Content warning: This blog contains references to suicide, which some readers may find upsetting.
It’s not often discussed that some of the people hardest hit by COVID-19 were struggling even before their lives changed around them.
Care Management Matters (CMM), a business journal for adult social care providers and organisational partner of NCPS, was already working to address the mental health of registered managers before the horrors they endured during the pandemic. Here, CMM explains how the impact of the pandemic is making it all the more important that this particular group of people can access the professional support they need.
Adult social care is not an easy system to understand or navigate. There are nuances that even those in the sector find difficult. But something that is understood is that working in the sector can be as challenging and all-consuming as it is rewarding and fulfilling.
This is especially the case for registered managers. These are the people who run the care homes and homecare agencies, who report to regulators and support the hands-on staff, who are legally responsible for anything that might go wrong. Their roles come with vast pressure and responsibility, and very little support, and for many this is taking its toll.
The scale of the issue
Before the pandemic hit, CMM took part in a conversation with a network of registered managers, who told us that one of their members had taken their own life due to the pressures of the role and following a negative inspection from the regulator. There were also instances of attempted suicide and conversations around suicidal thoughts.
When those in the room were asked whether they had felt or were feeling the same way, most of them raised their hands. They spoke of the immense responsibility, the isolation and the lack of support for people in the role – and this from a group of managers who were very active in terms of seeking out help and connections.
We discovered that, while there were several resources available for supporting care workers (those doing the day-to-day care work), there was virtually nothing available in terms of supporting registered managers.
In larger organisations where employee assistance programmes were available, registered managers were reluctant to sign up, as they were concerned this would affect their ‘fit and proper person’ status, which is required by the regulator.
In smaller organisations, the registered manager is often also the owner of the business and has no one above them to check in on how they are.
Ultimately, outside of what a manager might discover and do for themselves, there was no support available to them.
A compounding situation
Sadly, this largely remains the case now, and the situation for registered managers is worsening. Shortly after our initial meeting, the pandemic hit the sector hard, and registered managers were often the ones trying to sort out appropriate PPE, staff schedules, ambulance calls, infection control and information for families, as well as trying to make sure that those passing away were still given good deaths.
Once the worst was over, floods of employees left adult social care altogether, and as things continue to settle, we expect an enormous amount of post-traumatic stress amongst staff who have worked through this time.
This adds to what registered managers were already handling; staff wellbeing is an area the regulator expects registered managers to have covered, but how can we ask them to deal with big mental health issues – both their own and those of their staff – when resources are limited in terms of time and money?
Today, registered managers are facing a challenging landscape, with new inspection regimes and criteria being introduced, a workforce shortage and recruitment battle that is worse than ever before, constant pressure to deliver better care for less money, and myriad other considerations, all while making sure that the people they care for and their families are supported, well-informed and happy.
Making a difference
At CMM, we want to do more to support registered managers. We are working with NCPS to provide real help to registered managers for the first time, acknowledging the vital work they do and the difficulties that come with it.
We are developing our online Wellbeing area to offer tips from counsellors and psychotherapists on specific issues that registered managers face, to give them tools to cope when times are hard and to help them understand and identify whether they need to seek professional support, as well as giving them the contacts to reach out to.
We are therefore asking NCPS members to get in touch if you have advice you’d like to share. We’ll be looking to cover topics such as coping with stress, depression, trauma and grief, as well as boosting self-esteem, reaching out for help, how to say no and much more. Email firstname.lastname@example.org for more information on getting involved.