Last week, I explored where the responsibilities of the Registered Manager and Nominated Individual meet, and why effective oversight can look very different depending on the size and structure of the organisation.

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But whatever the structure, the Registered Manager and Nominated Individual both need to understand what's really happening in the service.

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They don't need to be doing the same job, but they do need to be working from the same understanding of it.

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Start with good governance

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A Registered Manager with robust governance arrangements should already have much of that information at their fingertips: incidents, safeguarding, complaints, medication, care plans and risk assessments, call attendance, staffing, recruitment, training, feedback and audits.

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But collecting information isn't governance. It's what you do with it that matters.

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One medication error may be an isolated incident. Several similar errors may point to something else. A complaint may have been resolved appropriately, but several complaints touching on the same issue should make you curious.

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The same applies across the service. What is changing? Where are themes emerging? Are actions making a difference? Is the same issue appearing in different places?

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Good governance helps the Registered Manager see the story behind the numbers. And that same picture gives the Nominated Individual much of what they need to provide effective oversight.

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Some things shouldn't wait for the monthly picture

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Routine governance gives both people an opportunity to step away from the day-to-day and look at what is happening over time.

But it can't be the only route through which information reaches the Nominated Individual.

There will always be things significant enough that they need to be escalated when they happen rather than appearing for the first time in next month's governance return.

A serious safeguarding concern. Significant staffing instability. The unexpected absence or resignation of a key person. A serious complaint or incident. Something that could affect the safety, compliance or stability of the service.

Exactly what needs immediate escalation will depend on the organisation, but there should be clarity about where that threshold sits.

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Good oversight needs both a regular governance picture and a clear route for the things that can't wait.

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Does the Registered Manager know what belongs in the routine governance picture?

And are they equally clear about what the Nominated Individual would expect to hear about straight away?

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But who checks the checker?

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There's another question that becomes particularly important in smaller organisations.

If the Registered Manager is responsible for completing the audits, reviewing the findings, identifying the trends, implementing the actions and reporting on the governance of the service...

who checks the checker?

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This isn't about mistrusting the Registered Manager.  It's about recognising the difference between trust and assurance.

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An owner or Nominated Individual may have complete confidence in their Registered Manager.

But if you ask whether governance is happening consistently and the answer is:

“I think so — my manager tells me they're doing it.” That's not quite the same as “I know.”

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So what gives the Nominated Individual confidence that the governance activity is happening consistently — and that the picture they're receiving is a reliable one?

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That doesn't mean repeating every audit the Registered Manager has already completed.

It might mean periodically sampling some of the evidence behind a governance return. Looking at whether actions identified through audits have actually been completed. Speaking to clients or staff. Looking at feedback. Asking why a particular indicator has changed — or occasionally asking why something hasn't changed for a very long time.

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Trust your Registered Manager. But build a system that means you don't have to rely on trust alone.

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The aim isn't to catch anybody out.

It's to provide assurance that the governance system itself is working.

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From information to assurance

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A dashboard full of green boxes can look reassuring.

But good governance requires curiosity too.

If there have been no complaints for six months, does that mean everyone is happy — or could it mean people don't know how to complain?

If every audit is consistently showing 100%, is that evidence of excellent practice — or worth occasionally looking behind?

If training compliance is high, is that reflected in what you see in practice?

If incidents are increasing, are they unrelated events or is a pattern beginning to emerge?

This is where the Registered Manager and Nominated Individual can bring different perspectives to the same information.

The Registered Manager knows the detail of the service.

The Nominated Individual has the opportunity to step further back, look across the picture and ask questions.

Neither needs to duplicate the other's role.

But together they should be able to move from information to understanding, and from understanding to assurance.

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For me, knowing what's really happening in a service therefore needs three things:

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Routine governance — a regular picture of performance, quality, risk and emerging themes.

Timely escalation — a clear route for significant issues that shouldn't wait for the next governance cycle.

Independent assurance — enough checking behind the information to know that the picture being presented can be relied upon.

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The systems used to achieve those things will look different from one provider to another.

But the outcome should be the same.

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The Registered Manager knows their service.

The Nominated Individual has meaningful oversight of it.

And both are working from a shared understanding of what's really happening.

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If you're a Registered Manager or Nominated Individual, what gives you confidence that your governance systems are showing you what's really happening in your service?

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This is where I can help:

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Sometimes the hardest service to look at objectively is your own.

Through A B Training & Development, I offer independent Service Review Days for domiciliary care providers, looking across People, Quality and Growth to help identify what's working well, where there may be gaps and what deserves closer attention.

The aim isn't to produce another lengthy report that sits in a folder. It's to give you an independent view of the service and a clear, prioritised picture of what to focus on next.

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If you'd value another pair of eyes on your service, send me a message here via the contact box  and let's have an informal conversation about what would be useful.