Role of Registered Manager Adult Residential Care England
Champion, Leader, Protector
- the Role of the Registered Manager
in Residential Care for Adults
in England
(Pre-publication draft for consultation)
CPEA/SCA October 2011
1
Role of Registered Manager Adult Residential Care England
The guide to what Registered Managers of adult residential care
homes do and how they go about it on a page
CPEA/SCA October 2011
2
Role of Registered Manager Adult Residential Care England
1.
Introduction
1.1. Who is this guide for ?
The guide is designed for people who are responsible for leading and
managing all aspects of an adult residential care home in England. Properly,
this ought to be the person who is registered with the Care Quality
Commission (CQC), the regulator and inspection body for England. It is the
Registered
Manager
who
has
responsibility
for
the
leadership
and
management of residential services, including professional best practice,
staffing, communications, risk management, marketing, facilities, finance
and administration.
The guide uses the term Registered Managers, though, in practice, job
titles can vary depending upon the sector and type of service. The guide also
uses the terms Residents throughout, this is intended to include all adults
and older people living in care homes. The focus of this guide is on the
common roles and functions of a Registered Manager. The contextualized
knowledge and practice specific skills required for working with particular
groups are acknowledged, but are not included in this publication.
1.2. Why is this guide needed?
The Social Care Association, the UK wide professional association for care
practitioners, managers and those supporting them, considers this addition
to their practice guides1 timely for the following reasons:
i.
Emergent workforce and regulatory data and information suggest a
shortage of qualified Registered Managers. There is a need to
succession plan for aspiring managers.
ii.
Views and opinions in the Association indicate that there is an overemphasis on the administrative aspects of management to the
1
There is a UK version of this guide that is applicable across adult and children’s care homes.
CPEA/SCA October 2011
3
Role of Registered Manager Adult Residential Care England
detriment of the creative features of professional leadership. As
Pascale wrote in 1990: Managers do things right, while leaders do the
right thing2. The Registered Manager, as this guide will demonstrate,
has to both lead and manage seamlessly.
iii.
In a time of austerity there are more graduates, from a variety of
academic backgrounds, in the jobs market and entering residential
services. The guide is a contribution to harnessing the potential and
building on their qualifications. In England the recognised vocational
(QCF3) qualification for a Registered Manager is a level 5 Diploma in
Leadership in Health and Social Care and Children and Young People’s
Services. This is degree level equivalent and could be recognised as
such at both undergraduate and postgraduate levels. Residential Care
is aspiring to and deserving to be a graduate led profession.
iv.
Lastly, residential care has to move away from a ‘scandal-led’ and
therefore sporadic approach to improvement. The guide is intended as
an antidote to those who do not understand residential care as a
‘Positive Choice’4, to rebuff those who consider residential care a hotbed of abuse, to state best management practice for those wishing to
improve their services, to support managers in defending their
decision-making and to promote a sector-led model of continuous
improvement.
The leadership of the Registered Manager is what determines the quality of
life of the residents and the job satisfaction of the workforce. Every
Registered Manager should be an example of good practice in all aspects of
professional life, and take responsibility for providing an environment in
2
Richard Pascale, ‘Managing on the Edge’, Penguin Books, pp65, 1990
3
Qualification and Credit Framework
4
Residential Care, A Positive Choice, NISW/HMSO 1988
CPEA/SCA October 2011
4
Role of Registered Manager Adult Residential Care England
which residents live with dignity, choice and opportunities to participate in
life as they wish.
Registered Managers are the most influential people in determining the
professional practice and atmosphere in a home. They are also the lead
professional responsible for the quality of the care provided and the
performance and standards of the workforce.
It requires passionate, relentless leadership………leadership is about rising
above the day to day and taking people with you
5
This is a demanding and challenging role and not all Registered Managers
have ready access to support. This guide is intended to give an outline of the
key aspects of a Registered Manager’s role and to provide information and
signposting to further resources. It is additionally there for use by educators,
commissioners, inspectors, employers, service users and carers seeking to
understand and support Registered Managers in undertaking their roles and
tasks.
1.3. What is in the guide?
The guide covers the key aspects of the role of the Registered Manager,
what they are seeking to achieve as:

Champion for values and principles

Leader of professional practice in person-centred care and support

Protector of resident safety and rights
and how they go about it:
5

Leadership

Managing risks
South West Dementia Partnership: Improving Care in the South West. April 2010
CPEA/SCA October 2011
5
Role of Registered Manager Adult Residential Care England

Promoting effective communications

Marketing

Developing and supporting the workforce

Finance and administration
The guide explores the personal and professional skills needed by the
Registered Manager to be effective in each of these roles. Finally, within the
Appendices there is information on where to access further support.
Appendix A details key organisations and web links and Appendix B has
information on health and safety at work.
1.4. What sort of provision?
The guide is written in general terms that will be widely applicable in various
types of residential care homes for adults and older people. Homes come in
all shapes, sizes and ages, they cater for different people with differing
needs in varying numbers. The key roles of managing residential provision
will apply whether it is an establishment for older people, adults with
disabilities or mental health problems. There will be differences between the
provider organisations. Some larger organisations may have an extensive
hierarchy of senior staff who can, and do, provide support. The vast majority
of homes is owner/managed with little access to external support except via
membership of professional associations, such as SCA, and/or through trade
associations.
1.5. The Care Quality Commission
All residential care homes and their managers have to be registered with
CQC. This is the independent regulator of health and adult social care
services in England. They also protect the interests of people whose rights
are restricted under the Mental Health Act. The regulatory requirements are
focused on outcomes rather than systems and processes, and places the
CPEA/SCA October 2011
6
Role of Registered Manager Adult Residential Care England
views and experiences of people who use services at its centre. CQC have
produced guidance on the essential standards of quality and safety. The
guide is designed to help providers of adult social care to comply with the
Health and Social Care Act 2008. This guidance describes the essential
standards of quality and safety that people who use health and adult social
care services have a right to expect. The Guidance clearly shows the
regulations, the required outcomes and has prompts – some of which are
specific to service types.
A care home is defined by CQC as place where personal care and
accommodation are provided together. People may live in the service for
short or long periods. For many people, it is their sole place of residence and
so it becomes their home, although they do not legally own or rent it. Both
the care that people receive and the premises are regulated.
At every residential care home there will be one Registered Manager for the
regulated activity provided at that location. It is a manager’s responsibility
to demonstrate to CQC that they comply with the relevant regulations and
demonstrate their fitness to be registered as a Registered Manager.
Application for registration as a new Registered Manager will follow a series
of checks and processes to determine eligibility and suitability for the care
being
provided.
Registered
Managers
are
responsible
for
their
own
registration, including applying to register and to change the details of
registration. When a Registered Manager leaves a location they must submit
an application to either vary or cancel their registration. It is their
responsibility, not the provider’s, and they remain legally liable for the
regulated activity until the registration is changed or ended.
CPEA/SCA October 2011
7
Role of Registered Manager Adult Residential Care England
2. The Roles of the Registered Manager
2.1. Champion for values and principles
The values, principles and ethos of a home are the embodiment of how it
intends to ensure people are treated with dignity and respect, diversity is
valued and celebrated and that no-one is excluded from any part of life in
their home. Regulations require that these are captured and published in a
statement of purpose or equivalent. The statement should further document
what the home is seeking to achieve and for whom. CQC detail in their
guidance what should be included within the Statement of Purpose.
It is a responsibility of the Registered Manager to make certain that the
home owners have put in place their vision and purpose in such a
statement; guiding them professionally and making sure they understand
the implications. The responsibility is then to realise the values and
principles in social care practice that have positive outcomes for residents. It
is about ensuring that all aspects of life at the home are accessible and
inclusive. This includes:

