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20th May 2020

Mental Health Awareness – Why outstanding leadership is the cornerstone of good mental health

Download the free Mental Health Awarness Factsheet here.

It is a collaboration between QCS, British Psychological Society, Age UK, the National Care Forum and TRICRES

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Mental Health Awareness Week takes place 18-24 May 2020; it aims to raise awareness of mental health issues and promote positive wellbeing. It provides an opportunity for you and your organisation to add mental health to the wider conversation.

Especially now that the nation is in lockdown with drastically limited freedoms, keeping yourself mentally healthy is critical. In this challenging landscape, how can Registered Managers protect their staff? What are the key indicators that something is not right and, most importantly, how can they help them to cope and recover from their experiences?

Therefore, QCS has discussed with the British Psychological Society, Age UK, the National Care Forum and TRICRES, to create this guide that provide signposts to registered managers on how to maintain good mental health with their organisations. Download it for free now with the button above!

You can also read the article below, which outline some key points on the importance of outstanding leadership in maintaining good mental health. 


It has claimed the lives of over 315,000 people, hospitalised many more and deprived the world of its liberty. And without a vaccine, it may be sometime before COVID-19 is beaten. But when it is finally tamed, it is not just the physical injuries inflicted that will leave a mark, but the psychological scars too. Particularly vulnerable in this crisis are the nation’s frontline care workers.

With the Pandemic still at an early stage, nobody can be quite sure how many carers will suffer from mental health issues.

But, Lesley Carter, a registered nurse and clinical lead at Age UK, believes that “the scale, duration and intensity” of the COVID-19 Pandemic makes it relevant to the challenges faced by frontline care workers.

She says, “Staff working in the care sector are being put at huge risk. They are much more vulnerable than doctors and nurses who work on the frontlines. Arguably, it's more challenging for them because they have got to know the people they care for on a personal level. Therefore, when lives have been lost to Coronavirus in a home, it takes a much greater toll on their mental health.”

It is a view echoed by many of the 86,000 customers that subscribe to Quality Compliance Systems, the UK’s leading provider of compliance management systems. Philippa Shirtcliffe, QCS’s Head of Care Quality, says, “we know from conversations that Registered Managers are worried about the long term impact on the mental health and wellbeing of staff and we are providing a range of tools to support managers and staff to look after their wellbeing.”

QCS has been gathering information and best practice and has written about the mental health challenges front line workers face and the strategies they can employ to promote wellbeing and manage mental health issues. QCS has referenced evidence-based best practice and guidance from several organisations including Age UK, the National Care Forum, the Social Care Institute of Excellence, the British Psychological Society and TRICRES, a business consultancy. In doing so, it has summarised its findings into seven key points:

1. Inspirational leaders can promote and embed the foundations for good mental health

In any health crisis, strong leadership is essential. But according to the British Psychological Society, leadership must also be “accessible’ and “visible”. David Murphy, the President of the BPS says that “Leadership in a Pandemic doesn’t mean that you have to have all the answers. It means being proactive and not waiting for your staff to come to you, and it’s about demonstrating to them that you’re always with them.”

2. Outstanding leaders act quickly

The British Psychological Society says that breaking-up the Pandemic into three clearly defined stages – ‘prepare’, ‘action’ and ‘recovery’ – is key. Dr Murphy says that the psychological wellbeing of staff should not be picked up at the end of a health crisis. He says that “moral injury, burnout, compassion fatigue and PTSD are chronic difficulties that often develop over time” and therefore, “staff should be constantly assessed and treated”.

Dr Murphy adds, “As the crisis begins to dissipate, people will naturally reflect on their experiences and try to make sense of what they have been through.  A significant proportion will experience post-traumatic stress symptoms initially, many will recover naturally, but a proportion are at risk of developing chronic problems. At this point, we simply don’t know how many.”

3. Leaders attuned to mental health issues spot the warning signs

But if you’re a Registered Manager, with limited resources, how do you spot the indicators that reveal that a frontline carer might be suffering from poor mental health?

