The Nominated Individual Role: Why One Person, Not the Whole Board

The Nominated Individual position isn't an organisational preference or best practice recommendation, but a legal requirement under CQC Regulation 6. When a care provider is a corporate body (a company, partnership, or organisation rather than a sole trader), CQC mandates that one specific individual must be nominated to supervise the management of the regulated activities. 

This person becomes the regulatory focal point, the named individual whom CQC holds directly accountable for ensuring compliance. The regulation specifies ‘an individual’ deliberately and unambiguously. This isn't bureaucratic pedantry; it creates a clear line of regulatory accountability that protects everyone involved, including the broader board. 

The Skills for Care Nominated Individual Handbook reinforces this: the NI must be able to demonstrate that they're actively supervising the quality and safety of care, that they understand what's happening on the ground, and that they can respond decisively when CQC raises concerns. This requires an intimate, ongoing engagement that simply cannot be achieved through committee deliberation.

Martin Lowthian has many years of experience working with the UK regulators at Board level and said that:

Boards rightly pride themselves on collective decision-making. Strategic direction, financial oversight, and governance matter benefit from diverse perspectives and shared accountability. However, regulatory compliance operates under different rules, for several reasons: 

Immediate accountability - When CQC identifies a compliance concern, they need to speak with the person who can immediately explain what's happening, why it happened, and what's being done about it. A committee cannot provide this rapid, informed response. 

Personal liability - The NI can face personal regulatory sanctions, including prohibition from holding the role at other services. This level of individual consequence is incompatible with collective responsibility - you cannot collectively prohibit a board. 

Operational oversight - The NI must supervise the day-to-day management of regulated activities. This requires detailed knowledge of care delivery, staffing patterns, incident management, and quality assurance that goes beyond board-level strategic oversight. 

The roles of registered managers and nominated individuals share a commitment to quality, safety, and compliance, but they operate at different levels within a care organisation. Registered managers focus on the daily operations of a care service, ensuring legal and regulatory compliance, approving governance frameworks, overseeing high-level risks. 

In contrast, the nominated individual has hands-on responsibility for regulated activities, acting as the CQC’s primary point of contact and ensuring that systems and processes meet fundamental standards.

They monitor care quality, respond quickly to regulatory concerns, and hold personal accountability for day-to-day compliance. While the board establishes the framework, the nominated individual ensures that regulatory requirements are met within it. They monitor care quality, respond quickly to regulatory concerns, and hold personal accountability for day-to-day compliance.

While the board establishes the framework, the nominated individual ensures that regulatory requirements are met within it. They monitor care quality, respond quickly to regulatory concerns, and hold personal accountability for day-to-day compliance. They hold responsibility for regulated activities, acting as the CQC’s primary point of contact and ensuring that systems and processes meet fundamental standards. This role also monitors care quality, respond quickly to regulatory concerns, and hold personal accountability for day-to-day compliance. While the board establishes the framework, the nominated individual ensures that regulatory requirements are met within it. 

Why can't the whole board share NI responsibility? 

Because CQC needs one person who knows the service intimately enough to answer detailed questions about care delivery, staffing decisions, safeguarding responses, and quality assurance. When CQC rings, they need someone who can speak authoritatively about what happened, for example, on a specific night shift, not someone who needs to consult three colleagues before responding. 

This seems like adding bureaucracy to governance. 

It is removing ambiguity. Without a designated NI, every director carries undefined regulatory exposure. The NI role creates clarity: this person holds regulatory accountability, freeing other directors to focus on governance without confusion about who's responsible for what. 

We've always managed compliance collectively. 

Compliance oversight and operational compliance assurance are different activities. Boards should absolutely oversee compliance through reporting and scrutiny, but the NI provides that assurance by supervising the actual delivery of care - a granular, operational activity that boards aren't designed to perform. 

Is this just a passive, administrative role? 

Absolutely not. The NI role is intensely active and strategic. It requires regular presence in services, relationships with managers and staff, understanding of care quality nuances, and the authority to intervene when standards slip. It's not about paperwork, but more about knowing your services well enough to spot problems before CQC does. 

What Does This Mean in Practice? 

Your Nominated Individual should be spending substantial time in your services, not just reviewing reports in board meetings. They need to know your managers personally, understand your staff challenges, recognise your quality patterns, and maintain relationships with CQC inspectors. 

When something goes wrong - a safeguarding concern, a medication error, a staffing crisis - your NI should be involved immediately, not learning about it in next month's board papers. They're your early warning system and your rapid response capability. 

The NI then brings critical intelligence back to the board: ‘We're seeing patterns in incidents that suggest training needs,’ or ‘CQC feedback indicates they're concerned about our governance of a particular location.’ This creates a vital feedback loop between operational reality and strategic governance. 

When leadership changes occur, perhaps your NI becomes chairman, or a customer takes over direct operational leadership, the NI role must retain its priority status and dedicated focus. These transitions are precisely when regulatory accountability can become unclear, creating risk. 

Boards should ensure that whoever holds the NI position has: 

• Protected time for the role (this isn't a part-time administrative add-on)
• Direct access to operational management
• Authority to raise concerns without hierarchical barriers
• Support to maintain their regulatory knowledge and relationships 

The person may change, but the role's importance cannot diminish.

The Nominated Individual role exists because, at crucial moments, care services need someone who can confidently speak for the organisation and ensure people receive safe, high quality support. When everyone understands the unique purpose of this role, your board is better able to empower it while continuing to provide the strong, collective governance that guides your organisation day to day quality support. When everyone understands the unique purpose of this role, your board is better able to quality support.

Clarity around responsibilities doesn’t weaken governance, it strengthens it. It brings reassurance, removes uncertainty, and helps everyone work together confidently when the CQC seeks assurance. 

Because the Nominated Individual carries personal regulatory accountability, the role cannot be shared. This is collaboration as it is about protecting your entire organisation through clear lines of responsibility. Your board sets the strategic direction, and your NI upholds regulatory compliance in practice. Both perspectives are vital, equally valued, and mutually reinforcing. When the distinction is understood, the whole organisation benefits—and avoidable risks are reduced for everyone.