Identifying areas of potential discrimination

Challenging discriminatory or exclusive practice

Ensuring that systems and processes are accessible and founded on a
solid anti-discriminatory value base

Promoting equality and diversity in all aspects of policy and practice

Providing information about the effects of discrimination and exclusion
Registered Managers need to be able to review all the systems and
processes of the home and ensure that there is nothing that could be
excluding people or promoting discrimination. Asking people who live in the
home, their relatives and friends about their experiences of using the service
is one of the best ways of identifying issues and making sure that systems
CPEA/SCA October 2011
8
Role of Registered Manager Adult Residential Care England
and processes do not discriminate or exclude those they are meant to
support. It is also fundamental to any quality assurance system operated by
the Registered Manager.
There should be zero tolerance of discriminatory or exclusive practice, and
Registered Managers are best placed to champion and maintain this ethos
amongst the entire workforce and residents, as everyone within a home
needs to understand that discrimination in any form is not acceptable. For
staff any discriminatory practice should be dealt with through support and
supervision or as a disciplinary matter.
Evidence that Registered Managers are championing equality, diversity and
inclusion can be found in day to day arrangements for living and personal
care; such as easy access to information and processes, support for
individual rights, accessible and responsive complaints system and people’s
ability to make choices and decisions.
2.2. Leader of professional practice in person-centred care and
support
Commissioning of care and support is a two way professional process. This is
the case whether finance is from public money or through self-funding. It
should hinge on a dialogue about the home’s ability to be flexible in meeting
the needs of an individual.
Everyone living in a residential home should have a person centred plan 6
that is based around positive outcomes that the individual wants to achieve.
All residents should participate or be supported to participate in care
planning.
6
There are various models of person-centred planning. The Department of Heath have guidance for providers. www.dh.gov.uk
CPEA/SCA October 2011
9
Role of Registered Manager Adult Residential Care England
Registered Managers need to make sure that the achievement of planned
positive outcomes is possible through:

Having an ethos and culture that enables people to control and choose

Having systems and processes that support individual choice and
control

Ensuring workforce training, both mandatory as well as focused on the
particular needs of residents, is in place

Having a system for monitoring progress towards the achievement of
outcomes including blockage alerts

Managing resources so that outcomes can be achieved
Outcome based working means that the workforce is always looking forward
to the next positive development. The nature of achievements will vary with
individual capacity and capability but it is important for the Registered
Manager to promote an outcome based focus across the workforce so that
residential care is recognised as a means of supporting positive progress as
appropriate for the individual concerned.
Positive outcomes also mean that the residential workforce must take
account of people’s overall well being. Registered Managers must ensure
that the practice of all staff promotes the consideration of all aspects of well
being including:

Social

Emotional

Physical

Spiritual

Cultural

Intellectual
CPEA/SCA October 2011
10
Role of Registered Manager Adult Residential Care England
Registered Managers must check their staff team’s understanding of ‘wellbeing’ as part of supervision and through regular monitoring of individual
support and communal activities. Each home will have a group of residents
with different needs, but strategies to promote well-being may include the
following:

