CQC: The risks of appointing a practice employee as registered manager
For many, deciding who is going to be the Care Quality Commission (CQC) registered manager for their practice is another layer of red tape and often practice owners delegate this role to the practice manager, who is an employee in the majority of cases. Appointing the practice manager is an option many practices choose given that the role of CQC registered manager is to manage the regulated activity on behalf of the practice owner in the case in which the practice owner is not going to be in charge of the day-to-day regulated activities himself or herself.
The registered manager has legal responsibilities in relation to that position. Indeed, he or she shares the legal responsibility for meeting the requirements of the relevant regulations and legislation with the practice owner as the regulated provider. As such, the role of a registered manager goes hand in hand with managing the practice. However, what happens when the employee registered manager hands in his or her employment termination notice, or is found guilty of gross misconduct and has his or her employment terminated overnight?
Under CQC regulations, if a registered manager is going to be absent for 28 days or more, there is an obligation for the practice owner to give notification. This should be the first step taken when it becomes apparent that the registered manager has left or will be leaving. From there, it is a matter of applying to CQC to appoint a new registered manager as soon as possible, whether it be the practice owner, another employee or the new practice manager. At the same time, the outgoing registered manager should cooperate in cancelling his or her registered manager registration.
If the end of the employment was not amicable, however, this is something that may prove easier said than done. If the employee refuses to cancel his or her registration, it is vital that all reasonable steps should be taken to rectify the situation. It is in nobody’s interest to have an absent registered manager, not least the patients’. In any event, the practice could be left without a registered manager carrying out his or her obligations in the interim ten to 12 weeks while the application to appoint a new manager is being processed by CQC. This is not to say that employees should never be appointed as registered managers, but considerations must be given to situations in which they may no longer be employees.
How can these issues be overcome? The actual process cannot be avoided, but making the transition of registered managers smooth without disruption is achievable. When appointing a new employee as the practice’s CQC registered manager, some important factors have to be considered, such as having a ten- to 12-week contractual notice period in place to provide the practice owner with a time frame in which to deal with the CQC applications to change the registered manager—and negate the need to alert CQC to an absent registered manager. Specific provisions should be included in the contract of employment that oblige the employee to do all things necessary and sign all such documents that allow for the change of registered manager during his or her notice period or/and upon the termination of employment. If an existing employee has been appointed as the registered manager, practice owners should issue an updated employment contract and job description that place these obligations on the employee.
As the discussion shows, it is not difficult to fall foul of the CQC regulations. However, by carefully drafting all employment contracts for registered managers, and having guidance through the process, disruption to the practice can be avoided.