In episodes 1 and 2 , we looked at what you need to do to become a registered manager.
We have looked at what it means to be fit to be a manager, what skills and qualifications you need, and now we will tackle health.
This is the area that I find people get concerned about. You are asked within the process to sign a declaration to say you are fit and healthy for the job and to give your GPs details.
In this episode, Abi is going to walk you through the law, CQC guidance for providers, what you should expect in an interview and more!
In episodes 1 and 2 , we looked at what you need to do to become a registered manager.
We have looked at what it means to be fit to be a manager, what skills and qualifications you need, and now we will tackle health.
This is the area that I find people get concerned about. You are asked within the process to sign a declaration to say you are fit and healthy for the job and to give your GPs details.
In this episode, Abi is going to walk you through the law, CQC guidance for providers, what you should expect in an interview and more!
Hello, my name is Abi Spence and I am a Registration and Inspection Specialist working with QCS.
Welcome to Episode 3 of my podcast Inspection Inside Out.
In episodes 1 and 2 (which you can catch up on, on this platform), we have been looking at what you need to do to become a registered manager.
We have looked at what it means to be fit to be a manager, what skills and qualifications you need and now we are going to tackle health.
This is the area that I find people get concerned about. You are asked within the process to sign a declaration to say you are fit and healthy for the job and to give your GPs details.
That gets people’s hearts going.
But I am here to reassure you today.
So, what does the law actually say?
Well, it says it in legalese. The line is in Regulation 7 of The Health and Social Care Act .
It doesn’t make much sense unless we read it together with the bits before.
So, it says ‘M is not fit to be a registered manager in respect of a regulated activity unless M is
a. of good character,
b. has the necessary qualifications, competence, skills and experience to manage the carrying on of the regulated activity,
c. able by reason of M's health, after reasonable adjustments are made, of doing so, and
What does that actually mean? Some of you may be sat at home thinking, I had nervous exhaustion three years ago – will they bring that up? Or I am on medication for depression…maybe you had time off for a bad back.
CQC Guidance for Providers
Well, CQC is a little more helpful here in giving you some guidance on their webpage – which you can find on cqc.org.uk and look at Regulations for Service Providers and managers.
Let’s break this down in relation to you. Firstly, if you look at your job role as manager. Can you fulfil it? Well, I am guessing you feel you can, because you applied for it.
The second part is you got it. You got the job. The provider took you on. As part of their recruitment, they will have thought about whether you can physically or mentally carry out the role. If there was anything you disclosed, or from observation they were concerned about, they should have followed their employment processes such as,
checking the law in relation to equality and diversity. Let’s pause on this part for a moment.
Equality Act 2010
The law says you can’t discriminate against 9 protected characteristics. One of those is disability and age. So, you should not have unfair treatment because you have a disability, or you are of a particular age – that is important because some people can perceive if you are older, you either have a disability, or you have a condition – which is discrimination.
Two – the law says employers should make reasonable adjustments
The Equality and Human Rights Commission says ‘Your employer has a duty to take steps to remove, reduce or prevent the obstacles you face as a disabled worker or job applicant, where it's reasonable to do so.
The employer only has to make adjustments where they are aware – or should reasonably be aware – that you have a disability.’
So in relation to being a Registered Manager – you need to manage the day to day regulated activity (if you are working as manager of a care home – that’s what you are managing – the staff, nutrition, health and safety, safeguarding, person centred care – and so on).
An example would be – if you are a care home manager, and you have daily seizures which impacted your ability to function within your service on a day to day basis which cannot be managed medically or environmentally and negatively impact your ability to fill your role and reasonable adjustments cannot mitigate that risk. The likelihood, however good you are, at the role when the seizures are not happening, and there are no adjustments that can remedy the situation you would not be safe to manage the regulated activity, for yourself or others.
If you had seizures, which were medically prevented or reduced, or the environment could be changed and the risk assessment show they do not impact your ability to manage the service on a day to day basis,I would, as the provider, employ you if you were the best person for the job and my risk assessment determined any risks were mitigated.
So what would happen at interview?
The first thing you will be asked would be whether there are any changes to your application? If there is a change to your health which will affect your application. Now is the time to say. Remember, if this has been risk assessed – this is also the time to say how this will be managed.
If you have woken up with a sore throat – tell your family, a friend or pet. This isn’t the space for that!
You have filled out an application form. There happens to be a gap on your employment history and the inspector hones in on it. This may be due to ill health. You may have had glandular fever which stopped you working for a year. This is the point where you honestly disclose why if you are asked. Remember, CQC cannot discriminate against you because you have been ill. It is about what is happening now.
Mental Health
The same can be applied for mental health. If there are adjustments that are reasonable – and let’s hear reasonable in this sentence. Then exactly the same principles apply.
To help with this, CQC say that the provider must have processes for considering the person's physical and mental health in line with the requirements of the role.
Observation will be part of your fit person interview. When I see you, I will also be assessing this aspect, and whether I need to ask additional questions.
Medication
Throw away comments such as ‘I am sleepy because I have taken my medication’ would prompt – ‘how will you stay alert and able to respond if your medication makes you drowsy?’ How can you assure me of the safety of the people you support and staff?’
So, will your GP be contacted? I have been asked this often. Well, if there is no necessary reason for your GP to be contacted because CQC are assured, then your GP will not be contacted! If you tell me you experience psychosis, but not for 5 years, but you have stopped taking your medication as you feel you do not need. I may want to confirm and follow up what is in place for you and that may mean contacting your GP. And, also look at the risk assessment of the provider.
Perspective
I hope I have put this in perspective for you. We all have illness and mental health issues and illness at some point, some of us have ongoing conditions and disabilities which are managed. And CQC certainly do not contact GPS and open medical files just to have a read with their breakfast.
I hope you have enjoyed this podcast. Further information can be found on the QCS website QCS.co.uk and follow this podcast for more information on registration and your journey through it.