Interactive communal activities such as games, communal meals,
outings

Maintaining contact with friends and family

Supporting making and maintaining new social contacts

Encouraging
and
facilitating
membership
of
outside
clubs
and
organisations

Individual emotional support as needed

Referral to specialist support if necessary

Healthy eating

Exercise based activities

Regular health checks

Support for religious activity

Access to private, personal time and space

Facilitation of access to creative and artistic activities

Maintaining cultural links

Access to relevant cultural events and organisations

Recognition of cultural norms and values

Intellectual activities such as: formal study, informal study, reading
groups, games, puzzles, discussions or debates
Outcome based working results in a residential home that is active and
forward looking and is a place where all individuals, whether younger adults
or older people, can reach their full potential and make choices and decisions
about their own lives. The Social Care Institute for Excellence (SCIE) has an
CPEA/SCA October 2011
11
Role of Registered Manager Adult Residential Care England
online database with a range of information and research on all aspects of
social care and social work. They produce learning materials, short films and
videos
that
are
particularly
relevant
for
residential
care
homes
on
Communication, Personalisation, Safeguarding and End of Life Care.
2.3. Protector of resident safety and rights
Person-centred care and support goes hand in hand with safeguarding. A
personalized service is a safe service and a safe service is personalized. As
the third leg (the other two being values into practice and positive
outcomes)
of
what
Registered
Managers
are
seeking
to
achieve,
safeguarding is often regarded as being the most professionally challenging.
It is self-evident that the Registered Managers want to keep residents safe.
It is how they go about this and how they balance values and the pursuit of
positive outcomes with safeguarding that will test the seamlessness of the
leadership and management approach of the Registered Manager. More will
be said about this as the guide considers issues of leadership and risk later.
Regardless of the resident group, ensuring that everyone is aware of their
responsibilities in relation to safeguarding is a key task for Registered
Managers. The policy and procedures to be followed in relation to
safeguarding will be stipulated by the Local Safeguarding Adults Board
(LSAB).
Registered Managers must ensure that all key people (owners, workforce
volunteers) attend appropriate safeguarding training and that everyone is
familiar with the procedures to follow if they receive an allegation, or
suspect abuse.
CPEA/SCA October 2011
12
Role of Registered Manager Adult Residential Care England
Safeguarding is about much more than protection from abuse; importantly,
it includes the empowerment of individuals by providing information about
abuse and how to stop it. Residents with choice and decision-making power
in their lives will have greater self esteem and overall well-being making
them more in control and less vulnerable.
Abuse by professionals and whistle-blowing
In managing a residential home, it is essential to be alert to the possibility of
abuse by professionals. It is always difficult for any Registered Manager to
believe that members of their team or visiting colleagues are capable of
abusing vulnerable people, so a high level of awareness and vigilance is
essential at all times
Some of the factors that are known to contribute to the risk of harm and
abuse by professional support workers can include:
 a closed (secure) environment
 poor-quality staff training
 lack of knowledge and understanding by staff
 inadequate staffing numbers
 lack of investment in continuing professional development
 little or no staff support or supervision
 low staff morale
 lack of opportunity for care workers to form relationships with individuals
 organisational culture which fails to treat people with dignity and respect
as individuals
 culture of bullying of staff members by management
CPEA/SCA October 2011
13
Role of Registered Manager Adult Residential Care England
Each LSAB will set out procedures for dealing with professional abuse;
Registered Managers are required to follow procedures, which are likely to
include:
 immediate suspension of the person accused
 reporting the matter to CQC
 investigation by police if appropriate
 investigation led by an independent agency
 disciplinary procedures following the outcome of any police or protection
investigation.
Having an awareness of the possibility of alleged abusive situations and
being open to reports from ‘whistleblowers’ are both good strategies for
responding quickly.
The Public Interest Disclosure Act 1998 protects whistleblowers and ensures
that they cannot be victimised by their employer for reporting abuse, or any
other illegal acts. The Act protects people making disclosures about:
 a criminal offence
 the breach of a legal obligation
 a miscarriage of justice
 a danger to the health or safety of any individual
 damage to the environment
 deliberate covering up of information tending to show any of the above
five matters.
The basis for being protected by the Act is that the worker is giving
information that they ‘reasonably believe tends to show that one or more of
CPEA/SCA October 2011
14
Role of Registered Manager Adult Residential Care England
the above matters is either happening now, took place in the past, or is likely
to happen in the future’.
Where someone is aware of abuse, they must contact the local authority and
make a referral to the relevant department and follow the local agreed
procedures.
If it is believed that the abuse is potentially a criminal offence, such as
physical or sexual assault, theft or fraud, then it should be referred to the
police. At the same time, it should be referred to CQC.
Reporting and checking
Registered Managers have a responsibility to inform the Independent
Safeguarding Authority (or its successor organisation) if they dismiss anyone
because of a finding of abusive behaviour. Similarly, it is a requirement to
obtain a Criminal Records Bureau (CRB) check before anyone is able to work
unsupervised with vulnerable adults, and to ensure that the individual is not
barred from working with vulnerable people. This will include all staff
working in care homes for adults and older people.
The vetting and barring scheme in England and Wales is likely to be replaced
by a single organisation that carries out CRB checks and maintains a register
of those people not suitable to work with vulnerable adults or children.
Registered Managers will need to be aware of their responsibility for
reporting or checking with the appropriate organisation.
CPEA/SCA October 2011
15
Role of Registered Manager Adult Residential Care England
3.
How Registered Managers Fulfill their Roles
3.1. Leadership
Armed with vision, values and purpose to achieve positive and safe
outcomes with residents how does the Registered Manager set about the
roles and tasks?
The importance of effective leadership is what underpins this guide and
shapes all aspects of the Registered Manager’s role. Leadership is partly
about setting an example and modeling good practice, but it is also about
developing the vision of what makes an excellent residential home and
inspiring everyone, sharing the vision and working together to deliver it.
A Registered Manager leads in championing the interests of residents at all
times and making sure that the best interests of residents are central to any
activity. Leadership should provide inspiration for the workforce, as well as
security and reassurance for residents where needed.
Skills for Care have developed management induction standards. They are
part of the extended suite of products that support a leadership and
management strategy and provide essential tools for Registered Managers to
use in providing high quality leadership and management. The standards are
based upon management practice which has person-centred planning at its
heart, with people who use services firmly in control and identifying what is
personally important for the achievement of preferred outcomes.
All roles and tasks identified in this guide require both leadership and
management. Broadly, leaders have to inspire and motivate whilst managers
organise and co-ordinate as well as give direction. One of the key challenges
for Registered Managers is that they are required to both seamlessly lead
CPEA/SCA October 2011
16
Role of Registered Manager Adult Residential Care England
and manage - nowhere more so than when balancing risks in turning vision
into good social care practice.
The
National
Skills
Academy
run
and
endorses
leadership
and
management training and learning programmes. The programme for front
line
managers
is
targeted
particularly
to
registered
residential
care
managers and for those who work or lead at the front line of social care. It
aims to equip managers with the skills and capabilities to manage their own
experience and their teams. By improving skills in these areas it can help
registered managers to deliver better care and help the social care sector
face its current challenges.
3.2. Managing risks
There are different types of risk that make up the area of responsibility of
the Registered Manager; the risks that must be managed to keep people
safe from hazards, and the risks relating to the standards of professional
practice, the provision of an equitable and diverse environment and the
planning and development of the workforce.
Registered Managers of residential homes have day to day responsibility, on
behalf of their employer, to take steps to ensure the safety of the people
who live in the home, any visitors and the workforce. Residential homes are
generally covered by the Health and Safety at Work Act 1974 (HASAWA).
This Act is like the overall ‘umbrella’ that has been updated and
supplemented by all the regulations and guidelines that extend it, support it
or explain it. At Appendix B there is additional material that covers:

Employers and Employees responsibilities

Hazards

Assessing and Managing risks
CPEA/SCA October 2011
17
Role of Registered Manager Adult Residential Care England

Reporting (RIDDOR)

Moving and Handling

Hazardous Substances

Fire Safety

Security

Reducing the spread of infection

Medication
The health and safety duties of the Registered Manager may at first appear a
bit daunting and inhibiting. Life is full of risk both relating to practical
hazards and professional decision-making. It is quite difficult to separate
them so it is important to understand the ideas and concepts behind
effective risk management and apply them to all risks accordingly.
A first principle for the Registered Manager is that risk does not equate to
harm. Risk-taking can lead to benefits and/or harm. A second is that inaction
has as much inherent risk (beneficial or harmful) as action. And a third is to
be pro-active with a communicated policy, procedure and approach to risk
assessment and management. Assume that things will happen and base
decisions on professional judgment backed by knowledge and experience
plus the support of professional colleagues.
Effective risk assessments make it possible for people to do things. Risk
assessments are not about restricting what people do, they are about
making best efforts to see that they are done safely. The potential for health
and safety concerns to limit people’s activities and restrict their rights can be
greatly decreased by good risk assessments. These put sensible measures
in place to minimize foreseeable harm and maximize benefits from risktaking.
CPEA/SCA October 2011
18
Role of Registered Manager Adult Residential Care England
Risk assessments relating to care planning are just as important as health
and safety. Registered Managers have to maintain the balance, when
dilemmas arise, between people being able to make choices and exercising a
Duty of Care7. There are often choices to be made between what is enabling
and what is restrictive, what is cautious and what is reckless. For example,
Registered Managers need to have criteria and mitigation in place for
situations such as:

