Crisis and turnaround support for care services
When a service is in serious trouble, we help you turn it round
Enforcement action, an Inadequate rating, compliance slipping by the week. You're still running a safe service while the regulator waits for answers. We step in alongside your leadership team, work out what matters first and help you fix it, evidence it and make it stick. It's serious, but it's fixable.
We know how this feels
Maybe the inspection report landed and a service you thought was fine is now rated Inadequate. Maybe a Warning Notice arrived, or a Notice of Proposal. Maybe nothing formal has happened yet, but audits are slipping, incidents are rising and you can see where it's heading.
Whatever happened, you're now the person everyone is looking at. Staff want to know what happens next. Families and commissioners are asking questions. There's regulatory language to unpick, a long list of actions and no certainty that they're the right ones. And you still have a service to run, safely, every shift.
It's a lot. It's also more common than it feels. Services come back from this. In our experience, the ones that do get experienced help in early, before the gaps turn into breaches.
What is crisis and turnaround support?
Crisis and turnaround support is fast, hands-on work to stabilise a care service facing serious regulatory concerns and improve it in a way that lasts. It's for providers dealing with enforcement action, an Inadequate rating, special measures, safeguarding concerns, deteriorating compliance or operational difficulties.
We usually work alongside your existing Registered Manager, Nominated Individual and leadership team, not instead of them. We bring the experience, the structure and the extra capacity. They keep leading their service, with us beside them.
If your Registered Manager has left or you have a gap in leadership, that's a different need: experienced interim management and continuity. Some providers need both at once. Some only need one.
This page is general information, not legal advice.
When does a service need turnaround support?
- Serious concerns raised by CQC or Ofsted, at or after an inspection
- An Inadequate rating, or a service placed in special measures
- Enforcement action: a Warning Notice, Notice of Proposal, Notice of Decision or section 31 urgent notice
- Conditions, a suspension or a restriction on the services you provide
- Compliance that's deteriorating: audits not done, actions not closed, incidents and complaints rising
- Safeguarding concerns, or financial or staffing pressure that's starting to show in the care
- A new owner who has inherited problems nobody mentioned
Why is it so hard to fix from the inside?
Because the work doesn't stop while you fix it. Your managers are still covering rotas, supervising staff and keeping people safe, while also bringing in structures, processes and safeguards that may not have existed before, and showing the regulator that they work.
In that situation it's almost impossible to see the wood for the trees. Everything feels urgent, so nothing gets finished. Actions get written that nobody has the time to deliver, and evidence gets gathered in a rush the week before it's due.
There's stakeholder pressure, too, and understandably a lot of emotion. Some owners have called it life-changing, and the fallout can run for years. In our experience, most providers only get proper help after something has gone wrong, and by then they're fighting on several fronts at once.
How we turn a service round
Supportive, but calculated. Your service, and the regulator, set the real pace.
Acknowledge
We start from what the regulator found, not from what you wish it had found. Owning the concerns is what makes the rest of the response credible.
Assess
We review the findings, the breaches and the service itself, then work out the root cause behind the symptom the regulator saw. In our experience it's often governance: audits nobody acted on, or one person holding everything in their head.
Fix
A clear plan with priorities, owners and dates. Our people work in the service with your team to deliver it: risks first, then the systems that let the risks build up.
Evidence
A dated record of every change, and proof that it's working, so you can show the regulator what's different and why it will stay different.
Embed
Improvements built into day-to-day practice, with the oversight to keep them there after we step back.
Respond
Clear, structured responses to CQC or Ofsted, built on the evidence. Where a challenge is justified, we make it on the evidence too.
What our crisis and turnaround support covers
Adapted to your service and the regulatory position you're in. Not every service needs all of it.
