The role of registered manager is, without doubt, the most challenging in adult social care. I describe the ideal registered manager as needing to have the business skills of Richard Branson, Oprah Winfrey’s ability to connect and empathise with people, Churchill’s leadership qualities, Margaret Thatcher’s determination, Nelson Mandela’s vision, Gandhi’s wisdom and, of course, like David Blaine or Dynamo, the ability to create magic.
The heightened profile of the Care Quality Commission’s (CQC) regulatory regime and rating system now sees providers issuing press releases when one of their care homes is rated as ‘Outstanding’, whilst a care home rate as ‘Inadequate’ becomes front page news in the local newspaper.
Behind both the press release and the local newspaper headline is a registered care home manager or domiciliary care manager, who is regularly working 60/70 hours a week under enormous pressure to deliver.
Current registered managers
The 2016 Skills for Care State of the Adult Social Care Sector and Workforce report paints an interesting picture of registered managers which, if it hasn’t caused providers to reflect and consider the implications by now, it should.
According to the report, there were 22,500 registered managers in post at March 2016, and they had on average been in the sector for over 18 years, with eight years in their current role. This data supports what we intuitively know, that many worked their way up to become a registered manager, perhaps starting as care or support workers.
The report also stated that around 20% of registered care managers left their role in the previous 12 months and that 11.2% of posts remained vacant. These numbers are higher for care homes with nursing. One can only speculate how many of those managers left their posts following a poor CQC report and how many vacant manager posts were a result of managers finding it impossible to live up to the ideal, and perhaps reluctantly finding less stressful ways to make a living. Of course, I can only speculate, we don’t know.
However, given this level of turnover, when combined with the demographic data contained within the Skills for Care report that shows 29% of registered managers were aged 55 or over and could retire within the next 10 years, perhaps it begs the question, where will the next generation of registered managers come from?
Barriers to finding registered managers
We know from the 2016 Skills for Care report that 73% of registered managers were recruited from within the adult social care sector. Some might argue that such a high figure shows that the sector has an established route for those in the sector who have the ambition to become a manager to build a career. However, we would be complacent to think that whatever has worked in the past, be that by luck or design, will continue to work and bring forward the registered managers of the future.
Many providers have responded to the increase in the National Living Wage by flattening the hierarchical structure within their services. This is mainly because they cannot afford the pay increases for each tier of the hierarchy that would maintain the differential in the hourly rate paid between frontline care workers, senior care assistants, team leaders and assistant managers.
Whilst in some cases, that difference was as little as 50p an hour, it encouraged staff to take the next step up the ladder. It allowed managers to incrementally increase levels of responsibility that provided staff with the experience and confidence to work their way up to registered manager over a number of years.
An unintended consequence of combining roles, or in some cases removing whole tiers within the hierarchy, is that it makes that next career step a little higher, and potentially beyond some staff.
This fracturing of the ‘next generation’ care manager pipeline, will only be made worse with the further increase in the National Living Wage, which came into force in April. To add to that worsening situation, some staff who previously might have thought about taking at least the next step up the ladder towards becoming a registered manager, now see how demanding and stressful the manager’s role has become and may be asking themselves, ‘You know what, is it worth all the hassle?’.
One final area of consideration that may impact on the future, is the changing attitude to work of the groups described as ‘Generation Y’ and ‘Millennials’, (born between 1983 and 2000) and how different it is to the ‘Baby Boomer’ generation (born between 1946 and 1964), who make so many of today’s managers.
How many of today’s 20 and 30-somethings are going to remain in adult social care for 18 years, and work their way up to become the registered managers of the future? Many may see their vocation as cause related, in working with vulnerable people more generally, and may work across different care and support sectors.
Although, ‘Generation Y’ and ‘Millennials’ are more likely to have degrees and be more comfortable with technology and the digital age, meaning that, arguably they have many of the base requirements needed to become registered managers of the future.
Preparing care managers of the future
We’ve seen the current picture and the barriers to increasing the pipeline of future registered managers, so, what should providers start thinking about to respond to and prepare for a future where there may not be enough registered manager calibre people to go around?
If organisations do not have a social care workforce planning strategy in place that is reviewed on an annual basis, now might be a good time for them to start developing one. If not for the whole organisation, at least for their registered managers. This should include the age profile of those in post, the possible retirement profile of those in post over the next five years, capacity and succession planning. This will, at least, create a ‘conversation piece’ for senior managers to start considering the possibilities and options.
With resources being limited, very few organisations will have in place a formal ‘Next Generation Care Managers’ programme, but there are things that, with commitment and planning, can be achieved to keep the pipeline of future managers open.
A good place to start might be developing an understanding of who amongst their care and support staff sees their future as a registered manager, including understanding and testing the motivation of those who have expressed an interest through a formal evaluation process. Such an approach will give an indication of how wide the base of the talent pyramid is, as one should expect many to drop out.
However, this cannot be done in isolation and will only work as part of an organisational culture that is open, engaging and encourages ambition and learning.
Those staff who have expressed a desire and shown that ambition to become a registered manager should be encouraged to start investing in their own futures by taking short courses, registered care manager qualifications, or registered manager training, in their own time and at their own expense. This could be through distance learning or as evening courses.
In return, the organisation commits to providing opportunities for those staff to develop their care management and leadership skills and competencies. This could be through acting up or secondment opportunities, internal or external mentoring, involvement in ‘Task and Finish’ or working groups, giving additional responsibilities to individual staff members and even giving them the opportunity to sit in on management development training.
This would inspire staff to want to become registered managers, encourage them to take a proactive approach to their own development and increase their understanding of what is required to become a successful registered manager.
Organisations should also consider making a special effort to engage their ‘Generation Y’ and ‘Millennial’ BME staff in such initiatives. With over 80% of today’s managers being of white ethnicity (London is the exception, where 48% of registered managers are white), clearly some organisations are failing to reflect their staff demographics or local populations and are not establishing role models for others to follow.
Finally, it’s worth remembering that the Care Quality Commission is clear that ‘A person (M) is not fit to be a registered manager in respect of a regulated activity unless M has the necessary qualifications, competence, skills and experience to manage the carrying on of the regulated activity’. It is this regulation that has limited the number of people from outside the sector being directly appointed as registered managers.
With a potential crisis in registered manager numbers heading towards the care sector, it is crucial for the long-term sustainability of adult social care that the sector maintains the pipeline that has delivered 73% of today’s registered managers from within. CMM
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