An older person who wants to go shopping even though they have got
lost a few times previously

Someone with a learning disability who wants to go night clubbing

A young adult who wants to maintain a relationship with a boyfriend
who is known to abuse drugs

An older person who wants to see a relative even though it is likely
they are being financially abused
Getting this balance right is a challenge and it is the Registered Manager’s
role to ensure that all decision makers, particularly in the workforce,
understand how to both facilitate and protect.
Everyone should be able to make informed choices wherever possible, but
issues of capacity and age related competence must be taken into account.
Registered Managers should ensure that there are clear policies and
processes in place to monitor individuals’ capacity in relation to decision
making, and also ensure that processes are compliant with the Mental
Capacity Act 2005. The Act is intended to enable and support people who
lack capacity rather than restricting or controlling their lives. It assumes a
person had capacity unless it is established by their social worker or doctor
7
A Duty of Care is the legal responsibility of taking all possible steps to keep people safe from harm
CPEA/SCA October 2011
19
Role of Registered Manager Adult Residential Care England
that they lack capacity. A key point to be aware of is that capacity is viewed
as decision specific and although a person may not be able to take decisions
about certain aspects of their life there are other areas where they will be
able to. Research into practice for adults (RIPFA) has produced a guide
“Safety Matters: developing practice in safeguarding adults”, that provides
practical advice, hints and tips8.
Many organisations will have comprehensive policies, systems and processes
in place to deal with decision making and capacity issues. However, part of a
Registered Manager’s role is to constantly monitor the implementation of
policies and to identify where changes are needed.
Registered Managers have a pivotal role in respect of risk – life fulfillment is
about getting the best out of risk-taking - and this aspect of their work
warrants further exploration and learning opportunities9
3.3. Promoting effective communication
The communication strategy of any residential care establishment needs to
cover the following key aspects:

Communicating with residents and their families

Communicating with the workforce

Recording and information systems that have clear purpose

Communicating with external partners

Communicating with the local community
8
www.ripfa.co.uk
9
Professional Risk and Working with People, Carson and Bain, Jessica Kingsley 2008
CPEA/SCA October 2011
20
Role of Registered Manager Adult Residential Care England
Communicating with residents and families
Inevitably, the approaches will vary depending on the needs of the people
who live in the establishment. For example; communication in a unit for
people with dementia may include the use of short visual messages to back
up verbal communication. Communications in a unit for people with learning
disabilities are likely to be easy read and based on visual symbols.
The Registered Manager needs to be able to demonstrate that there is a
clear communication strategy covering all the different forms and modes of
communication. This will need to include:

People’s individual communication needs. Registered Managers must
ensure that the entire workforce is familiar with the best approaches to
communicate with each resident and how to overcome any barriers.

Communicating general information and sharing feedback. This could
be through a residents council, informal meetings, notice boards, emails, texts or social media

Sharing information with families and/or advocates. This is usually
communication to provide information or notification of events or
activities.
It may be appropriate to have a regular newsletter for
relatives and friends, either paper based or electronic, or a care home
website could have designated pages where families and friends can
log in to get the latest information.

Registered
Managers
need
to
develop
clear
protocols
about
information sharing. Obviously, there are organisational and statutory
policies and processes that must be followed, but there should be
criteria for when relatives are contacted and all of the workforce
should know exactly what information can be shared, and with whom.

Registered
Managers
have
a
responsibility
to
ensure
that
the
boundaries of confidentiality and possible reasons for breaching that
CPEA/SCA October 2011
21
Role of Registered Manager Adult Residential Care England
confidentiality are both clear and understood by staff, residents and
relatives.
Broadly, Registered Managers have a responsibility to ensure that all
residents and those who are important to them are able to communicate
within and outside the home, and that accessible, user friendly information is
available to all those who need to have it.
Communicating with the workforce
The aim of a Registered Manager should be to have a workforce that shares
a vision to achieve positive outcomes for the people they support.
Inadequate communication will result in a staff group that operates on
partial information, rumour and gossip; inevitably this will result in low
morale among the workforce and a poorer quality service.
Registered Managers need to make sure that the entire workforce is a key
part of the team. Part of this is about having information but also about
having well understood channels of communication. Registered Managers will
do this through a range of approaches including:

Regular staff meetings

Notice boards

‘Open door’ times

e-mail, text, social media

supervision

informal discussion

recording systems and processes

modeling good practice
CPEA/SCA October 2011
22
Role of Registered Manager Adult Residential Care England
People working different shift patterns means that it can be difficult for
everyone to feel that they are ‘in the loop’. Registered Managers need to
ensure that communication channels are available for staff working nights
and weekends; staff meetings for people on permanent nights and the
Registered Manager making themselves available from time to time, will help
staff be part of a workforce team where everyone’s contribution is valued.
Recording and information systems
A key part of a communication strategy for a residential home is to have an
effective system of recording information so that:

residents have access to accurate recorded information

significant information about residents is communicated between staff

information is recorded for sharing with partners

data is available for reporting and inspection

data is available for business, financial and workforce planning
Registered Managers need to monitor the systems that are in place and
make improvements where the systems are not fit for purpose. Some
information can be used for more than one purpose, for example; data
gathered for regulators or national returns can also be used for financial and
workforce planning. Monitoring of recording and information systems is a
regular part of a Registered Manager’s role.
Whether or not information is readily available for each of the purposes
listed above is a good test as to the fitness of the systems. If the data
required for inspections takes a great deal of time to collate, or if there is
inadequate data on which to base a workforce development plan, then the
Registered Manager must develop better systems that can do this quickly
and
robustly.
CPEA/SCA October 2011
Depending
on
the
governance
and
administrative
23
Role of Registered Manager Adult Residential Care England
arrangements for the home, the Registered Manager must make the
improvements to the systems or advise those responsible that changes are
necessary.
Communicating with external partners
Working in partnership with others is a major part of achieving positive
outcomes for adults and older people. One of the most important
partnerships is with the funder - often the local authority - but can be
relatives or other representatives or advocates for self-funding residents.
There are other key partners such as General Practitioners, Pharmacists,
Community Nurses, Occupational Therapists and other health professionals,
Psychiatrists,
Psychologists,
Speech
and
Language
Therapists,
Social
Workers, colleges, sport and leisure clubs and organisations that are
important to the residents and their families. Multi-professional leadership is
a significant aspect of the Registered Managers role. This might include
challenge on such issues as hospital discharge or medication practice,
coordination of activities or seeking expert support in training.
The home’s communication strategy should include well-defined channels for
maintaining communication with the whole range of external partners.
Effective communication is the basis for partnership working and the
Registered Manager will need to ensure that there is an effective
communication route for each of the partners with whom the home works.
The options for the best approach will include:

