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I make no apologies for continuing to share my thoughts, hope and fears about the role of the Registered Manager in health and social care. It is universally recognised and accepted that the role of Registered Manager is the hardest and the most challenging in the sector. It’s a role that provides the ultimate test of management and leadership on a day-to-day basis as Managers strive to deliver high quality and safe services, deal with the constant stream of people issues and respond to a constantly changing operating environment. It’s a tall order!

The best Managers are in high demand and any Manager who achieves an ‘Outstanding’ CQC rating for their service can pretty much write their own ticket! However, we know that right across the country many Managers are really committed but are struggling to keep all the balls in the air. There are others of course who, as it was once described to me, ‘have learnt the words of the song’! They say all the right things in meetings, nod and smile at the right time, and never allow their service to fall far enough under the internal and external quality assessment and scrutiny spotlight to warrant action, but you know when you spend time in their home or service that they just don’t get it! You know who they are in your organisation.

Several years ago I recall reading an article about the ‘4 types of Manager’ and remember thinking it was so applicable to the Managers in my organisation, and perhaps the health and social care sector generally. My views have not changed and perhaps the ‘4 Types of Manager is just as applicable today.

Type 1 Managers meet all (or mostly all) of the objectives set by the organisation. They are signed up to and articulate the values of the organisation. They deliver and just get it done! Type 1 Managers are like gold dust and the organisation’s challenge is to keep these managers, nurture them and maximise their worth before another organisation tries to tempt them away.

Type 2 Managers are totally signed up to and articulate the organisation’s values, but do not meet all (or mostly all) of the objectives set by the organisation. They work their socks off, but despite their best efforts they just don’t deliver. Despite questions about their performance, organisations would do well to keep them, support, coach and train them to become Type 1 managers. They are worth the investment.

Type 3 Managers generally meet all (or most) of the objectives set by the organisation, but they give you a sense that they are not really signed up to the organisations values and perhaps have established a sub-culture within their service that sets the hairs on the back of your neck on end. Every health and social care organisation has them. Perhaps they’ve been around for years and know how to play the game. This a difficult one for organisations to manage as on the face of it, their performance is OK, but their future in the organisation will need discussion…at some point!

Type 4 Managers quite simply do not deliver the objectives set and are not signed up to the organisations values. Put simply these managers have no future in organisations as their teams will never deliver and organisations owe it to the staff, the service users, their families and others to performance manage them out of the organisation.

I remember sitting down with senior colleagues and we discussed our Registered Managers individually and at the end of each conversation we agreed on what type of Manager each was. I recall that the majority were Type 1 and 2 Managers. Yes, we had a couple of Type 4 Managers and a couple of Type 3 Managers. We then developed individual strategies for each Manager to discuss with them.

With the growing pressures on health and social care organisations to deliver more for less, the role of the Manager is becoming more and more crucial. Organisations would be wise to do everything in their power to retain and reward their Type 1 Managers, overinvest in the development of their Type 2 Managers and commit to tackling their Type 3 and 4 Managers.

Of course, all Managers would be wise to invest in their own continuous professional development, but how many do?

If you look at your Managers, how many would you say fall into each category? Might be worth a discussion


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