April 2020: Changes in relation to the COVID-19 Outbreak

The COVID-19 outbreak is the most challenging situation to face the health and social care sectors. It will be demanding in relation to staff sickness and / or self-isolating and an increase in the numbers of adults requiring care and support services. This will be testing for managers logistically and emotionally. But despite the challenges, much positive action is taking place to support health and social care  staff and many offers of help.

At such times, it is vital that managers in all agencies work together to ease the burden and supporting staff and managers. Staff will be tired, overwhelmed and at times frightened, but will also be determined to do the best for the people in their care. It is therefore vital that they receive the best possible encouragement from managers, who are required to be organised, flexible and emotionally supportive. It is also essential that managers also receive emotional and organisational support from senior staff.

See also Responding to COVID-19: the ethical framework for adult social care chapter.

1. Introduction

Inspection reports, complaints and Safeguarding Adult Reviews (SARs) repeatedly show that that leadership is crucial to the safe and effective provision of services for adults with care and support needs.

Good leadership and management skills are therefore crucial to all providers in order to deliver effective and safe services through the people they employ.

In order to ensure that high quality management and leaderships skills are provided within provider services, it is important that managers understand what those skills and qualities are.

2. Leadership Qualities

Good leaders:

  • begin with what they want staff to do rather than what they do not want them to do;
  • treat staff with respect and maintain a human approach to day to day management, in which they support staff and respond flexibly to their needs;
  • are emotionally generous – being available to staff, listening, welcoming and encouraging views, ideas and concerns to be voiced openly;
  • see themselves as part of their team – they think ‘us’ rather than ‘us and them’;
  • see themselves as providing a service to their teams, to enable the organisation to deliver its service consistently and to a high standard;
  • balance the results needed by the service with the needs of its employees;
  • ask for help when needed and consult or refer to senior managers when necessary;
  • are aware of their own strengths and weaknesses and are open to feedback from frontline staff;
  • ensure all staff have a shared understanding of the achievements of the service, as well as the challenges, concerns and risks;
  • understand that positive reinforcement is usually more powerful than financial reward to staff;
  • delegate appropriately;
  • are confident in managing conflict;
  • enjoy communicating with adults who use their services, their families and friends and staff.

Leaders, at whatever level of the service, should be visible and inspire staff to provide a quality service to adults and their families. They should be prepared to lead by example.

3. Policy Partners Project Key Lines of Enquiry Inspection Tool

The Key Lines of Enquiry: Pre-Inspection Tool for Providers and in particular Section 5, Is the Service Well Led, lists the Care Quality Commission (CQC) questions in relation to leadership and management standards. These also link to the Management Standards of Skills for Care.

Completing this tool should enable providers to obtain full evidence of all management and leadership activity prior to a CQC inspection.

4. Culture, Vision and Strategy

The culture of an organisation can be described as ‘the way that we do things’. Organisational culture, therefore, is the way that people behave and practice on a day to day basis.

A positive professional culture is vital to ensure the provision of high quality services which meet the needs of adults and their families. Managers are at the heart of creating and maintaining this culture.

Because achieving a positive culture and having a clear vision of the future of the service, it is vital that the provider describes these clearly and directly, alongside its aims and objectives, in its Statement of Purpose. This should include values, attitudes and behaviours expected of staff and managers.

The culture of the organisation should be evidenced in the following ways in order to meet the CQC requirements:

  • staff and managers feeling positive and proud of the service and their role within it;
  • person centred care is the guiding principle of the service and all its activities;
  • there are cooperative, supportive and appreciative relationships amongst staff;
  • there is fair, transparent and open communication between staff and managers including learning from incidents, accidents and inspections;
  • staff and teams work collaboratively, share responsibility and resolve any conflict quickly and constructively;
  • staff are valued and respected, treated with care and support;
  • the rights of staff are upheld;
  • staff are developed, rewarded and motivated with thanks and recognition;
  • managers encourage innovation and questions from staff.

5. Performance Management and Governance

The central role of the service is to deliver high quality, safe and consistent services to adults with care and support needs, and their families.

In order to ensure this the service must be able to describe the standards by which it evaluates its services (see also Quality Assurance and Learning Lessons).

The service should review its day to day practice, identify areas of best practice and areas for improvement as part of the quality assurance process.

It is crucial that quality assurance operates in a culture of open and honest communication with managers, staff, sharing information with partners, adults and their families as appropriate. This is particularly important following an incident (see Duty of Candour). Managers should ensure that adults, their families and staff who are involved are supported during such processes.

Managers should also ensure that staff receive feedback in a constructive and motivating way, which enables them to know what action they need to take (see also Supervision and Performance Development Review).

6. Skills, Knowledge and Experience

Do leaders have the skills, knowledge, experience and integrity they need to lead effectively – both when they are appointed and on an ongoing basis?

Good leadership and management is provided by staff who have the appropriate skills, knowledge, experience and integrity, not only when they are appointed but on an ongoing basis as well (see Management Training).

Such managers should:

  • receive and offer regular high quality supervision and give meaningful feedback to develop staff skills in line with the needs of the service;
  • manage performance issues in a positive way;
  • have good administrative, IT and organisational skills;
  • have good professional skills and experience;
  • be able to assess and manage risk including capacity and capability of staff and service users and manage critical situations under pressure;
  • implement a regular audit / learning / continuous improvement cycle to ensure quality and consistency of service delivery and ensure that outcomes are shared;
  • motivate, recognise innovation, good work and success;
  • be excellent communicators, so that they can inspire staff and describe clearly the culture of quality and actions that the service needs to achieve;
  • good communication includes written, verbal and high levels of emotional intelligence;
  • good at listening and empathising with staff and will be respond flexibly to the needs of staff;
  • lead and manage by example and be visible and accessible to staff and be able to put policy into front line practice.

7. Roles and Responsibilities

In order to achieve high quality service delivery, it is crucial that managers understand their own roles and responsibilities within the organisation and also those of the staff they manage, in conjunction with the local community and partner agencies.

The following factors are taken from Skills for Care Leadership Qualities Framework:

Developing networks

  • build and maintain positive relationships;
  • encourage contributions;
  • work as part of a team and as an individual;

Managing services

  • planning;
  • managing resources, people and performance;

Improving services

  • safety;
  • evaluation;
  • encouraging improvement and innovation;
  • facilitating transformation and integrated working;

Setting direction

  • identifying change;
  • applying knowledge and evidence;
  • making decisions;
  • evaluating impact;

Delivering strategy

  • implementing;
  • embedding strategy.