agreements about what needs to be communicated and to whom

triggers for communication and information sharing

arrangements for care planning and review

checking compatibility of communication systems
CPEA/SCA October 2011
24
Role of Registered Manager Adult Residential Care England

meetings and conferences

telephone briefings

e-mails and social media
Communicating with the local community
For any home, the relationship with the local community is very important.
This is partly about supporting the residents to be part of a wider community
with opportunities to get to know their immediate neighbours, but also about
relationships with community organisations and how well people are able to
integrate into local activities.
Registered Managers need to plan communications with the local community
so that people recognise the home as a real part of the local neighbourhood.
Communications should offer a two way link between the home and the
community; so that local people are able to visit friends and residents and
able to be fully involved in local activities. Even small things like sending
birth congratulations cards to neighbours or offering help at local events will
contribute to effective communication channels.
It is important to get the right balance between being part of the local
community and allowing open access to what is the residents’ home. Any
parts of a communication strategy that involve invitations to the local
community must have the consent of residents, but equally, people must be
free to invite local friends and contacts to their home.
Promoting understanding of the role of the home and the needs of the
people who live there is an important part of communicating with the
community. This is particularly important when the residents are people with
mental health problems as there are often fears and misunderstanding in the
CPEA/SCA October 2011
25
Role of Registered Manager Adult Residential Care England
local community or people with learning disabilities who can be subject of
bullying
and
harassment.
Prejudice
can
be
challenged
by
effective
communication and information giving, and being an accepted part of a local
community will support the achievement of positive outcomes for residents.
My Home Life10 is a collaborative programme aimed at improving the quality
of life of those who are living, dying, visiting and working in care homes for
older people. Working in partnership with the care home sector they provide
a range of educational activities to assist everyone in this field to share best
practice and enhance quality of care. They have resources on a range of
topics including communication, culture and community focusing upon older
people in residential care homes.
3.4. Marketing
All residential care homes are businesses, whether private, voluntary or
publicly owned, full occupancy by satisfied residents is a key indicator of
success. Making a return on investment, or securing value for money is an
important part of the Registered Managers functions. Marketing the service
is part of the communications message.
The role of the Registered Manager here is to:

Understand the market for the services. This includes competitors and
collaborators

Promote the services to the public and funders

Ensure that the purpose of the home is known

Report to the owners on business opportunities or new markets

Plan admissions to ensure that resident needs can be met within the
statement of purpose
10
http://myhomelifemovement.org/
CPEA/SCA October 2011
26
Role of Registered Manager Adult Residential Care England
A good marketing strategy thinks ahead as part of the home’s business plan.
It considers questions such as:
 Where will the home be in 3 years time?
 Why did the current residents choose to live here?
 Will the same reasons continue to apply?
 Why future residents might chose to live here?
The Registered Manager needs to support the owner in scenario planning as
well as being the number one ‘salesperson’ for the home in the same way a
Headteacher is for a school.
3.5. Managing the workforce
The Registered Manager’s role is to lead the staff team within the home.
Effective Registered Managers are those who model good practice in their
own work and provide excellent examples of professional behaviours and
values for their staff. Registered Managers need to be visible and both staff
and residents benefit from a leader who is regularly seen around the home
rather than being hidden behind an office door. Being involved and active in
the home also gives Registered Managers a better feel for what is working
well and what needs attention.
Registered Managers are likely to be responsible for recruitment, retention,
reward, workforce deployment, development and support, professional
standards and discipline. It is their overriding responsibility to ensure that
the home has recognised levels of competent practitioners. To provide
effective leadership they must motivate and enthuse the workforce, give
clear and honest information, provide supportive supervision, encourage
CPEA/SCA October 2011
27
Role of Registered Manager Adult Residential Care England
professional development and be fair and impartial in offering praise and in
taking disciplinary action.
National Occupational Standards (NOS) have been developed in most
industries including adult social care. Initially, the standards were used as
the basis for qualifications, but wider uses of the standards are now
emerging, such as their use in human resource management. They:

describe best practice in particular areas of work including residential
care

bring together the skills, knowledge and values necessary to do the
work as statements of competence

provide managers with a tool for a wide variety of workforce
management, quality control and specification tasks

are the basis of training and qualifications.
NOS are organised into units of competence. Each “unit” describes an area
of work, with the activities separated out into “elements” with associated
performance “criteria” and “knowledge” listed. The standards also include
units that highlight the “values” required to work in adult social care. The
care standards can be separated into different levels of competence and
used to benchmark the skills, knowledge and responsibilities associated with
more complex roles within a residential care home.
They are being used to identify clearly the skills required for posts and are
also used in writing job descriptions and drafting job adverts. They also
contain descriptions of best practice. Standards can be used as the basis for
objectives in performance appraisal and as an aid in setting milestones in
personal development. The standards are used for training and development
so it is tailored for individual staff while meeting operational or business
CPEA/SCA October 2011
28
Role of Registered Manager Adult Residential Care England
objectives. The different levels of standards enable both managers and
individual staff to be clear about future development and training, to enable
individuals to undertake work at a more complex level. Standards have been
published on the Skills for Care website for levels 2 to 4 in Adult Social Care
and for Registered Managers.
Workforce planning and workforce development are two vital functions for
the Registered Manager. A high quality outcome based, person centred
service depends on a well planned and well trained workforce.
The extent to which Registered Managers will be able to undertake workforce
planning will depend on the size of organisation. Many large organisations
will undertake workforce planning and development at a corporate level, and
Registered Managers will need to implement planning at a local level and to
monitor the effectiveness of corporate plans.
However in the majority of homes the Registered Manager will be
responsible for planning the workforce and ensuring that the workforce has
the capacity and capability to deliver the commissioned services. Even in the
smallest of homes the simplest workforce plan is an effective staff roster.
Skills for Health, Introduction to Workforce Planning (2007)11 describe it as:
At its simplest, effective workforce planning ensures you will have a
workforce of the right size with the right skills and diversity organised in the
right way within the budget that you can afford to deliver the best services
you can provide.
11
www.healthcareworkforce.nhs.uk Workforce Projects Team revised 2009
CPEA/SCA October 2011
29
Role of Registered Manager Adult Residential Care England
Skills for Care12 identify key questions that providers of services need to ask
themselves:
 Does your organisation have the skills to deliver the range of services
that people want?
 Are you in tune with both national and local policy?
 Have you got a picture of what others are doing in your area?
 How does your plan address productivity and value for money?
 Will commissioning organisations and the service-using public want to
buy the services you offer from the workforce you have to deliver
them?
The answers to these questions provide a useful starting point for workforce
planning.
The basis for any workforce plan is to bring together the aims and
aspirations of both the residents and the people who work in the
organisation. It also has to consider:

