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These restrictions are also applied to managers whom enter their own skills/qualifications - their own managers will need to review & approve the skills/qualifications which they've entered for themselves (eg. from their own manager or system-administrator).
For certain skills/qualifications, you may want to further restrict whom (of the people whom manage your staff/volunteers) can approve certain qualifications. In this instance, you just need to enter the names of those people into the "Restrict approvals to" box, when editing a qualification (eg. a Driving Licence, or a first-aid certificate).
This will mean that only those managers whom are listed will be able to approve those certain qualifications (provided they have access to manage those people already).