2.2 Explain management and governance across models of service delivery

This. guide will help you answer 2.2 Explain management and governance across models of service delivery.

Good management and governance provide the structure, direction and oversight that every model of service delivery needs. Without these, services can become disorganised, unsafe or even unlawful. Management is about planning, organising, leading and monitoring care. Governance refers to the systems and processes that maintain quality, accountability and compliance. Different models of service delivery bring distinct challenges and requirements for both management and governance.

What Management Means in Service Delivery

Management in adult care involves a range of tasks. These include setting clear objectives, allocating resources, guiding teams and dealing with risks. Managers make sure that staff deliver care and support in line with policies, values and goals. This includes:

• Scheduling work and staffing
• Setting and monitoring standards
• Reporting on results and outcomes
• Identifying and solving problems or gaps
• Providing leadership and coaching
• Managing budgets and equipment

The management approach often needs to fit the chosen service delivery model. For example, a person-centred model requires managers to promote autonomy and listen to feedback. A medical model may involve more clinical supervision and risk management.

What Governance Means in Service Delivery

Governance provides the framework for safe, ethical and lawful practice. It defines how decisions get made, who holds responsibility and how compliance gets checked.

Common areas covered by governance include:

• Safeguarding adults and child protection
• Data protection and confidentiality
• Quality monitoring and improvement
• Accountability and oversight
• Raising and handling complaints
• Financial oversight and fraud prevention
• Professional registration and codes of conduct

Governance is supported by policies, procedures, audits, staff appraisals, supervision and external inspections.

Management and Governance in the Person-Centred Model

The person-centred model requires managers to create a culture where the person’s views shape their support. Governance frameworks must support choice and control.

Management tasks include:

• Promoting staff training in person-centred values and active listening
• Reviewing care plans regularly with the individual and their support circle
• Recording outcomes that reflect quality of life, not just completed tasks
• Supporting staff to balance risk-taking and independence

Governance tasks involve:

• Making sure policies promote dignity, privacy and rights
• Having accessible complaints procedures
• Monitoring the uptake of choices and involvement in reviews
• Regularly checking compliance with the Care Act 2014

Managers must demonstrate a clear link between feedback and changes made.

Management and Governance in the Medical Model

In medical or clinical models, managers take a more directive role. The focus lies on safety, risk control and clinical outcomes.

Management tasks include:

• Ensuring that staff understand and follow care protocols
• Organising training in medication, infection control and clinical interventions
• Allocating clear lines of accountability for staff
• Coordinating with doctors, nurses and health professionals

Governance tasks focus on:

• Medical audits (such as medication errors, wound care and falls)
• Record-keeping that meets the requirements of regulatory bodies
• Checking staff registration with nursing or medical councils
• Having systems for reporting clinical incidents and learning from them

These services often use strong supervision and clinical governance structures.

Management and Governance in the Social Model

The social model highlights rights, inclusion and removing barriers. Management needs to involve people in service decisions.

Management responsibilities:

• Training staff to understand equality legislation
• Promoting involvement of people using services in interviews, service planning and review
• Responding to discrimination or inaccessible practices

Governance duties:

• Maintaining policies to counteract discrimination
• Auditing accessibility and inclusion measures
• Reporting compliance with the Equality Act 2010
• Enabling people to challenge barriers through complaints or advocacy

Such services need robust systems for feedback and community engagement.

Management and Governance in the Recovery Model

The recovery model puts self-determination and hope at the core. Managers must encourage a culture of trust and positive expectations.

Management focuses on:

• Supporting peer-led services or user involvement groups
• Training staff to promote hope, possibility and self-management
• Encouraging reflective practice and open discussion about setbacks

Governance focuses on:

• Tracking personal outcomes, not just clinical measures
• Involving people with lived experience in monitoring and service design
• Ensuring policies support choice, control and risk-taking
• Reviewing incidents not just for mistakes, but for lessons that can improve support

Leadership styles need to be inclusive and open to creative solutions.

Management and Governance in the Reablement Model

The reablement model needs effective goal-setting and review in a short timeframe. Staff work closely as a team and rapidly adapt support.

