Crisis Intervention and Governance Overhaul in a Care Service
Rapid response to regulatory risk and operational breakdown following a critical incident.
Background
Following a serious incident with tragic consequences, a care provider came under immediate regulatory scrutiny. The Care Quality Commission (CQC) identified multiple systemic failings and was actively considering full enforcement action—including potential closure of the service.
The provider urgently required independent expertise to assess risk, stabilise operations, and provide visible assurance to the regulator. Fulcrum Care was commissioned to deliver an intensive intervention—initially for one month, later extended—focused on both emergency response and the foundation for long-term improvement.
Our Approach
Fulcrum’s assessment identified four pressing challenges:
- Regulatory enforcement risk with the CQC poised to act due to critical failures
- Operational breakdown, including weak clinical oversight, risk management, and safeguarding
- Urgent need for credible intervention to demonstrate change and avert closure
- A lack of governance structures to support sustainable compliance
In response, Fulcrum deployed a team of consultants to lead a structured turnaround strategy. Multiple weekly visits were made to provide direct leadership, reinforce accountability, and support crisis decision-making.
Key components of the intervention included:
- Regulatory engagement – Fulcrum maintained open, frequent dialogue with CQC inspectors, providing evidence of progress and ensuring concerns were addressed in real time.
- Emergency governance implementation – A full suite of operational and clinical governance systems was rapidly deployed. This included infection prevention protocols, medication audits, wound care tracking, incident reviews, and health and safety assessments.
- On-site crisis management – During the most critical phase, Fulcrum consultants were present on site, guiding decisions, leading staff responses, and ensuring immediate risks were mitigated.
- Ongoing oversight – A longer-term compliance monitoring plan was established to help the provider embed improvements beyond the immediate intervention period.
The Outcome
Fulcrum’s intervention produced measurable and high-impact results:
- Closure was avoided – The CQC withdrew its consideration of full enforcement action following visible and rapid improvements.
- Regulatory sanctions were minimised – Rather than severe enforcement, the provider received three warning notices and was permitted to continue operating under enhanced monitoring.
- Governance frameworks were reinstated, enabling the provider to regain control of clinical safety, care quality, and risk management.
- Sustained support was secured – Fulcrum continues to provide governance oversight, ensuring ongoing accountability and resilience.
Client impact
This case highlights the essential role of expert-led crisis intervention in high-risk care environments. By acting decisively and working closely with both the provider and the CQC, Fulcrum Care helped steer the service away from closure and onto a path of recovery.
In situations where regulatory pressure is immediate and reputational risk is high, Fulcrum’s structured, hands-on approach delivers not only short-term stabilisation, but also the groundwork for long-term improvement.
Facing a crisis or urgent regulatory challenge? Fulcrum Care provides immediate support to safeguard your service and restore compliance.
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