A day in the life of…

Dementia Care
January 21, 2022

Our QCS specialist Barry Price salutes the work of registered managers and gives a very real insight into the work they do.

Now, as we begin 2022 the role of a registered manager does not seem to be getting any easier.

With COVID-19 and its family of variants, looking at the horizon this period of ‘high expectation’ will not be changing anytime soon.

Skills for Care workforce data 2020/21 suggests a turnover rate of 20.7% with an 11.2% average vacancy rate. With 23,500 registered managers in post for 26,400 CQC regulated establishments. As a result, some services remain without a manager in place at a time when they vitally need that commander in chief in place. The same workforce data also shows that registered managers are at risk of ‘burnout’ due to the pandemic.

This is alongside the 105.000 vacancies in social care according to Skills for Care.

Ever-changing landscape

Sadly, I speak to many managers who are considering or have left the sector after many years of loyal service to our loved ones simply because they can no longer cope with this brutally demanding, ever-changing landscape.

But what can we expect? The abuse some managers experience due to having to close a service to visitors following a COVID-19 outbreak. I have spoken to numerous managers who are regularly abused by friends and families for having to make the decision to close to keep people safe knowing the effects this decision will have for many.

The way Government guidance is currently set out, I believe, is making this task much harder to justify and CQC is certainly not helping as the minute something goes wrong who do they head for? When a wave sweeps through a service it’s the manager who will have to justify their actions. It’s the manager who bears this legal and regulatory burden above anyone else.

The Registered Manager has to weigh up the consequences of their actions trying to balance the needs of service users, families, friends and staff as well as the regulations and ensure they remain compliant with any changes and requirements.

Staff pressures

Many of us joined in the “clap for carers” but as that memory fades into the distance even some staff seem to have forgotten the lived experiences of the pandemic. Pre vaccinations and treatments that have left many traumatised. Once again this has given way to the re-emergence of selfish behaviours from some staff. Not turning in after nights out, leaving without notice, arguing and general staff management issues, all that seemed to fade while everyone was focused on keeping people safe. As members of the public, we don’t see how this creates further pressures on staffing and levels of support as a manager is working hard to avoid and navigate these daily tasks too.

If only the relentless guidance changes – usually on a Friday evening – that have a significant impact on work life balance were a little bit better organised and laid out in a way that managers can actually make sense of them.

These current pressures are on top of an already complex day job managing ROTA, staff attendance, admissions, care plan reviews, training, recruitment, infection control, audits, quality assurance, health and safety, CQC requirements and other regulator demands, the role is much harder than it has been in years.

Dealing with admission demands from hospitals to reduce the pressures on NHS beds, we simply do not seem to understand that Registered Managers have to operate within safe limits and legal frameworks too. Refusing admissions is not about making the job easier it’s about maintaining safety and when you have so many staff absent with additional staff vacancies, safe staffing levels override everything.

Talking about staffing levels, those managers who have already had to adapt to the mandatory vaccination requirements for staff last November will know how hard that has been. For those managers now busy planning for this incoming storm, negotiating with staff to get vaccinated, planning for leavers, recruiting, reviewing occupancy levels and dependencies, assessing business viability and business continuity plans and the relentless box ticking, ask yourself do they really need all this stress?

I wrote previously pointing out that care homes are like no other business they are open for business 24/7, all year, and can’t just close the doors if staff do not turn up. Business goes on and it’s at times like this that managers once again become carers to ensure that basic fundamentals are carried out, going back to the day job when they then should have gone home.

Thank you managers

So, for me I think it’s about time we just sat back and gave some credit to those managers who come to work every day, sometimes having to sit and give their head a little wobble, have a little cry before coming into work with a smile and a can-do attitude so that they can be the one that everyone else at the service looks up to in the crisis.

The ones who have the answers when asked to reassure the anxious, to support the bereaved and continue to plan for tomorrow, next week and whatever changes present next.

Thank you, managers, each and every one of you.

Thank you.

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