argued that all qualities do not exist in one person - life shows you that doesn't it? You are right it is a flawed unrealistic expectation underpinning this. CEO level? Agreed - it is a business manager role in the truest sense.
        read less

        Replied by: Liam Palmer
    • Karen Sweeney 3 months ago
      Karen Sweeney
    • Karen Sweeney
      3 months ago

      100% true...and time someone looked into this.

      • Thanks Karen. Agreed. There are some people like myself talking about this; Martyn Dawes is another prominent voice trying to give extra support to home managers. Jonathan Cunningham is another regist... read more

        Thanks Karen. Agreed. There are some people like myself talking about this; Martyn Dawes is another prominent voice trying to give extra support to home managers. Jonathan Cunningham is another registered home manager doing his best to help registered managers. You are right Karen it needs taking seriously.
        read less

        Replied by: Liam Palmer