Management and leadership

Dementia Care
February 28, 2017

Managing and leading are important in the operation of care services. They are often seen as being combined in one person, the person in charge. However, it is useful to see them as different functions which are usually but not always combined in the one person. I’d like to look at how these are often separate and what lessons can be learnt from this, in running an effective and successful service.


Management duties are many, and include monitoring performance, organising resources and generally maintaining the stability, performance and purpose of the service as laid down in advance.

These things must, of course, be done to ensure compliance with the regulator’s requirements, with the objectives set by the proprietor or service providing organisation, and to follow agreed business and service development plans.

In itself, this function is quite complex and relies on good communication at all levels with service users, staff and other stakeholders. It often involves specialised technical skills and knowledge to be carried out properly.


This involves motivating and nurturing everyone involved in the service. A good leader inspires and develops their people, engendering a culture of trust and good collaboration. Although it could be argued that this is part of management, I would argue that it is something more. I have encountered in my previous work managers who were technically competent in many areas, but lacking in leadership, or people skills. This was often shown in demoralised staff and a service which had not changed or moved on in decades. The good leader facilitates innovative approaches and solutions. They are prime movers, setting their own goals and encouraging original thinking in those around them.

In the management role it is often said, sometimes seriously, that a manager should be working to make themselves redundant. This is because a well performing and properly managed service needs less input from the manager in order to carry on its course of effectiveness.

However, in today’s atmosphere and culture of reduced funding support and increasing demands from higher standards and customer expectation, it is best to look at the leadership role more closely.

The leadership role

A good leader empowers others and develops their capacity, either through example, specific support, or motivational approaches, to ensure effective working. The leader tends to inspire leadership in others.

Co-production and participation with the users of a service in its development and improvement is a touchstone of quality in the regulation of care. The regulator in Scotland, the Care Inspectorate, has stipulated that the highest grades will only be awarded to services which are not only performing to the highest standards but are doing so sustainably. In other words, it is not just good leadership by one person which determines excellence, since that person could move on at any time. There must be a culture of excellence, where leadership is distributed and promoted across the service. Once established, this does indeed make the leader (partially) redundant: in the sense that where it is securely established, the excellence will be sustained and passed on as staff change and move on.

How to lead

I think there must be a passion for improvement in leaders, combined with responsiveness to the service users’ aspirations and requirements. I have seen excellent examples where service users were supported to lead an initiative which brought about greater participation in policy decisions. I have also seen services so focussed on improvement that it has spread into the community, with effective advocacy for better public transport and other services.

Given the passion, there are more everyday steps to develop leadership and awareness of its importance. A good starting point is a resource on the Scottish Social Services Council’s webpage. The resource, Stepping into Leadership, outlines six basic capacities which good leaders possess, and provides resources to develop and pursue these further.

It is important in today’s challenging environment that services provide the best value, improved outcomes and support for the aspirations of people who use the services. Good leadership, I maintain, is something to be strived for, and an important part of the quality which ensures survival and effectiveness of any service seeking to support people.

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Tony Clarke

Scottish Care Inspectorate Specialist


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