- Immediate stabilisation: practical intervention to strengthen management oversight and deal with urgent risks
- Crisis intervention and turnaround: intensive support to address serious regulatory failings, often alongside your existing management team
- On-site support: experienced people working in your service to implement improvements, support staff and oversee change
- Regulatory assessment and prioritisation: a detailed review of the findings and breaches, and a clear list of what to do first
- Governance and compliance restructuring: governance frameworks, management systems and internal assurance that work
- Turnaround planning: a structured action plan with clear responsibilities, timescales and measurable outcomes
- Managed care support: hands-on management and operational oversight where you need more leadership and delivery capacity
- CQC and stakeholder engagement: support with regulatory communications, improvement meetings, local authorities and commissioners
- Evidence management: collating, reviewing and presenting evidence of improvement, including structured responses to notices
- Ongoing implementation and assurance: working with your managers so improvements are monitored and embedded
- Senior clinical and regulatory expertise: experienced compliance, clinical governance and operational professionals giving practical direction
What to do in the first 48 hours
General information, not legal advice.
Hour 1: put one person in charge of the response
Name who leads it, and tell your managers. One owner stops ten people doing half of everything.
Hour 1: call us
We'll tell you on the first call how we can help and who we can put in the service.
Day 1: deal with today's risks
Medicines, care plans, staffing, incidents and safeguarding referrals. Start with anything that could hurt someone today.
Day 1: read what the regulator actually said
Note every concern and every date. If a notice has arrived, the deadlines in it are what matter.
Day 2: talk to staff, commissioners and families
Tell them what's happened and what you're doing about it. Keep it short and factual, and say when you'll update them next.
Day 2: don't promise what you can't evidence
A rushed reply full of commitments is easy to send and hard to deliver. Plan the fixes first, then say what you'll do and when.
What happens if you do nothing?
The concerns grow. Records slip, actions stay open, and the next inspection finds them.
In our experience, a regulatory concern that isn't dealt with properly tends to escalate: more scrutiny, then further enforcement action, which can mean conditions, a suspension or a proposal to cancel your registration. For serious failings, prosecution is a real possibility too.
The earlier the response is structured, the more options you keep.
Why providers call HLTH
We deal with CQC enforcement and regulatory challenges day in, day out, with decades of collective experience across different types of enforcement action. We cut through the noise, identify what matters and bring structure to what can feel like an impossible situation.
Kath Cox, our Head of Adult Social Care (Service Transformation), leads our adult social care interim and crisis support. She's a former Registered Manager and Operations Manager, so she has run the kind of services she now steadies.
Anita Willoughby, our Clinical Operations Coordinator, is a Registered General Nurse and former Clinical Services Manager. She keeps oversight of delivery across our interim and crisis work.
Behind them are Adam Duncan, our Managing Director and a former CQC Specialist Advisor, and Greg Bamber, our Chief Executive, who founded and ran CQC Compliance Limited. Where a notice needs a legal response, we work with our trusted legal partners, while our team keeps the improvement work moving.
The people behind the support
Experienced compliance, clinical governance and operational professionals, working with you from the first call.
Kath Cox
Head of Adult Social Care (Service Transformation)
Former Registered Manager and Operations Manager. Leads our adult social care interim and crisis support, stabilising services and putting sound governance in place.
Adam Duncan
Managing Director
Over 20 years of senior clinical and operational leadership in urgent and primary care. Former CQC Specialist Advisor and Director of Quality and Governance.
Helen Stevenson
CQC Registration Associate
A qualified dentist and former CQC inspector, who understands compliance and governance from both the provider's and the regulator's side.
Dr Atif Ghaffar
Medical Director
GP Principal for 16 years and his practice's CQC lead. Former Medical Director at CQC Compliance Limited.
A case study
An established adult social care provider with a long record of Good ratings was served a Notice of Proposal to cancel its registration. Then its Registered Manager left without notice. The provider called us on a Friday morning. By the following Monday an experienced interim manager was running the service, and our governance team was building the formal reply.
In our experience, the two often arrive together. A notice puts the manager under pressure, and losing the manager makes the notice harder to answer. That provider needed crisis support and interim management at the same time.
They were able to provide staff and support for our compliance needs rapidly and professionally. The team were always available for any needs and they have a vast amount of CQC compliance and HR experience and knowledge.
Russell Kourting, