If you're a Registered Manager, there's a good chance you've spent quite a lot of time learning what your role involves.

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You most likely will have, or will be working towards, a Level 5 qualification. You may have had an induction into the role, attended Registered Manager networks or forums, read CQC guidance, spoken to other managers and, quite possibly, learned a fair amount through experience along the way.

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But if you're the Nominated Individual, how did you learn what your role actually is?

Not simply what it says on your CQC registration.

What does being an effective Nominated Individual look like in practice?

What should you know about the service? What should your Registered Manager tell you? What should they be able to get on with without you? What needs to reach you routinely — and what should be escalated immediately?

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And perhaps most importantly, where does effective oversight end and managing the service begin?

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Two roles with different responsibilities

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CQC describes the Registered Manager as the person in day-to-day charge of the regulated activity.

The Nominated Individual has a different responsibility: supervising the management of the regulated activity on behalf of the organisation.

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On paper, the distinction sounds relatively straightforward:

The Registered Manager manages whilst the Nominated Individual oversees.

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In practice, finding the right balance can be much less straightforward.

An experienced Registered Manager needs sufficient authority and autonomy to lead their service. If every decision needs to travel upwards for approval, or every conversation with the Nominated Individual becomes a list of operational tasks to account for, it's reasonable to ask whether the Registered Manager is really being allowed to manage.

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But autonomy can't mean isolation either.

The Nominated Individual still needs sufficient visibility to understand how the regulated activity is being provided and where there may be risk, deterioration or a need for additional support.

So how much contact is enough?

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Does good oversight mean a weekly meeting?

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I've recently been reading some guidance for Nominated Individuals which recommends a weekly one-to-one with the Registered Manager.

There are certainly situations where I think that could be valuable.

A newly appointed Registered Manager may need more frequent support. A service going through significant change or rapid growth may warrant closer oversight. If there are quality concerns or an improvement plan underway, weekly conversations might be entirely appropriate.

But I don't think that means every Nominated Individual needs to sit down with every Registered Manager every week.

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For a start, organisations are structured very differently.  In a small independent provider, the Nominated Individual may work in the same office as the Registered Manager and speak to them regularly.  At the other end of the scale, a large national provider may have one Nominated Individual overseeing regulated activities across numerous locations, supported by layers of operational and quality leadership.

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The Registered Manager in that organisation may rarely see the Nominated Individual.

That doesn't necessarily mean the Nominated Individual doesn't know what's happening.

They may have access to extensive dashboards, analytics and reports. Information may flow through Area Managers, Regional Managers, quality teams or operational directors. Risks and exceptions may be escalated through established routes.

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The Nominated Individual can be relatively invisible to an individual Registered Manager while still having considerable visibility of the service.

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I've worked in organisations where that oversight looked very different. In some, Registered Managers submitted weekly reports. In others, information was gathered through dashboards, analytics and management structures. Elsewhere, regular conversations played a greater part.

The method isn't important. What matters is that the Nominated Individual has a reliable line of sight into the services they represent, and that everyone is clear about what should be reported routinely and what needs escalating immediately.

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Oversight shouldn't turn into duplication. 

 

The Nominated Individual needs enough information to understand what is happening, identify emerging risks and ask questions when necessary. But they don't need to become a second Registered Manager.

A capable Registered Manager needs the authority and space to manage their service.

And good oversight should bring more than accountability.

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Some of the most useful conversations I've had with senior leaders weren't about them telling me what to do. They offered another perspective, asked a question I hadn't considered or helped me step away from the immediate operational pressure and look at something differently.

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The Registered Manager retains ownership of their service, but they aren't leading it in a vacuum.

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So where does one role end and the other begin?

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I don't think there's a single model that will work for every provider.

The relationship between an owner/Nominated Individual and Registered Manager in a small independent service will inevitably look different from the relationship between a Nominated Individual and individual Registered Managers within a national organisation.

The support required by a newly registered manager may be different from that needed by somebody who has successfully led services for years.

And even within the same service, the level of oversight may need to change when circumstances change.

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Perhaps the better test is whether both people can answer these questions:

Do we both understand our respective roles?

Do we know what the Registered Manager has the authority to manage?

Are we clear about what information should routinely reach the Nominated Individual?

Are we equally clear about what should be escalated immediately?

Does the Registered Manager have enough autonomy to lead?

Does the Nominated Individual have enough visibility to provide meaningful oversight?

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Perhaps the most revealing question is this:

If I asked the Registered Manager and Nominated Individual separately to describe where their responsibilities sit, what information should travel between them and what should trigger an escalation — would I hear the same thing?

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They don't need to use exactly the same words. But there should be a shared understanding.

Because effective oversight isn't just about having two clearly defined roles on paper.

It's about both people understanding how those roles work together in practice.

If you're a Registered Manager or Nominated Individual, how does that relationship work in your organisation — and what helps you get the balance right?

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Next week, I'll explore how the Registered Manager and Nominated Individual can create effective

oversight without creating duplication — and the role good governance plays in making sure the right information reaches the right person.