Following publication of “Leadership in Homecare Services – What Works Well?”, Rebekah Luff from My Home Life England at City St George’s, University of London reflects on what the research reveals about leading homecare today.
Whilst we already knew from our work with homecare leaders that the demands of their role are many and varied, having it set out so plainly was striking — and the capability of managers to keep all of those plates spinning is inspiring. We presented the insights from the report to homecare leaders, and their keenness to share it so others can better understand their work and the challenges they face has highlighted how unseen a lot of what they do often feels.
The report identifies six interwoven elements of effective homecare leadership: culture, communication, wellbeing, community of practice, professional identity, and reflective practice. For me, the most critical right now is creating that positive community of practice. This element is deeply connected with the others, and it’s where you really see that golden thread — from the culture inspired and demonstrated by leaders every day, through to how care staff interact with the people they support in their homes.
When care staff move from one provider to another, it may, of course, be about pay or hours, but often it’s about culture: a feeling that something isn’t quite right, or that the organisation isn’t supporting them to do their job well.
When I read feedback from our programmes, I’ve been struck by the number of homecare leaders who reported how alone they had previously felt. We must recognise these leaders do a very difficult job. Commissioners need to fund and prioritise both professional development — equipping leaders with the theories and tools of leadership — and professional support, giving them the opportunity to safely discuss and share what is and isn’t working well with other care leaders, to better understand themselves and their own wellbeing, and to seek support as they take steps to make positive changes in their organisations.
Leaders participating in our programmes share how they’ve grown in professional confidence, are more resilient, and are building stronger relationships within their organisation and beyond. One striking thing we see repeatedly is the realisation that, for leaders to continue providing effective support to their team, they also need support themselves. This often relates to setting boundaries and changing the dynamic of how leaders work with their teams. The impact is teams who feel more empowered, are more likely to take the initiative, and more confident responding to situations themselves. It might seem counterintuitive, but some of the best examples of growing confidence in their leadership style — and in their teams — is when managers say they finally took a day off without receiving any calls!
If I could change one thing tomorrow to make homecare leadership more sustainable, it would be very simple: ensuring the rates paid to homecare providers meet the actual costs. We set out six elements of good leadership, but those reflect six areas that need funding if leaders are to meet them. Too many homecare leaders are feeling personally responsible for the consequences of a funding system that does not cover their costs.
Voices from the frontline
Care leaders who took part in the Care Providers Forum (My Home Life England, Islington homecare group, 2025) echoed the report’s conclusions with remarkable honesty. What keeps them awake at night is the sense of being perpetually on-call — the fear that something is uncovered, a task unfinished, or a problem emerging unseen. Staffing worries dominate: rota gaps, last-minute drops, shortages, and the anxiety that valued care workers might leave. Leaders also carry the weight of complaints and safeguarding, including the worry about issues they don’t yet know could escalate. They spoke about particular people they support in very complex situations, and how responsibility for risk follows them home. External pressures matter too: extreme weather that makes visits unsafe or impossible, and growth targets or KPIs that can feel relentless.
Yet pride is equally powerful. Leaders described purpose in “getting through a difficult time with someone we support,” enabling reablement, restoring independence, or simply making someone smile. They feel proud when teams pull together, when colleagues they mentor flourish, and when inspections or audits recognise hard work. Still, holding onto that pride isn’t easy: doubt, fear, and preventable mistakes can quickly erode it.
On wellbeing, many said balance is learned the hard way. They talked about small wins, learning to accept praise, and realising — sometimes after illness — that looking after themselves is essential to caring for others. Boundaries, realistic workloads, and taking holidays were named as practical turning points.
Support, they said, comes from strong teams, trusted colleagues, and having the right resources. Loneliness creeps in when workload overwhelms, resources fall short, or there’s no peer to confide in.
Their message to policymakers and the public was blunt: homecare leadership is all-encompassing, not 9-to-5, and too often shaped by decisions made without real homecare experience. They want leaders’ contributions recognised nationally — not only when things go wrong, but for the quiet, daily work that keeps people safe at home.