The requirements of the commissioners

The requirements of the regulator and inspectorates

Compliance with legislation

The right mix of knowledge and skills to deliver high quality services
Registered Managers may need to develop or to implement a workforce plan.
Essentially, planning should be done to ensure that the workforce is the right
one for delivering the services. Effective workforce planning is also useful for
other purposes such as:

Giving confidence to the people who use the service that the provider
can meet their needs
12
www.skillsforcare.org.uk Taking Steps – A Detailed Guide to Workforce Planning for Providers
CPEA/SCA October 2011
30
Role of Registered Manager Adult Residential Care England

Ensuring that each shift has the right skill mix to provide a safe and
effective service

Demonstrating to commissioners that the organisation can meet the
requirements of the service

Providing evidence to the inspectorate that the organisation is
compliant with legislation and standards
Much of the information about the workforce is already available in the data
that residential homes should collect for the National Minimum Data Set
(NMDS-SC). CQC and Skills for Care have a ‘collect once use many times’
joint approach for the collection of workforce data. Detailed information on
how to prepare a workforce plan can be found on the Skills for Care website
Undertaking a skills analysis across the workforce in any home is a valuable
exercise that Registered Managers should undertake. This will help to
determine where there are skill strengths and shortages and feed into a
workforce development plan. This is a key aspect of the Registered
Manager’s role, even in large organisations where there is a corporate
workforce development plan and an in-house training and development
team.
Ensuring that the workforce can access appropriate training, both for
vocational qualifications and for continuing professional development, is
important, but there are other aspects to professional development that are
just as important. Supervision of staff is the time to identify training needs
to meet future career aspirations and to identify areas for further skills
development.
CPEA/SCA October 2011
31
Role of Registered Manager Adult Residential Care England
High quality supervision is one of the most important drivers in ensuring
positive outcomes for people who use social care. It also has a crucial role to
play in the development, retention and motivation of the workforce. Skills
for Care have produced a step-by-step workforce development tool on
providing effective supervision tailor made for the job. The guidance and
other resources have been designed to assist Registered Managers and
those receiving supervision to make the most of the opportunities that
supervision offers.
All members of the workforce should have a professional development plan
that identifies goals and targets. This should be a working document under
continuous review. Registered Managers must ensure that training and
development opportunities are identified and staff informed and encouraged
to take up any relevant opportunities.
Registered Managers should support all members of the workforce to
become reflective practitioners and to use reflection to improve and develop
practice. Providing constructive feedback and reviewing mistakes and ‘near
misses’ in a ‘no blame’ environment encourages the development of a
learning culture within the home and will support improvements in practice
and professional performance.
One of most important skills of the Registered Manager is delegation;
identifying what needs to be done and allocating the work around the
workforce appropriately. Registered Managers should seek to build a small
leadership team. Perhaps the team could share supervisory responsibilities
for practitioners (keyworkers) as well as having other specific areas of
responsibility such as catering, cleaning or medication practice.
CPEA/SCA October 2011
32
Role of Registered Manager Adult Residential Care England
Most importantly, Registered Managers should not neglect their own
professional development. Reflective practice and professional development
plans are equally important for the Registered Manager so that their own
professional
skills
are
constantly
developed
and
improved.
Owners,
particularly of single or small numbers of homes, may wish to consider
mentoring as a cost-effective way of supporting their Registered Managers.
3.6. Finance and Administration
Effectively managed resources will contribute to positive outcomes for all
residents. Registered Managers are responsible for the budget, or spending
according to an agreed plan. They need to be able to use financial
information and balance budgets across differing lines. The survival of all
homes depends on not operating at a loss, so financial management skills
are essential.
The
Registered
Manager
is
maintenance and purchasing.
responsible
for
facilities
management,
Homes have sizeable budgets for the
purchase of furniture, equipment, protective clothing, cleaning materials,
food, stationery, medical supplies, toiletries and anything else to provide for
the residents’ needs. The purchasing has to be undertaken efficiently and
economically to remain within budget, but it is the Registered Manager’s role
also to see that the residents’ needs are met properly. For example,
residents preparing for independence will need to be involved in shopping
and related activities, even if the route to achieving this outcome is not the
most economical. Good practice dictates that all residents should be involved
in choosing menus or anything else that affects their surroundings and
quality of life.
CPEA/SCA October 2011
33
Role of Registered Manager Adult Residential Care England
Finance and administration are often seen as chores however if considered
as performance measurement and audit then the rationale becomes clearer.
The Registered Manager has to be able to demonstrate that money has
achieved its purpose and that desired outcomes have been secured.
4.
Summary
The roles and responsibilities of a Registered Manager are the key functions
that make a residential home somewhere that provides people with a safe,
but stimulating living environment and that promotes independence and
choice for all residents regardless of age. Residential care can support the
achievement of a person’s outcomes towards a secure and positive future as
a fully participating citizen. It can also provide a supportive environment to
adapt to the changes in ability and capacity in the later stages of life, the
Registered Manager is the key person who brings together all the elements
of a happy and positive place to live.
CPEA/SCA October 2011
34
Role of Registered Manager Adult Residential Care England
Appendix A - Further Information
Best Practice
Social Care Association Practice Guides – www.socialcareassociation.co.uk
My Home Life – http://myhomelifemovement.org/
Social Care Institute for Excellence – www.scie.org.uk
Research into Practice for Adults - www.ripfa.org.uk
DH Advice on person-centred planning http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/
@ps/documents/digitalasset/dh_115248.pdf
Workforce planning and development
Skills for Care - www.skillsforcare.org.uk
Skills for Health - www.skillsforhealth.org.uk.
Centre for Workforce Intelligence – www.cfwi.org.uk
National Skills Academy – www.nsasocialcare.co.uk
Safeguarding
Independent Safeguarding Authority - www.isa.gov.uk
Medication
Royal Pharmaceutical Society of Great Britain has guidance on the handling
of medication in social care. - www.rpharms.com
Regulation and Inspection
Care Quality Commission – www.cqc.org.uk
Data Protection
Information Commissioner’s Office – www.ico.gov.uk
Health and Safety
Health and Safety Executive – www.hse.gov.uk
National Association of Safety and Health in Care Services www.nashics.org
CPEA/SCA October 2011
35
Role of Registered Manager Adult Residential Care England
Appendix B – Health and Safety in Residential Care
In considering this Appendix it should be remembered that Registered
Manager’s have an overarching responsibility to achieve a balance between
choice and independent thought, and risk control and management.
