Where Is The Manager?

copied from nursingandeducationplatform.webs.com c Carol Dimon

All care homes must have  a registered manager according to CQC guidelines England. The registered manager of a residential home may  be a senior care assistant as he or she is not required to be  a nurse. The registered manager of a nursing home is required to be  a Registered nurse.

Acceptance of registration means that the manager is legally responsible for care provided within that home. This extends from clinical care such as wound dressings, to PAT testing of electrical equipment. Indeed, in the UK registered managers have been jailed for such as low staffing ( Bunyan in Dimon 2013) , Within the USA , managers are jailed for opposing the human rights Act concerning residents . Therefore why do some homes not have registered managers? The only report I can find, informs us the CQC allowed 3500 care homes to run in England without a registered manager (Brindle 2013). They may argue they cannot afford them or they cannot get an appropriate person ;it would be interesting to identify the owners or companies who have been allowed to continue without  a registered manager. The argument in the case of nursing homes, may be that each nurse is registered and accountable but not for general issues to do with running the home which do affect care. Yet it is difficult for many registered managers who are torn between demands of residents and relatives, staff, and the owner or registered manager of  a company. Indeed, there are also requirements of the CQC or NMC offering further conflict. Yet managers also function differently. Some do not leave the office to such a degree that staff and residents do not know if they are there or not. Many argue there is too much paperwork. Others fear accepting responsibility further; if they are unaware  a dressing has not been done for 10 days – how can they be responsible they argue ?  Yet with huge homes of 200 beds plus, is it possible for the manager to be aware of the needs of all individual patients? Some homes do for this reason, employ a care manager who is not registered and  a budget manager who is registered. Yet there may be conflicts between the two for example, when resources or more staff are not allowed.

Why has the CQC allowed such situations? The CQC does have concerns about closing homes as there are few alternative places for residents; there is also evidence that they hush up findings of  inspections ( Matharu 2013 ) . The government do claim that the CQC is independent . However, the degree of this independence is questionable when they announce they are now to extend this (Dimon 2013 ). Nor is it known who selects CQC board members; most likely the privy council. In effect, the situation seems to be, is  a registered manager required within a care home at all? If not- who will be responsible?

Update: Paul Birstow in Ross identifies (2014) there are now more than 2000 care homes in England without  a manager.


Brindle D (2013) Orchard View inquest: Care home regulation has  a long way to go The Guardian 22.10

 Dimon C (2013) Nursingandeducationplatform.webs Further articles, also wideshut “staffing Dilemma”

Matharu H (2013) ‘CQC launched witch-hunt against me’ Claims ‘Failing’ Care Homes whistleblower from Epsom Your Local Guardian yourlocalguardian.co.uk (3.10)

Ross T (2014) More Than 2000 Care Homes Have No Manager 5.10 http://www.telegraph.co.uk/health/healthnews/11141427/More-than-2000-care-homes-have-no-manager.html  (ack Your care Home twitter)



3 thoughts on “Where Is The Manager?

  1. I know of one large carehome provider with Head Office in the north east where the regional manager sacked 9 managers is in one day. The reasons were mostly trivial or simply made up. HCAs wil do anything to please the reg manager
    Why? Because it saved money. To recruit a new manager needs 3 month to advertise the post, then at least another 3 months to appoint then another 3 months for the manager appointed to resign from their present post.
    At £30000 a year per manager the company saving the company over £200000.
    The regional manager who has since been promoted within the company is so proud of doing this
    CSCI (CQC) simply accepted this without question

  2. According to PSA it is the Privy Council that appoint the NMC Council hence nurses ended up with shape shifters with as much knowledge of nursing as an office clerk

  3. Update CQC email (2015) “There is no guidance that states that a registered manager for a nursing home must have a nursing qualification. They must have the appropriate experience and an appropriate managerial qualification and meet the standards required in Regulation 7.”
    In nursing homes- the question is fast becoming “Where is the NURSE?” See situtaions ion USA and Australia- nurseuncut
    Carol Dimon

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