Creating Psychologically Safe Leadership in the Care Sector

Psychological safety should not be one-directional. In the care sector, there’s growing recognition of the need for registered managers to create psychologically safe environments for their teams, and to step up and lead their teams with empathy, trust, and openness. But have care business leaders stepped back and asked themselves if they are providing a safe environment for those managers to lead?

The truth is, psychological safety starts at the top. If leaders don’t demonstrate trust, transparency, and support for their registered managers, how can we expect those managers to create the same environment for their teams?

Leadership flows both ways and if leadership begins at the top, this means senior leaders need to model psychological safety. If registered managers are expected to lead with empathy, transparency, and trust, they need to experience those same qualities from their own leaders.

Leadership behaviours at the top will inevitably influence behaviours throughout the organisation.The transition from managing to leading is especially challenging in care environments, where the focus is often on operational demands—schedules, compliance, budgets, and care standards. Registered managers often find themselves stuck in a "task-focused" role, which limits their ability to lead with vision and inspire their teams.

Leaders expect registered managers to go beyond managing the day-to-day and take ownership of the culture and development of their teams. But if this leadership shift doesn’t happen, the pressure from senior leaders can leave managers feeling overwhelmed and unsupported. High turnover in these roles suggests that managers often feel isolated, undervalued, or held to unrealistic standards—leading to burnout and resignations.

Where Things Go Wrong

1. Lack of Leadership Support and Development: It’s easy for senior leaders to assume that managers should "just know" how to lead well but many registered managers are promoted for their technical or operational expertise—not because they have leadership experience. Without targeted support and mentoring, these managers may struggle to shift their mindset from “managing tasks” to “leading people.”
2. Overloaded Expectations without Support Systems: Senior leaders expect managers to do everything—run day-to-day operations, manage compliance, keep staff engaged, and maintain high service standards. But if managers aren’t given the right tools, autonomy, or time to lead properly, it becomes overwhelming.
3. Mistrust and Micromanagement: Leaders may unintentionally undermine managers by micromanaging them or focusing only on KPIs and financials. This erodes trust, leaving managers frustrated and disempowered, which can lead to them stepping down or leaving the sector altogether.
4. Misalignment between Values and Leadership Style: Some leaders prioritise profits and compliance over team well-being and personal development. This creates an environment where registered managers feel squeezed between the expectations from above and the needs of their teams—leading to fatigue, stress, and burnout.

So how do we move away from simply expecting leadership skills and focus on enabling them instead? This means offering real support, being approachable, and encouraging open conversations about where managers are struggling. Actively creating psychological safety for them by being approachable, allowing failure without judgment, and encouraging honest feedback, including asking them how you can better support them?”

What Senior Leaders Can Do to Support and Encourage Leadership Growth (Without Offending)

1. Shift from "Managing Up" to "Supporting Down": Leaders need to shift their focus from monitoring performance to enabling their registered managers to grow. This means asking: How can I help you succeed? What barriers are in your way, and how can I remove them?
2. Mentorship & Coaching Over Instruction: Instead of issuing directives, leaders should adopt a mentoring or coaching approach—guiding managers to think like leaders. This encourages growth and ensures managers feel empowered, not controlled.
3. Create Safe Spaces for Honest Conversations: Leaders should regularly check in with Managers and ask meaningful questions like: - What challenges are you facing? Do you feel supported in your role? Are there any obstacles we’re creating that are making it harder for you to lead? This approach will encourage open dialogue without making managers feel criticised or pressured.
4. Align Values and Expectations: Leaders need to ask themselves if they are balancing performance metrics with care ethics. If managers sense a disconnect between the organisation’s stated mission (compassion, care) and its actual priorities (profits, KPIs), they’ll disengage.
5. Recognise and Celebrate Small Wins: Leadership growth happens incrementally. Leaders should acknowledge even small steps that managers take toward becoming better leaders. A little recognition goes a long way toward building confidence and motivation.
6. Lead by Example—Model Leadership Behaviour: Senior leaders must model the behaviours they want to see: humility, openness to feedback, and a focus on people over processes. If managers see leaders prioritising relationships and well-being, they’ll follow suit with their teams.

What else Care Organisations can do

• Leadership Development Programs: Regular training and workshops that focus specifically on leadership skills (e.g., emotional intelligence, conflict resolution) rather than just compliance and operations.
• Reduce Operational Load Where Possible: Give managers time and space to step back from daily tasks and focus on team development, strategy, and vision-building. This could mean delegating some operational duties to team leaders or administrative staff.
• Establish a Collaborative Culture: Create cross-level forums where registered managers and senior leaders can share ideas, discuss challenges, and work on solutions together.
• Set Realistic Expectations: Leaders should ensure that performance goals are both achievable and aligned with the values of care. Unrealistic or conflicting expectations (such as focusing on both cost-cutting and quality improvements) breed frustration.
• Prioritise Well-Being for Managers: Leaders need to check in not just on the performance of managers but on their mental health and well-being too. Offering access to coaching, mental health support, or peer networks can make a significant difference.

Why Managers might not be taking on leadership behaviours

If a senior leader feels that manager is not stepping up to lead, it’s essential to address the issue thoughtfully. Simply confronting the manager with criticism could demotivate them and risk further disengagement. Instead, the goal should be to inspire and empower growth toward leadership while identifying any hidden challenges the manager might be facing.

