Working in partnership with the registered manager
The nominated individual is responsible for supervising the day-to-day management of the service, which means that the relationship and partnership between the nominated individual and registered manager is central to the culture and ultimate success of a service.
If the nominated individual is also the registered manager, it is still important that they have access to support and an independent perspective on the service. If yours is a larger organisation, which has more than one registered manager holding a dual role, consider whether it might be possible for two or more managers to support each other. If yours is a smaller organisation and the nominated individual is also the registered manager and/or director, it may be more appropriate to reach out to an external nominated individual from a different service.
Building trust
Trust takes time to build when working in partnership with anyone and your ability, as nominated individual, to create positive relationships with others has the potential to transform the lives and experiences of the people you support. For nominated individuals and registered managers, it is possible to lay good foundations to the relationship by talking openly about company values and how they are demonstrated within the service. Give the registered manager time to share their views, including areas of the business that they are most proud of and areas of concern. Listen carefully without judgement. If the partnership between nominated individual and registered manager is to work well, it is important that you each understand the others’ strengths and areas that you find challenging, so that you can work together to balance strengths and weaknesses. It can be helpful to begin the relationship with a conversation about your own strengths and areas that you find challenging. For example, you may have excellent knowledge of legislation and the CQC requirements, but you may lack understanding of the practicalities of delivering care. Sharing your strengths and challenges first can help the registered manager to feel more comfortable to share their own. This can lead to a healthy conversation about how you can support each other – or even if you need to bring in additional support in areas where you both lack knowledge and expertise. The focus should always be on forming the best working partnership that you can in order to enhance the outcomes of the service.
Healthy conflict
An important part of the role of nominated individual is that of critical friend to the registered manager. It is easy to praise and celebrate success, but challenging how a service is performing can often feel uncomfortable to discuss and explore.
The nominated individual should carry out or support audits and quality assurance activities, such as mock inspections as part of their role. It is inevitable that these activities will seek to highlight areas of good practice and evidence of improvement, but also identify areas for improvement.
If the registered manager holds a dual role and is also nominated individual, it might be helpful to use the services of an external consultant to carry out audits and mock inspections. In this situation, it is essential that transparency is embraced between both parties and that the consultant is able to offer candid feedback without fear of blame.
If the nominated individual, or their consultant is uncomfortable about raising contentious issues with the registered manager, the service will be unable to grow and improve.
Challenges should always be respectful and never personal. Healthy conflict is not about power struggles. It is important for the registered manager to trust that the nominated individual respects them in their professional capacity and has the best interests of the service at the forefront of any challenge.
It is helpful to talk about how you will address any issues that are revealed during your quality assurance activities at the beginning of the professional relationship, rather than wait until an issue arises.
Sometimes emotion can get in the way of professional relationships. The nominated individual may have made every effort to form a good working partnership with the registered manager, (or the other way around), but the other party simply will not engage. This will hinder your ability to carry out the role of nominated individual effectively, so it is important that you avoid having “no go” areas of discussion due to discomfort.
If a registered manager has been closed and non-communicative from the start of the relationship, the nominated individual could open the lines of communication by saying “It is important that we work together effectively for the benefit of the service, and this seems to be a challenge for us at present. To try to resolve this, it is necessary to talk openly together about the difficulties in getting on together, however difficult we may find the conversation.”
Be prepared to be honest and transparent in your communication, but also to listen carefully to difficulties that the registered manager has in their relationship with you as nominated individ ual. A deeper understanding of each other can help, but it is important that a commitment to change is agreed in order for the relationship to work, grow and evolve.
Heartbeat” meetings
If the nominated individual is not based at the service, or nearby, a weekly “heartbeat” meeting can be an effective way of staying in touch with the registered manager via Teams or Zoom (or a platform of your choice).
“Heartbeat” meetings are a simple way to create accountability. Diarising a brief weekly meeting with the registered manager (or more frequent, if appropriate), will help to set a structure for accountability.
If the registered manager is also the nominated individual, it may be helpful to partner with another registered manager within the organisation who holds a dual role. This would offer the opportunity for peer-to-peer support and accountability to take place.
If the service is small and the nominated individual is also a director and registered manager, they could consider using the services of an external nominated individual with strong coaching skills to support them and encourage accountability.
Heartbeat” meetings can take place face-to-face or in the virtual world. What is important is that they take place at the same time and on the same day each week and are protected time for the nominated individual and registered manager. Each meeting should take no longer than 30 minutes, but you can agree a time frame which works for both parties.
As a suggestion, meetings could begin with the registered manager sharing what they achieved from the list of commitments from the previous week, what they haven’t achieved and why, and if they need any support to complete the task.
The registered manager then shares two actions that they will take in the coming week that will improve outcomes within the service.
Finally, they will share any challenges or what is keeping them awake at night. This offers the opportunity to share deeper concerns with the nominated individual.
The registered manager also holds the nominated individual accountable for what they agreed to do in the previous meeting.
The nominated individual then feeds back to the registered manager about what they committed to do, in the same way
Supervision
An important element of the role of nominated individual is to ensure that the registered manager has access to professional and effective supervision, and the CQC expects to see staff offered regular supervisions to ensure that they’re competent and confident to do their role. Supervision involves a person with appropriate knowledge and skill, (the supervisor), taking formal responsibility and accountability for work performance and mental wellbeing of the supervisee (the person being supervised). If you hold a dual role of nominated individual and registered manager, it is essential that you arrange provision of supervision for yourself. This could be with a director, or even an external supervisor, but for the safety of the service and your own wellbeing, it is important that supervision takes place. Formal supervision should ideally take place every four to six weeks, or more frequently if the service is experiencing issues or going through major change.
The purpose of supervision is to:
■ offer a framework to the registered manager to reflect on their practice
■ share information
■ build skills and confidence
■ support and signpost professional development
■ offer mentoring and coaching to improve performance
■ offer a safe space where both professional and personal issues affecting work can be shared
■ create accountability.