This month Flourish are delighted to host Bill Mumford as our guest blogger. Bill has worked for over 40 impressive years in the Health and Social Care industry. From being CEO at MacIntyre Care and Eden Valley Hospice to lecturing at The Tavistock and Portman NHS Foundation Trust, to building up experience at Skills for Care to taking the plunge into freelance work! Bill is also the Non-Executive Director of Cumbria Health on Call. We are lucky to have Bill share his thoughts and opinions about Recruitment and Retention in the social care industry.
The recruitment and retention of care staff are universally regarded as the single biggest issue facing the social care industry. While there are many factors which impact this vital issue, the one I wish to highlight is the role of the local manager. Individuals who receive social care support and their family members, will say that good service relies on a good local manager. I have heard this countless times and in many different settings, it doesn’t matter if the organisation is private, public or charitable, corporate or local, big or small - it is the local leader who makes the difference. The correlation is simple: good managers tend to have more fully recruited, better-trained staff who are motivated, achieve high standards and stay longer. The Care Quality Commission also agrees.
When I was CEO of MacIntyre, I focused on two strategic aims. Firstly, to ensure all interactions between colleagues and the people they supported were consistently good and, secondly, to ensure high-quality local leadership. In my view, quality of service rests on these fundamental twin pillars and we frequently ask ourselves: “Will what we are about to do help or hinder good local leadership, improve, or detract from great interactions?” I had in mind the analogy of the first-line managers being at the constriction point of an hourglass - with senior managers, CQC inspectors, social housing landlords and local government commissioners etc all pouring copious amounts of well-meaning but over-bearing sand on their heads! The best answers to those questions came directly from the managers themselves.
Given the importance of local leadership the latest Workforce Intelligence Report from Skills for Care provides some concerning facts:
In England, there are 26,400 Registered Manager posts and at the time of the survey 23,500 were in post, amounting to just over 1 in 10 services with a vacancy. Turnover was 20.7%, which although had fallen from 25.4% the previous year was attributed to the deep sense of duty of local managers during the pandemic. 76% of Registered Managers had been in the sector for 10 years or more and had served an average of 7.9 years in their current role. The qualitative feedback raised some concerns,
"Registered Managers are at risk of burn-out due to the pandemic. Sickness levels are running at double the usual level."
Taking together the vacancy, turnover, and sickness rates along with the length of time to develop good managers, I believe things won’t get better in social care until we learn how to stabilise and improve local leadership. Without this, the current initiatives to improve the recruitment and retention of care staff will fail to build traction.
What’s to be done? As a priority, we need to look after our local leaders. How many of the proposed initiatives that aim to make improvements will fall on their shoulders with nothing else taken away? As I mentioned above, they are the experts, and we need to consult and listen to them. We need to find diverse, localised, and sustained solutions, that work for individuals rather than imposing broad brush quick fixes. As part of this to place more trust in our local managers and delegate greater local decision making and financial autonomy. In doing so provide the training, mentoring, and local networks that will build their confidence and skills to be more self-directing. Registered Managers range from successful owners of their own care business to first-time appointed individuals in a large corporate organisation. The latter could learn a lot from the former.
Pay too needs to be improved in recognition of the key role they play in the sector alongside incentives for personal development. The move on to an Area Manager or Support Manager role looks too attractive to a lesser paid, overworked, permanently on-call first-line Operational Manager.
Last but not least we need to encourage our local leaders to look after their well-being. They excel at supporting others but often at a personal cost. Burn-out is an unacceptable price for anyone to pay - we must be aware that their extraordinary bravery and sense of duty may be masking serious health concerns.
To improve social care, we need to value and look after our local social care leaders.
A note from Flourish: Skills for Care Leadership and Management courses are ideally placed to support aspiring, new, and existing managers to build their skills and competence. Furthermore, where organisations commission programmes for their managers, they are then able to engage with the managers and gain the opportunity to listen and learn from them in exactly the way that Bill suggests above.
Find our upcoming Leadership and Management courses here.
