Roles and responsibilities of key people

It is important for you to be aware of the roles and responsibilities of individuals within your organisation and in the wider context with respect to governance and the inspection process. Some of these key roles are discussed below.

The Registered Manager

The Registered Manager (along with the registered provider) is legally responsible and accountable for compliance with the requirements of the Health and Social Care Act 2008 and associated regulations. Regulation 7 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 sets out the requirements for a registered manager. They must:

• be of good character
• be able to properly perform tasks that are intrinsic to their role
• have the necessary qualifications, competence, skills and experience to manage the regulated activity
• have supplied the provider with documents that confirm their suitability

The Nominated Individual (and who may be appointed to this role)

The nominated individual is the main point of contact with the Care Quality Commission (CQC) and has the responsibility for supervising the organisation’s management and ensuring the quality of the services provided.

Under Regulation 6 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, the nominated person must:

• be a director, manager or secretary of the organisation
• be of good character
• be able to properly perform tasks that are intrinsic to their role
• have the necessary qualifications, competence, skills and experience to supervise the management of the regulated activity
• have supplied the provider with documents that confirm their suitability

The Registered Manager may also have the role of Nominated Individual, however, often the two roles will be filled by separate individuals to prevent a conflict of interest.

The Registered Provider

It is also worth noting that as well as registering a nominated person and registered manager with CQC, the organisation itself must also register – this is referred to as the ‘registered provider‘. Further information about the registration process can be found here.

The ‘fit and proper person’

Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 sets out the criteria for a ‘fit and proper person‘ to ensure that staff “provide care and treatment appropriate to their role and to enable them to provide the regulated activity“. The registered provider must ensure that they have a robust recruitment process in place to comply with this regulation, along with regular monitoring of staff and procedures for if a staff member no longer meets the criteria.

Inspectors

The role of the CQC inspector is to monitor, inspect and regulate care services to ensure they meet fundamental standards of quality and safety. They perform inspections using the Key Lines of Enquiry and assign ratings for each service based on their findings.

Auditors

The role of the auditor is to find out if a service is operating in line with standards and identify areas that working well and those that require improvement. Often, organisations will work with external auditors so that they can get an impartial understanding of how their organisation is working for the purposes of quality improvement. Local authorities and larger organisations often have a Quality Assurance Framework (QAF) in place which is managed by a team of auditors. For the NHS, the Healthcare Quality Improvement Partnership (HQIP) manages national and local clinical audit programmes.

Board members

The role and responsibilities of board members include strategic planning, setting policies, establishing values, mission and vision and overseeing the day-to-day operations of an organisation. Members of the board should be ‘fit and proper persons‘ as described above.

Non-executive directors

Non-executive directors are board members that aren’t involved in the day-to-day management of the organisation. They may be used to bring expertise, experience, different perspectives and insight to an organisation as well as oversee management and ensure they remain accountable.

Trustees of adult care businesses and charities

Similar to board members, trustees are the governing body associated with charitable organisations or public benefit organisations, such as NHS Trusts. They have the same responsibilities as a board and may have further responsibilities under additional legislation based on their legal structure (e.g. Charities Act 2011).