Management responsibilities:

• Coordinating multidisciplinary teams (e.g., physios, occupational therapists, support workers)
• Monitoring progress towards agreed goals
• Allocating staff efficiently for short, time-limited interventions
• Supporting families to be part of the process

Governance includes:

• Tracking outcomes like hospital avoidance, regained skills or reduced dependency
• Regulating consent and mental capacity decisions
• Maintaining accurate documentation to show progress
• Checking that reviews take place as planned

This model demands clear recording, reporting and rapid learning from results.

Management and Governance in Task-Based Models

Task-based models focus on completing specific duties within set times. Management emphasises monitoring performance and timekeeping.

Management tasks:

• Setting clear, task-based shift rotas for staff
• Monitoring completion of tasks (such as personal care or cleaning)
• Using checklists or timesheets for supervision

Governance approaches:

• Checking that care plans balance efficiency with dignity and safety
• Staff spot-checks and audits to prevent neglect
• Handling concerns about missed visits or rushed care
• Regularly reviewing time management and staff workloads

Rigid task-based models need regular checks so that care quality does not suffer from too much focus on speed and efficiency.

Management and Governance in Strengths-Based Models

Strengths-based models need managers to build a supportive, flexible team culture. They focus on what people can do, with skilled staff guiding rather than directing.

Management involves:

• Coaching staff to empower people, not just meet needs
• Encouraging joint problem-solving and community involvement
• Supporting continuous learning about assets-based practice

Governance actions:

• Using strengths-based assessment tools and auditing their use
• Reviewing involvement of families and community networks
• Monitoring impact on independence, not just activity stats
• Including feedback from people using services in quality monitoring

Genuine strengths-based working must be checked and reinforced in supervision and appraisal.

Management and Governance in Relationship-Based Models

Relationships are central in this model. Managers must create the right environment for trust and communication.

Management focuses on:

• Assigning key workers to build ongoing relationships
• Providing time for staff to listen and talk with people using services
• Supporting reflective practice about relationship dynamics

Governance tasks involve:

• Monitoring complaints or concerns relating to the quality of relationships
• Checking whether people feel supported and respected
• Reviewing continuity of staff and turnover rates
• Maintaining boundaries and safe practice

There must be policies for professional conduct and whistleblowing in case of any over-familiarity or unsafe relationships.

Management and Governance in Integrated and Multi-Disciplinary Models

Here, teamwork and information sharing are key. Management must break down barriers between services.

Management requirements:

• Coordinating regular team meetings and shared reviews
• Aligning objectives between health, social care and other partners
• Appointing clear case managers or coordinators
• Supporting effective communication and respectful challenge

Governance requirements:

• Joint protocols for information sharing, consent and confidentiality
• Shared record-keeping systems
• Agreed processes for resolving disputes or complaints
• Joint reviews and audits to check integration works in practice

This model may require agreements like Memoranda of Understanding and shared training across agencies.

Management and Governance in Community-Based Models

Community-based approaches need managers to link services to local networks, groups and resources.

Management tasks:

• Mapping and engaging local community assets
• Encouraging staff to support access to mainstream activities
• Building partnerships with voluntary sector and housing providers

Governance mechanisms:

• Keeping policies up-to-date with safeguarding and lone working requirements
• Checking that people have access to advocacy and community inclusion
• Monitoring equality and participation in community activities
• Recording and reporting on links to housing, employment or social networks

Governance often includes feedback from local advocates, commissioners and people using services.

National Context and Regulatory Expectations

Every adult care provider is inspected and regulated by bodies such as the Care Quality Commission (CQC). These regulators check that management and governance systems fit the delivery model and remain safe, effective, caring and responsive.

Key aspects checked by inspectors include:

• Written policies and procedures, up-to-date with new guidance
• Evidence of risk assessments and continual review
• Learning from complaints, incidents or feedback
• Safe recruitment, training and supervision
• Duty of candour (being open and honest when mistakes happen)

Providers also need to demonstrate financial and resource management. Leadership must be visible, proactive and accountable.

Final Thoughts

Good management and governance support effective service delivery in every model. They help maintain trust, safeguard people and drive improvement in adult care settings.