Question: What do you consider to be the differences, the high risks, and challenges in being a registered manager of a supported living service to that of being a registered manager for a domiciliary care service?

Answered by Barry Price

The main differences for me usually factor on and around client abilities where supported living is about enabling someone to live life to the full, improve life and in the long term for many try and reduce dependency on support on the pathway to independence. Supporting and finding meaningful activities, Paid work and not just token volunteering or educational opportunities are key areas of this sector.

Dom care on the other hand is generally about supporting someone to remain at home as an alternative to longer term care environments or needing short term End Of Life or re-ablement at home following an illness or injury.

In both the levels of need can vary significantly. Supported Living, Domiciliary Care its in the name really. How you interpret it depends on how you manage it.

For many getting your head around the changes in funding routes, benefits systems, paying bills and general money management in supported living can present headaches along the way. Supporting people to budget and live within these constraints can be the most challenging part of this role.

Within Domiciliary care this is generally not an issue as the nature of support is under a regulated activity such as popping in to give medication, personal care, support with a meal etc. It can be a very task focused role and not as holistic as supported living.

High risks again in my view with supported living centre on choices and ability. I find myself regularly reminding providers and staff teams about the MCA Principle 3 – A person should not be treated as incapable of making a decision because their decision may seem unwise. Paternalistic practices and restrictions around this area can present high risks and some of the most significant challenges as a result of denying personal choice, without being able to communicate the Why!. Being a good negotiator helps.

Within Dom care in my view the highest risks come from not receiving enough funded support and significant risks arise outside the time allocated for staff support. Falls, Confusion, Fire, Medication to name a few and are all about keeping someone safe which a provider can feel helpless outside of the short visits allocated. Support levels in Supported living usually ensure a much better overview of Health and Safety.

As for challenges this is always an easy one and is the same for me in both areas. Dealing with families, Social workers and Advocates simple. Managing these sometimes quite intense and emotional relationships can be difficult but I can’t stress enough how vital they are to succeeding in both sectors. Just to make clear as many Domiciliary Providers will be shouting at the screen right now ROTA management, Recruitment and Staffing is probably THE BIGGEST challenge they have right now.

My main advice for anyone working and managing in both areas is get yourself some conflict resolution training alongside Time Management and How to communicate effectively.