Which care leadership roles this covers
This guide is about the people who run services and the people who run the people who run services:
- Deputy managers and registered managers.
- Clinical leads and clinical managers in nursing settings.
- Operations and regional managers.
- Directors of care, quality or operations.
The principles are the same across them. The regulatory detail differs, and registered managers have their own guide.
Why leadership searches are different
The pool is smaller. There are far fewer experienced registered managers or clinical leads within reach of any one service than there are care workers.
Most of them are employed and doing well. They are not reading adverts. They will consider a move if someone explains why this role is worth their time.
Notice periods are longer. Senior contracts commonly ask for more than a month, so even a quick search needs a longer runway.
Confidentiality runs both ways. The candidate usually does not want their employer to know they are talking. You may not want your current manager, your staff or your competitors to know you are recruiting.
Skills for Care reports registered manager turnover of 17.0% in 2024/25. That is the lowest point in its reporting period, but it still means a lot of services go through this each year.
Start with what the service needs next
The same job title can need very different people. A service recovering from a poor inspection needs someone who can stabilise a team and put systems in quickly. A service that is stable and growing needs someone who can build on what works without unsettling it.
Before the search starts, agree answers to these:
- What does the service need to look like in eighteen months?
- What is the new person expected to change, and what should they leave alone?
- Who will they report to, and how much will that person be involved day to day?
- What is the salary, and is there flexibility for the right person?
Promoting from within
A strong deputy may be ready to step up. They know the service, the team knows them and the handover is shorter.
They will usually need support. The care workforce pathway says registered managers must have or be working towards a Level 5 Diploma in Leadership and Management, or an equivalent. Check where your deputy is on that, and whether they have handled the parts of the role they have not seen yet, such as budgets, commissioning and the CQC relationship.
Run an internal candidate through the same assessment as external ones. It is fairer to them and to the team.
How to assess care leadership candidates
A leadership interview should test what the person has actually done, with evidence.
- Ask about their most recent inspection. What did it find, and what did they change afterwards?
- Ask about a safeguarding concern they handled, step by step.
- Ask about a staffing decision they got wrong.
- Give them a short case study from a real situation in your service.
- Take references from their line manager and from someone they managed.
Let shortlisted candidates spend time in the service. Good leaders will want to, and what they notice on a visit tells you a lot.
Running a confidential leadership search
When a search needs to stay quiet, the role can be described by sector, size and scope without naming the organisation. For example: a registered manager for a 60-bed nursing home within a regional care group. That is usually enough for a candidate to decide whether to have a conversation.
The organisation's name is shared once the candidate has spoken to us and agreed to go further, and only with your agreement.
Our executive search service is built for these roles. Some are best filled this way from the start. Our guide on when to use executive search covers which ones.
Questions
How long does it take to recruit a registered manager?
Plan for the candidate's notice period, which is often longer than a month for senior roles, and for CQC registration once they start. Both sit outside your control, so start the search as early as you can.
Do registered managers need a Level 5 Diploma?
The care workforce pathway says registered managers must have or be working towards a Level 5 Diploma in Leadership and Management, or an equivalent. CQC looks at qualifications, competence, skills and experience together.
What do we have to tell CQC if our registered manager leaves?
Registered providers must notify CQC when a registered manager will be absent for 28 days or more, and when a registered manager stops managing the regulated activity. Check CQC's notification guidance for the forms and timings.
Should we tell the team we are recruiting?
Usually yes, once the current manager knows and you have decided how to handle it. Staff tend to find out anyway, and hearing it from you first causes less worry.
Sources
This guide covers England unless it says otherwise. It is general information, not legal advice. We review it when the rules change and update the date above.