Being Told to Improve Leadership When You’re Barely Keeping the Service Running

You have covered a staffing gap, dealt with a complaint and spent part of the morning trying to resolve a problem that began last week. Your own work is waiting. Then comes the feedback: leadership needs to improve.

It can be difficult to hear. You may feel that the effort involved in keeping the service running has gone unnoticed. Perhaps your first instinct is to explain everything happening behind the scenes. Perhaps you say very little, then spend the evening wondering whether you are good enough for the role.

For leaders in health and social care, criticism can touch something deeply personal. The work involves people’s safety, dignity and wellbeing. Being told that leadership is falling short can feel like a judgement on your commitment, even when the concerns relate to specific systems, decisions or working arrangements.

CQC’s State of Care report, published on 23 October, makes this a timely conversation. The regulator identifies leadership as the area most in need of improvement, while also recognising the significant pressures facing services and the work of staff delivering compassionate care. Its adult social care findings highlight governance, accountability and clarity of roles and responsibilities as areas needing attention in care homes.

Those findings require action. They also raise a practical question: what helps an already stretched leader receive difficult feedback, understand it properly and make changes that last?

Your first reaction does not have to become your final response

Feeling defensive after criticism is understandable. You know the vacancies, difficult conversations and extra hours that may be invisible to the person giving the feedback. You may also feel protective of a team that has worked hard in difficult circumstances.

That reaction deserves some space, but it should not determine the whole response. Where a concern involves immediate safety, action cannot wait. For other feedback, taking time to read, reflect and prepare questions can help you respond more usefully than trying to explain everything in the moment.

It may help to identify what is affecting you most. Is the feedback accurate but painful? Is it too vague to act on? Does it overlook relevant evidence? Or does it describe a problem you have already raised without receiving support?

Each possibility needs a different response. Understanding your reaction can help you move towards the issue that needs resolving.

Make “improve leadership” specific

Broad criticism is difficult to use. A manager cannot build a meaningful improvement plan around a general instruction to become a better leader.

Ask which decisions, behaviours or systems need to change. What evidence supports the concern? How has it affected staff or people using the service? What would improvement look like in everyday practice?

If staff say communication is poor, for example, the next step is to understand where it breaks down. They may receive information late, be unclear about responsibilities or feel that concerns disappear after being raised. Each issue points towards a more specific response.

Likewise, weak oversight might involve audits that are not completed, actions that are not followed through or information that does not reach the person responsible for making a decision. Naming the problem makes it possible to assign responsibility and assess progress.

Leaders should be able to ask for this clarity without being treated as resistant. Seeking examples is part of understanding feedback properly, provided the questions are asked with a willingness to listen.

Effort matters, and outcomes still need attention

Working exceptionally hard can coexist with gaps in a service. That is a painful reality when someone already feels they are giving everything they have.

A manager may spend so much time responding to urgent problems that supervision, quality checks and development work keep being postponed. Their effort is real. So are the consequences of the work that remains undone.

Our article, You’re Not Just Running a Service—You’re Carrying People, offers a related reflection on the human weight of leading in care. Recognising that weight should help an organisation examine how the work is arranged and where support is needed.

A useful discussion can acknowledge the manager’s contribution while asking why important responsibilities are repeatedly displaced. If the service depends on one person dealing with every urgent issue, the improvement needed may include delegation, stronger cover and clearer decision-making authority.

Ask what will make change possible

An improvement plan adds work. Someone needs to review processes, speak with staff, arrange development, follow up actions and check whether changes are helping.

Before agreeing a timetable, leaders and providers should consider who will do that work and when. What can be delegated or postponed? Is additional expertise required? Does the manager have authority to change the arrangements being criticised?

A plan that assumes someone will complete everything after their normal working day may be difficult to sustain. Protected time and practical assistance should be discussed as part of delivery.

Support also needs to match the concern. A course may help someone develop a particular skill, but a problem involving unclear responsibilities also requires decisions about who does what. A manager struggling to interpret quality information may benefit from coaching and better reporting arrangements. Development works best when the person has an opportunity to apply it.

Feedback should reach the wider organisation

Registered managers and service leaders have important responsibilities. Providers and senior teams must also examine their own contribution to the conditions being reviewed.

Were earlier requests for support answered? Were responsibilities clear? Did the leader receive appropriate induction and supervision? Were they expected to deliver changes without the necessary resources or authority?

These questions help establish an accurate picture of what needs to improve. They should sit alongside scrutiny of the manager’s own decisions, rather than being used to avoid it.

Where the manager is also the owner, suitable external advice or professional support may help them examine the service with fresh eyes. Having final responsibility does not mean every problem must be understood and resolved alone.

Build a plan that allows progress to be seen

An exhausted leader can look at a long list of recommendations and feel that everything is equally urgent. Prioritising helps turn that list into manageable work.

Immediate risks need prompt attention. Other actions can be organised around their impact, dependencies and available capacity. Each should have a clear owner, a realistic timescale and an agreed way to check whether it has made a difference.

Completing an action is only part of the assessment. If a new communication process has been introduced, do staff understand decisions more clearly? If responsibilities have been rewritten, do people know when to act and when to escalate?

Regular reviews can recognise progress, identify obstacles and adjust the plan. They also give the leader somewhere constructive to bring concerns, rather than carrying an undefined sense of failure between meetings.

Leave room for professional confidence to recover

Difficult feedback can remain in someone’s mind long after the discussion ends. They may begin questioning decisions they previously handled confidently or interpreting every new problem as confirmation that they are failing.

Keeping reflection specific can help. Identify what you need to change, what support has been agreed and what evidence will show progress. Continue noticing what the service and team do well, so that improvement is built on an accurate picture of both strengths and weaknesses.

Leaders should also have an appropriate place to discuss the personal effect of criticism, whether through supervision, a trusted professional relationship or other suitable support.

Being asked to improve is a serious professional responsibility. It should come with enough clarity to understand the concern, enough honesty to examine your own practice and enough organisational support to act. The most useful response is a plan that changes how the service works, and gives the person leading it a realistic opportunity to succeed.