Employers and Employees
The law places certain responsibilities on both employers and employees. For
example, it is up to the employer to provide a safe place in which to work, but
employees also have to show reasonable care for their own safety.
Employers have to:
 make the workplace safe
 prevent risks to health
 ensure that machinery is safe to use, and that safe working practices are
set up and followed
 make sure that all materials are handled, stored and used safely
 provide adequate first aid facilities
 tell employees about any potential hazards from the work they do,
chemicals and other substances used by the organisation, and give the
workforce information, instructions, training and supervision as needed
 set up emergency plans
 make sure that ventilation, temperature, lighting, and toilet, washing and
rest facilities all meet health, safety and welfare requirements
 check that the correct work equipment is provided and is properly used
and regularly maintained
 prevent or control exposure to substances that may damage people’s
health
CPEA/SCA October 2011
36
Role of Registered Manager Adult Residential Care England
 take precautions against the risks caused by flammable or explosive
hazards, electrical equipment, noise and radiation
 avoid potentially dangerous work involving manual handling and, if it
cannot be avoided, take precautions to reduce the risk of injury
 provide health supervision as needed
 provide protective clothing or equipment free of charge if risks cannot be
removed or adequately controlled by any other means
 ensure that the right warning signs are provided and looked after
 report certain accidents, injuries, diseases and dangerous occurrences to
either the Health and Safety Executive (HSE)
Hazards
Registered Managers need to ensure that the entire workforce is aware of
the potential hazards in the particular home. These will vary according to the
needs of the people who live there; obviously the types of hazards and risks
for a group of older people with dementia are different from those for a
group of people with learning disabilities
The hazard checklist in the following table is a general guide, but Registered
Managers will need to develop their own checklist that is relevant for their
own care environment.
Area
Hazards/risks
Check
Environment
Floors
Are they dry?
Carpets and rugs
Are they worn or curled at the edges?
Doorways and corridors
Are they clear of obstacles?
Electrical flexes
Are they trailing?
Beds
Are the brakes on? Are they high
Equipment
enough?
CPEA/SCA October 2011
37
Role of Registered Manager Adult Residential Care England
Electrical or gas appliances
Are they worn? Have they been
safety checked?
Lifting equipment
Is it worn or damaged?
Mobility aids
Are they worn or damaged?
Substances
such
as
cleaning
Are they correctly labelled?
fluids
People
Containers
Are they leaking or damaged?
Waste disposal equipment
Is it faulty?
Visitors to the building
Should they be there?
Handling procedures
Have they been assessed for risk?
Intruders
Have the police been called?
Violent and aggressive behaviour
Has it been dealt with?
Who is out?
Where are they? Who are they with?
When are they due back?
Workforce
Skills and competence
Are the right skills available on shifts
as needed? Can individuals’ needs be
met? Are skills gaps being identified?
How will they be met?
Personal
and
development
professional
Do
people
have
professional
development plans? Is there planning
for succession?
Retention of staff
What are levels of job satisfaction?
Are
staff
given
responsibility?
opportunities
areas
Are
for
of
there
progression?
Is
there a culture of team working and
shared
vision?
achievement
Do
of
staff
see
outcomes
residents?
CPEA/SCA October 2011
38
the
for
Role of Registered Manager Adult Residential Care England
Registered Managers need to ensure that the workforce understands the
importance of reporting, and taking appropriate action relating to any
hazards that they notice such as:
 wet or slippery floors
 cluttered passageways or corridors
 rearranged furniture
 worn carpets or rugs
 electrical flexes.
 faulty brakes on beds, wheelchairs etc
 worn or faulty electrical or gas appliances
 worn or damaged lifting equipment
 worn or damaged mobility aids
 incorrectly labelled substances, such as cleaning fluids
 leaking or damaged containers
 faulty waste-disposal equipment.
 handling procedures
 unknown visitors to the building
 intruders
 violent and aggressive behaviour.
Assessing and Managing risks
Risk assessment in health and social care is important for everyone whether
they are employers, self-employed or employees, who are required by law to
identify and assess risks in the workplace. This includes any situations where
potential harm may be caused.
CPEA/SCA October 2011
39
Role of Registered Manager Adult Residential Care England
There are five key stages to undertaking a risk assessment, which involve
answering the following questions.
1. What is the purpose of the risk assessment?
2. Who has to assess the risk?
3. Whose risk should be assessed?
4. What should be assessed?
5. When should the risk be assessed?
The Management of Health and Safety at Work Regulations 1999 state that
employers have to assess any risks which are associated with the workplace
and work activities. This means all activities, from walking on wet floors to
dealing with violence. Having carried out a risk assessment, the employer
must then apply risk control measures. This means that actions must be
identified to reduce the risks. For example, alarm buzzers may need to be
installed or extra staff employed, as well as steps such as providing extra
training for staff or written guidelines on how to deal with a particular hazard.
Reporting
The Reporting of Injuries, Diseases and Dangerous Occurrences (RIDDOR)
Regulations
1995
(amended
2008)
require
that
accidents,
dangerous
occurrences and ill-health at work should be reported to the Incident Contact
Centre. Registered Managers, or employers, need to report the following if
they occur among the workforce. This requirement does not apply to
residents:
 deaths
 major injuries
CPEA/SCA October 2011
40
Role of Registered Manager Adult Residential Care England
 accidents resulting in more than three days off work
 certain diseases
 dangerous occurrences
Moving and Handling (People moving People)
Depending on the client group for which the home provides a service,
moving and handling is a major area of management responsibility. Lifting
and handling individuals is the single largest cause of injuries at work in
health and care settings. One in four workers take time off because of a
back injury sustained at work.
The Manual Handling Operations Regulations 1992 require employers to avoid
all manual handling where there is a risk of injury ‘so far as it is reasonably
practical’. Where manual handling cannot be avoided, then a risk assessment
must be undertaken and all appropriate steps must be taken to reduce risks.
Everyone from the European Commission to the Royal College of Nursing has
issued policies and directives about avoiding hazardous lifting.
The Provision and Use of Work Equipment Regulations 1998 (PUWER) require
employers to ensure that all equipment used in the workplace is:
 suitable for the intended use and for conditions in which it is used
 safe for use, maintained in a safe condition and, in certain circumstances,
inspected so that it continues to be safe
 used only by people who have received adequate information, instruction
and training
 accompanied by suitable safety measures, for example, protective
devices, markings, warnings
CPEA/SCA October 2011
41
Role of Registered Manager Adult Residential Care England
The regulations also mean that where the risk assessment has shown that
there is a risk to the workers from using the equipment; employers must
ensure that suitably qualified people inspect equipment at regular intervals.
The Lifting Operations and Lifting Equipment Regulations (1992) (LOLER)
came into effect on 5 December 1998 and apply to all workplaces. An
employee does not have any responsibilities under LOLER, but under the
Management of Health and Safety at Work Regulations, employees have a
