Innovate’s Approach to Training, Accountability and Clinical Oversight
At Innovate Complex Care Services, we specialise in delivering personalised, nurse-led healthcare for individuals with complex needs in their own homes. A key part of ensuring safety and quality in this environment is the effective delegation of clinical tasks — a process that is far more than just training and instruction.
True delegation is a clinical decision made in context. It involves a registered nurse (RN) assigning specific tasks to healthcare assistants (HCAs) or support workers only when it is safe to do so, based on the client’s needs, the staff member’s capabilities, and the availability of ongoing supervision. It also requires careful alignment with CQC regulations, particularly where tasks fall under the Treatment of Disease, Disorder or Injury (TDDI).
The Fundamentals of Nurse Delegation
In community complex care, nurse-delegated tasks might include:
- Administration of enteral feeds
- Tracheostomy care
- Suctioning
- Catheterisation
- Oxygen therapy
- Administration of medications (via non-intravenous routes)
While these tasks are clinical, they can be delegated under the right conditions — and only if the nurse remains actively involved. At Innovate, we never treat delegation as a handoff. We treat it as a responsibility.
A Safer Delegation Framework: Innovate’s Five-Part Standard
We use a framework tailored to community care, grounded in five key safeguards:
1. Patient-Specific Task Planning
Every delegated task must be appropriate to the individual’s care needs and condition. Training is designed with the patient’s unique profile in mind — not as a generic or one-size-fits-all module. If the person’s needs change, tasks are reassessed.
2. Clinical Environment and Support
Delegation must suit the environment in which care is delivered. We only delegate if there is a safe structure around the HCA, including access to clinical advice, escalation protocols, and supervision.
3. Competency-Based Staff Selection
No task is delegated unless the individual has been trained, assessed, and signed off as competent by one of our registered nurses. Training alone is not enough — ongoing observation and review are vital.
4. Clear, Documented Instructions
Innovate’s nurses provide task-specific written guidance, including red flags, reporting procedures, and escalation protocols. This ensures consistency and compliance with care plans and regulatory expectations.
5. Ongoing Supervision and Review
We maintain regular clinical contact, competency refreshers, spot checks, and documentation reviews. Delegation is always conditional — if oversight or safety is compromised, it is withdrawn immediately.
Delegation ≠ Abdication
Delegation does not mean shifting responsibility. The nurse is still clinically accountable, even if they are not present during every instance of care delivery. That’s why, at Innovate:
- We never outsource training without ensuring our own supervision.
- We build supervision into our service model.
- We view delegated tasks as living decisions, not fixed authorisations.
CQC and TDDI: Regulatory Standards You Can Rely On
Delegated healthcare tasks that involve invasive procedures — such as tracheostomy care or enteral feeding — fall under Treatment of Disease, Disorder or Injury (TDDI). Only providers registered with the CQC for this regulated activity can legally deliver these services in the community.
🔗 Explore the CQC’s expectations on delegation and TDDI
At Innovate, we are fully registered for TDDI, meaning our clients and NHS partners can trust that every element of clinical care — including delegated tasks — is delivered with full accountability and in line with regulatory expectations.
Why Delegation Matters in Complex Care
In a home setting, properly managed delegation enables:
- Personalised, cost-effective care close to home
- Greater independence and dignity for the patient
- Consistent, round-the-clock support
- Reduced strain on hospital services
But it only works if it’s done right.
Without tailored training, direct clinical involvement, and real-time oversight, delegation breaks down — and safety is compromised. At Innovate, we refuse to let that happen.
The Innovate Difference: Delegation with Integrity
We integrate safe delegation into our nurse-led model from day one. Our nurses:
- Deliver training in-house
- Sign off staff only after real-world assessment
- Maintain continuous clinical involvement
- Adjust delegation decisions in real time
Every clinical task delegated is governed by one question:
Can this still be done safely, today, for this person, by this worker?
If the answer is ever “no,” the delegation ends — immediately.
Ready to Work with a Trusted Complex Care Partner?
Whether you’re an NHS commissioner, CHC case manager, or family member, you need confidence that your care provider takes clinical safety seriously — not just in theory, but in practice.
📞 Call us on 0203 879 1520
📩 Email [email protected]
