Proactive Turnaround and Governance Oversight in a Care Service Facing Leadership Gaps
Stabilising leadership, reinforcing compliance, and preparing for regulatory scrutiny.
Background
Following the unexpected departure of its registered manager, a care service was left without formal on-site leadership. This created immediate concerns around operational continuity, governance oversight, and regulatory risk. With prior experience of similar challenges across its portfolio, the provider acted pre-emptively, engaging Fulcrum Care to implement structured support and avoid potential escalation.
Drawing on lessons from previous interventions, Fulcrum deployed a governance-led approach, combining interim leadership, on-site consultancy, and remote oversight to deliver stability, assurance, and regulatory preparedness.
Our Approach
Fulcrum’s initial assessment identified four key areas of concern:
- Leadership void placing day-to-day operations and team cohesion at risk
- Governance exposure due to the absence of formal monitoring systems
- Regulatory vulnerability, particularly with the potential for an unannounced CQC inspection
- Limited visibility into service quality, care planning, and incident management
To address these challenges, Fulcrum implemented a phased, proactive intervention strategy.
An experienced deputy manager from a sister service was placed into the home to provide interim leadership and ensure continuity. Simultaneously, Fulcrum introduced a comprehensive governance framework, covering all operational domains—from medication management and infection control to risk assessment and care documentation.
A dedicated turnaround consultant visited the service weekly to guide the care team, monitor progress, and respond to on-site challenges. This hands-on support was backed by remote oversight from Fulcrum’s senior governance team, including detailed weekly reviews of care plans, incidents, and accidents to identify patterns and mitigate risks.
With a potential CQC inspection in view, the intervention was designed not only to restore stability but to ensure the service could demonstrate real-time compliance, readiness, and progress. Early feedback from a PAMMS (Provider Assessment and Market Management Solution) review confirmed encouraging initial signs of improvement.
The Outcome
Fulcrum’s proactive intervention delivered immediate and ongoing impact:
- Leadership continuity was re-established, restoring operational stability and decision-making.
- A governance infrastructure was embedded, bringing oversight and assurance across all key service areas.
- The service became better positioned for regulatory review, supported by real-time monitoring and demonstrable progress.
- A culture of continuous improvement was fostered through regular on-site and remote quality assurance, enabling early intervention and risk mitigation.
Client impact
This case highlights the value of early, structured consultancy intervention during periods of leadership uncertainty. By combining interim management with expert governance and layered quality monitoring, Fulcrum Care helped the provider avoid crisis, strengthen compliance, and build a more resilient foundation for future sustainability.
In high-risk environments, proactive measures are not just preventative—they are transformative.
Facing a leadership gap or preparing for inspection? Fulcrum Care provides strategic consultancy to help your service stay compliant, stable, and inspection-ready.
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