duty to ensure that they take reasonable care of themselves and others who
may be affected by the actions that they undertake.
Employers do have duties under LOLER. They must ensure that all equipment
provided for use at work is:
 sufficiently strong and stable for the particular use and marked to indicate
safe working loads
 positioned and installed to minimise any risks
 used safely – that is, the work is planned, organised and performed by
competent people
 subject to ongoing thorough examination and, where appropriate,
inspection by competent people
 In addition, employers must ensure:
 lifting operations are planned, supervised and carried out in a safe way by
competent people
 equipment for lifting people is safe
 lifting equipment and accessories are thoroughly examined
 a report is submitted by a competent person following a thorough
examination or inspection.
CPEA/SCA October 2011
42
Role of Registered Manager Adult Residential Care England
Lifting equipment designed for lifting and moving loads must be inspected at
least annually, but any equipment that is designed for lifting and handling
people must be inspected at least every six months.
If employees provide their own lifting equipment, this is covered by the
regulations.
Hazardous Substances
The Control of Substances Hazardous to Health (COSHH) Regulations applies
to substances that have been identified as toxic, corrosive or irritant. This
includes cleaning materials, pesticides, acids, disinfectants and bleaches, and
naturally occurring substances such as blood, bacteria and other bodily fluids.
Workplaces may have other hazardous substances that are particular to the
nature of the work carried out.
The Health and Safety Executive states that employers must take the following
steps to protect employees from hazardous substances.
Step 1: Find out what hazardous substances are used in the workplace and
the risks these substances pose to people’s health.
Step 2: Decide what precautions are needed before any work starts with
hazardous substances.
Step 3: Prevent people being exposed to hazardous substances, but where
this is not reasonably practicable, control the exposure.
Step 4: Make sure control measures are used and maintained properly, and
that safety procedures are followed.
Step 5: If required, monitor exposure of employees to hazardous substances.
Step 6: Carry out health surveillance where assessment has shown that this is
necessary, or COSHH makes specific requirements.
CPEA/SCA October 2011
43
Role of Registered Manager Adult Residential Care England
Step 7: If required, prepare plans and procedures to deal with accidents,
incidents and emergencies.
Step 8: Make sure employees are properly informed, trained and supervised.
Every workplace must have a COSHH file, which should be easily accessible to
all staff. This file lists all the hazardous substances used in the workplace. It
should detail:
 where they are kept
 how they are labelled
 their effects
 the maximum amount of time it is safe to be exposed to them
 how to deal with an emergency involving one of them
From April 2005, employers are required to focus on the following eight
principles of good practice in the control of substances hazardous to health.
1. Design and operate processes and activities to minimise emission, release
and spread of substances hazardous to health.
2. Take into account all relevant routes of exposure – inhalation, skin
absorption and ingestion – when developing control measures.
3. Control exposure by measures that are proportionate to the health risk.
4. Choose the most effective and reliable control options that minimise the
escape and spread of substances hazardous to health.
5. Where adequate control of exposure cannot be achieved by other means,
provide, in combination with other control measures, suitable personal
protective equipment.
6. Check and review regularly all elements of control measures for their
continuing effectiveness.
CPEA/SCA October 2011
44
Role of Registered Manager Adult Residential Care England
7. Inform and train all employees on the hazards and risks from the
substances with which they work and the use of control measures
developed to minimise the risks.
8. Ensure that the introduction of control measures does not increase the
overall risk to health and safety
In addition to following the regulations about storing and using hazardous
substances, Registered Managers must ensure that procedures are in place
for the safe disposal of any of the substances 13 in the COSHH file, and also
of any body fluids or body waste.
Fire Safety
Fire is a particularly serious risk for many of the client groups who live in
residential care. Registered Managers have a responsibility to ensure that all
staff attend annual fire lectures and that they are up to date with the
procedures to be followed in the event of fire. The staff also need to be aware
of the number of residents in the home on any given day.
The Regulatory Reform (Fire Safety) Order 2005 requires that all businesses
must have a person responsible for fire safety and for carrying out a risk
assessment. The government recommends a five-step approach to a fire risk
assessment.
1. Identify hazards: anything that could start a fire, anything that could burn.
2. Identify who could be at risk and who could be especially at risk.
3. Evaluate the risks and take action to reduce them.
13
The regulations have additional requirements for a number of specified substances such as asbestos
CPEA/SCA October 2011
45
Role of Registered Manager Adult Residential Care England
4. Record what has been found out about hazards and the actions taken.
Develop a clear plan of how to prevent fire and how to keep people safe if
there is a fire. Train staff so they know what to do in the case of fire.
5. Keep the assessment under regular review and make changes if necessary.
Security
Most residential homes are not under lock and key. This is an inevitable part of
ensuring that people have choice and that their rights are respected. However,
they also have a right to be secure. Security is about:
 security against intruders
 security in respect of people’s privacy and decisions about unwanted
visitors
 security against being abused
 security of property
Registered Managers have an important role in putting procedures in place
to ensure the safety and security of residents, staff and visitors.
Reducing the spread of infection
Registered Managers are also responsible for ensuring that steps are taken
to reduce the spread of infection, it is important that Registered Managers
understand the chain of infection and how they can spread so that the
workforce and residents can all be made aware of what they can do to
contribute to reducing risks. Infections are caused by micro-organisms
(bacteria or viruses). The purpose of infection control is to break one or
more links in the ‘chain of infection’ and thus stop the spread, this will
include steps such as:
 All staff using correct hand washing procedure
CPEA/SCA October 2011
46
Role of Registered Manager Adult Residential Care England
 Cleaning equipment with appropriate materials
 Disposing of waste correctly
 Wearing personal protective clothing where necessary
 Maintaining personal hygiene
Medication
Registered Managers are responsible for ensuring that medication is
administered in accordance with legislation and regulations. (see Appendix
X). This means making sure that all staff who may give medication are
suitably trained for the type of medication they are administering, and are
using appropriate methods. It is also important that, in the interests of
choice and independence that people are supported to administer their own
medication wherever possible. In situations where there has been a decision
of lack of capacity, and it is necessary in someone’s best interests to
administer medication covertly, this must be done in accordance with the
Mental Capacity Act 2005.
CPEA/SCA October 2011
47
Role of Registered Manager Adult Residential Care England
Appendix C – Acknowledgements
Pat Bailey
Joan Beck
Janti Champaneri
Vic Citarella
Sue Davis
Des Kelly
Yvonne Nolan
Janet Pearson
Michaela Pinchard
Liz Taylor
CPEA/SCA October 2011
48