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14th July 2016

Health and Social Care Sole Directors: Are you ready? Are you steady? Are you CQC fit?

                    <a href= Health and Social Care Sole Directors 2" width="400" height="400" />I was sitting on the back step looking out over the garden when my husband asked, ‘what are you going to write about this week?’ ‘ Fitness.’ I said.  ‘What?’ He said. ‘Aerobics?’.  That made me chuckle.

In the Launch for the Conservative leader race, Theresa May said ‘My pitch is very simple, I’m Theresa May and I think I’m the best person to be Prime Minister’. That was a nice soundbite, but we know Theresa May has a lot more in her arsenal to qualify her for the job than words.  As Directors of organisations, a lot more is required than your word for your fitness.

What is regulation 5?

Well it is not jogging bottoms and sweat bands! Born out of findings from the failings at Winterbourne View Hospital and the Francis Inquiry report into Mid Staffordshire NHS Foundation Trust the law requires assurances under regulation 5 that an organisation’s Directors (or equivalent) are Fit to undertake their role.

The CQC Provider Guidance should be read with further information here.  The annexes are particularly helpful.

Regulation 5 is:

  • For directors of organisations
  • Defines Directors need to be Fit for their role and not unfit
  • The provider is responsible for checking fitness at the outset with regular review
  • The provider needs to ensure that where unfitness is identified, action is taken

What will CQC check at registration?

At the point of registration CQC say ‘We will require the chair of the provider to declare that appropriate checks have been undertaken in reaching a judgement that all directors are deemed to be fit and none meet any of the unfit criteria. We will ask questions and seek evidence about the recruitment process as part of the interview with the nominated individual.’

So let’s get to the point. Hang on a minute…there is only me here as director!

That is difficult for CQC too!  If you are the sole Director of a company, how are you checking yourself?  And how can you show unbiased?

  • A clear policy and procedure on the checks you will undertake such as DBS and other areas outlined in the CQC guidance
  • You could consider an external source to run your checks
  • Keep a clear audit of what you have checked and when and how this meets the fitness criteria
  • Be prepared to show CQC how you understand your separate functions eg director, NI, Chair
  • Show your ‘workings out’ and the steps you took where a concern has been raised or fitness is in doubt

The regulation is meant to pinpoint the ‘controlling mind’ of an organisation, which can work well for the NHS, but in a very diverse Social Care Landscape, it becomes awkward and difficult to hang, like handed down clothes that have not been properly altered to fit its new host.

So unless the uniform is more sports casual…you can take off the sweatband and fitbit and concentrate on a good clear audit of checks to ease the path.


Abi Spence

Registration and Inspection Specialist

Abi has worked for and with Government agencies relevant to social care for the past 12+ years. Primarily with the Department of Health, Social Services Inspectorate, Commission for Social Care Inspection (CSCI) and since its inception the Care Quality Commission (CQC). As part of this long involvement Abi has developed a wide and detailed understanding of relevant issues and has worked closely with stakeholders such as people that use services, carers, providers, local government, the Department of Health , Ofsted and the Audit Commission. Read more

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