TRICRES’s Rebecca Bonnington, who trains leaders to recognise mental health issues believes that “it is not huge budgets that are important”, but Registered Managers, who have “the knowledge and experience to recognise the signs that something is wrong”.

“The key signs that Registered Managers should look out for are changes in behaviour and/or appearance... Sometimes, however, mental health issues are exceptionally difficult to detect. It could be a slight change in body language or a lack of engagement or a lack of self-care. Most crucially, it’s important to be aware that poor mental health doesn’t always mean that people will withdraw. Sometimes they’ll become more extrovert. So, it’s being vigilant and noticing changes in people that really counts.”

4. Excellent leaders intervene and engage

When a Registered Manager recognises that care staff are struggling with their mental health, Bonnington, recommends “a light-touch conversation over a tea or coffee” as being the best initial approach.

She says, “It might take several informal chats for a person to open up. But that doesn’t matter. It's really important that the Registered Manager gently perseveres. Just listening without judgement holds great value. It demonstrates their support for the person and that’s what counts. When the manager earns that person’s trust, they should listen, comfort, support, and if need be put in an appropriate action plan...”

5. Outstanding leaders embed a culture of mental health awareness in their service

Instilling the right culture is vitally important. Age UK’s Lesley Carter, who has also worked for The Care Services Improvement Partnership, says that a mental health awareness culture must prioritise vigilance. So how should best practice look in this respect in both care homes and domiciliary care environments?

“Registered Managers should bring people together at the start and at the end of a shift. They should also be monitoring staff throughout the day. Coffee breaks are a good time to observe a staff member’s level of concentration and their ability to make a decision. Managers, too, must deeply embed the notion that it's natural to cry, to become angry and to be overwhelmed at times. It's also fine not to become emotional. Everyone is wired differently and everybody has different psychological thresholds. For some, the best therapy is not talking. This is also important to recognise.”

Philippa Shirtcliffe adds, “For Domiciliary Care staff, providing 1:1 support by phone or video during the Pandemic is important to help support staff who may be struggling or feel isolated. This is a particular issue when care offices may be closed. or where social distancing is restricting the face-to-face contact with managers and staff.”

6. Effective leaders allow staff the time and space to grieve

Frontline carers must also be given the time and space to process their experiences. If they have witnessed service users or their colleagues pass away, they need time to grieve, to recognise the value of the people that they have lost and to think about the impact that that loss has had on their mental health.

Liz Jones, Policy Director for the National Care Forum, says, “It is important to recognise that everyone responds differently to traumatic events. Dedicated mental health resources and support for Managers should enable people to understand the reasons why they feel they way they do, what the as Managers can do to help people self-manage their mental health, how their teams can come together to support each other and help to identify when that person might benefit from professional support/counselling or other help.”

7. Excellent leaders develop robust but agile communications strategies

Communication is absolutely critical in a fast-moving Pandemic. Policies, procedures and guidance are being updated almost daily as regulators and governments adjust their strategies to keep pace.

QCS’s Philippa Shirtcliffe explains, “There’s no shortage of guidance out there. But a lot of it is neither accessible, digestible or in the same place. We’ve worked hard to make sure that information is presented in the form of accessible factsheets, blogs, webinars, and that each policy is broken down into manageable chunks. This enables Registered Managers to provide the guide to the right carer at the right time drawing on the most relevant and up-to-date best practice information.”

8. Excellent leaders will bring about positive change

There will be positive consequences too. Sheila Scott says the crisis will serve as a catalyst for monumental change.

Mrs Scott says that the media has revealed a gaping chasm between the resources available to the NHS and those available to the social care sector”.

“This,” she explains, “will inevitably mean closer union and that resources will be shared more evenly. In terms of mental health care and awareness, maybe this will open the ways for care workers to be able to access in-house employee wellbeing services and psychologists - as and when they need them. That is the very least that these brave men and women deserve,” she concludes.

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

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