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COVID-19 and registered managers’ mental health

Lisa Lenton, Chair of the Care Provider Alliance (CPA) explores the additional pressures registered managers are facing and offers ways of maintaining and improving mental health.

Coronavirus has impacted businesses in social care like nothing else. But it’s impacting the sector’s staff too.

As we enter into the summer months, the requirement of the social care workforce to support the most vulnerable within our communities continues.

Our already stretched sector, as highlighted by the King’s Fund’s Social Care 360 review, is under intense pressure. As the virus began to spread across the globe, the care sector was taking note, and as early as February CPA surveys revealed where support was needed the most:

  • Maintaining the care workforce.
  • Access to, and the supply of, the correct PPE to keep people safe.
  • Finding novel strategies to care for people in the absence of appropriate protection.
  • Understanding new hospital discharge rules, driving providers to adapt existing policies quickly to support people returning into care settings.
  • Cash flow– Increased payroll costs and escalating costs for PPE caused significant numbers of providers to report concerns.

The CPA has worked extensively to influence Government action and resolve key issues, and whilst progress has been slow, there have been some successes. Despite this, the pressures on registered managers are huge, and it’s bound to impact their mental health.

Additional pressures

In the face of challenge, care workers have gone above and beyond in their resolve to care for the most vulnerable in our society. It’s with a heavy heart that we hear of the tragic loss of care workers to the virus. This has had an impact on the wellbeing of our care workforce beyond anything we have experienced in the past.

Skills for Care estimates there are around 22,000 registered managers in social care, and the additional pressures relating to the massively expanded responsibilities of their role potentially pose a significant risk of overloading to managerial mental wellbeing. Furthermore, confusing and sometimes conflicting official guidance has managers questioning whether they are doing the right thing to keep both staff and the people they support safe.

As well as being energy draining, it’s physically time-consuming to read through endless new protocols, source PPE, communicate to staff the latest guidelines and, at the same time, reassure everyone they are doing OK.

Then there are the stresses unique to each service; Nick Kelly, Chief Executive at Axela Healthcare, points out the COVID-19 pandemic has led to his management resources being diverted towards multiple scenario contingency planning. For example, drawing up transport provisions for care workers when the Government was considering shutting Transport for London services.

Sharing, caring and supporting

Social care managers we know have an enviable resilience, and together with the right team and resources behind them, they continue to not only deliver quality care services in these challenging times, but also support their exhausted teams.
Harnessing technology, the sector is witnessing countless online meetings, creating Facebook and WhatsApp groups where knowledge is shared; there’s reassurance from the top, and there is mutual support across services like never before.

Axela has given all its staff mental health first aid training and, like many organisations, has ensured all staff have access to resources to help manage and address any mental health issues they are experiencing. These support tools go beyond stresses at work, to giving guidance to manage stress and anxiety in personal lives too, such as with finances or relationships.

Making Space manager, Judith Oaks points out it’s a team effort in keeping the physical working environment upbeat and humorous. She highlights the importance of having open and honest conversations with staff when there’s conflicting and confusing guidance. ‘It’s also about acknowledging it’s OK to get annoyed and to have times where you vent to trusted individuals,’ she says.

Sector support

To help with the practical side of things, we are collating and signposting to the latest guidance and advice from reliable sources on the coronavirus workstream on our website, but there’s also a wealth of mental health and wellbeing resources available to the sector.

We have partnered with Big Health to give care workers the tools to manage their sleep and anxiety at no cost for all staff through to December.

Sleepio is a highly personalised, digital sleep improvement programme based on cognitive behavioural therapy (CBT), that gets to the root of poor sleep. There are also tools to help manage any worries and thoughts that make it difficult to sleep and ways to improve your environment and habits for better sleep. Sleepio is backed by clinical evidence, including 12 published randomised control trials and 37 published papers. Key workers can access Sleepio from a computer or laptop at

Daylight is an app that teaches ways to manage worry and anxiety in life. The programme gives a range of techniques and guides the user through daily practice sessions. Key workers can access Daylight at

In addition, our ten members all have resources and guidance on their websites, specific and relevant to their members.

Additional support for business continuity

Knowing where to look for guidance and help in these unprecedented times can also help take some of the stress away from managing a service.

The King’s Fund has a dedicated section on its website aimed at providing support to health and care leaders, working in the NHS, social care, public health or the voluntary and independent sector.

As well as local networks and guidance webinars, Skills for Care has also set up a new advice telephone line and email inbox to provide managers with support and answers to questions.

Furthermore, the Government has recently launched the Care Workforce app , a single digital hub for social care workers to access relevant updates, guidance, support and discounts from their phone. It has also published tips and guidance for managing any concerns and worries that social care managers might have as a result of COVID-19 on its website.

While there is good support available to managers now, let us not forget months down the track, when times are less challenging, the support for care managers, and indeed the workforce as a whole, must carry on to ensure continuity of the sector.

How one care provider is supporting manager mental health
Coverage Care Services is a not-for-profit care provider which currently operates 14 care homes in Shropshire.

The support it has provided to ease the risk of overstretching and exacerbating the mental health of managers includes:

• Zoom meetings as often as needed to keep abreast of national, local and company developments at least twice weekly.

• Access to Director support 24/7.

• HR managers being available to talk to managers and reduce their own anxieties or stressful situations with staff issues.

• Listening to the managers’ suggestions for maintaining staff morale and implementing the suggestions, such as small gifts of thanks.

• Weekly letter from the Chief Executive to managers and staff explaining what the company is doing and why and praising their contribution to keeping residents safe.

• Agreeing a very flexible approach to managers’ working week and ensuring they are getting time away to rest.

• Zoom session with external trainer focusing on personal wellbeing and resilience.

Advice for care managers from WHO
Social care managers are recognised by the World Health Organisation (WHO) as a group currently facing particular challenges to mental and psychological wellbeing.

It has outlined the official following guidance to support care managers:

• Keeping all staff protected from chronic stress and poor mental health will mean that they will have a better capacity to fulfil their roles. Focus on longer-term occupational capacity rather than repeated short-term crisis responses.

• Ensure that good quality communication and accurate information updates are provided to all staff. Rotate workers from higher-stress to lower-stress functions. Partner inexperienced workers with their more experienced colleagues.

• Initiate, encourage and monitor work breaks. Implement flexible schedules for workers who are directly impacted or have a family member affected by a stressful event. Ensure that you build in time for colleagues to provide social support to each other.

• Ensure staff are aware of how they can access mental health and psychosocial support services and facilitate access to such services. It is important that the above provisions are in place for both workers and managers, and that managers can be role-models for self-care strategies to mitigate stress.

• Manage urgent mental health and neurological complaints (e.g. delirium, psychosis, severe anxiety or depression).

Lisa Lenton is Chair of the Care Provider Alliance (CPA). Email: Twitter: @CPA_SocialCare

How are you ensuring your registered managers’ mental health is maintained, despite the current challenges? Share your tips and ideas in the comments section below.

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