1. Start with Curiosity, Not Criticism

• Rather than assuming a manager is complacent, approach them with curiosity. Ask open-ended questions to explore what might be holding them back from leading.
• Example questions: How are you feeling about your role lately? What are the biggest challenges you’re facing? Is there anything getting in the way of you being more proactive with your team?

This creates psychological safety and allows the manager to share if they feel overwhelmed, unsupported, or unsure about how to lead.

2. Look for the Root Cause of Resistance

There could be several underlying reasons why a manager isn’t taking on leadership behaviours:

• Fear of failure or lack of confidence in their leadership abilities.
• Burnout from juggling operational demands.
• Unclear expectations—they may not know what leadership looks like or believe they’re doing what's required.
• Perceived lack of autonomy—feeling micromanaged or over-controlled by senior leaders.
• Mismatched incentives—the manager may feel rewarded only for operational tasks (e.g., meeting KPIs) rather than leadership behaviours (e.g., developing staff or building culture).

Identifying the root cause helps address the right problem rather than treating symptoms.

3. Clarify the Shift from Management to Leadership

Many managers, especially in care settings, focus on “keeping things running” because that’s what they’ve always done. They may not know how to shift from managing tasks to leading people.

• Sit down with the manager and clearly define what leadership means in their role. Help them understand the difference: Management: Ensuring the daily operations run smoothly. Leadership: Creating a shared vision, empowering the team, developing staff, and team culture.
• Make your expectations specific. For example: “I need you to focus less on completing tasks yourself and more on delegating, mentoring, and empowering your team to take ownership.”

4. Provide Mentorship and Practical Tools

If the manager is struggling with leadership behaviours, offer mentorship or coaching rather than simply demanding change. Provide them with practical tools, resources, and frameworks.

• Offer shadowing opportunities with senior leaders or peers to observe leadership in action.
• Provide training on leadership skills, such as emotional intelligence, conflict resolution, or delegation.
• Introduce leadership frameworks, such as situational leadership, so they can adapt their style based on the needs of their team.

5. Set Short-Term Leadership Goals with Feedback Loops

Break down leadership growth into achievable goals. Senior leaders should not expect instant transformation—leadership is a skill that takes time to develop.

• Set specific, measurable leadership objectives—e.g., “In the next three months, I’d like to see you hold 1:1 development conversations with each team member and work with them on career goals.”
• Provide regular feedback and support—not just at performance reviews but in real time. If the manager tries something new, acknowledge the effort, even if it’s not perfect.

Feedback could sound like: "I noticed how you delegated that task to the team leader yesterday—that’s a great start. Next time, try giving them more autonomy to decide how they complete it.”

6. Offer Autonomy, but Stay Supportive

Sometimes, managers stay stuck in a “management mindset” because they don’t feel they have the freedom or trust to lead. They may feel micromanaged or overly scrutinised.

• Give them room to lead: Offer autonomy in small, manageable areas—e.g., “You decide how to handle the ..... this month.”
• Let them know you’re there as a sounding board if they encounter challenges.

This way, the manager feels empowered to take ownership but knows they have support if needed.

7. Recognise and Celebrate Progress

Leadership is a journey, not a switch. Acknowledging small wins along the way reinforces positive change and motivates the manager to keep growing.

• Example: “I saw the way you encouraged your care workers to come up with their own solutions—that’s great leadership.”

Celebrating progress, even if incremental, builds the manager’s confidence and signals that leadership is valued.

8. Create a Safe Exit Strategy (if Needed)

If, despite your efforts, the manager continues to resist growth or seems unmotivated to lead, it’s worth having an honest and respectful conversation about their future. Not every person in a management role will thrive as a leader—and that’s okay.

• Discuss other possible roles where they can add value without being expected to lead (if appropriate).
• Offer support for transitioning out if the role no longer aligns with their aspirations.

This ensures that even if the relationship doesn’t work out, it ends on good terms—with dignity and mutual respect.

9. Reflect on Senior Leadership Behaviour

Senior leaders should also reflect on their own behaviours—have they unintentionally created barriers to leadership for this manager?

• Ask yourself: Have I been too focused on KPIs and compliance, leaving little room for creativity or leadership? Have I provided clear guidance and feedback, or just assumed the manager should know what to do? Have I engendered a supportive environment, or could I be contributing to stress and burnout?

Leaders need to model the leadership behaviours they expect from others—trust, support, empowerment, and empathy.

Final Thought: Don’t Assume, Engage

To support care managers in the transition to leadership, it’s important to engage them in a collaborative conversation and to coach them into leadership by providing clarity, autonomy, and support—without making them feel criticised or undermined. If the issue is deeper (e.g., misaligned values or burnout), it’s crucial to address that openly and constructively.

This approach fosters trust, encourages personal growth, and ultimately creates stronger, more resilient leadership within care organisations.

By balancing accountability with empathy, senior leaders can inspire registered managers to grow from competent managers into confident, empowered leaders.

In summary, we need to ask ourselves:

• Are we giving our managers the time and tools to lead?
• Are we providing psychological safety for them, just as we expect them to provide it for their teams?
• Are our goals realistic—or are we pushing our managers to their limits?If we want to retain our best managers, we need to stop measuring success by tasks completed and start focusing on the leaders we’re building.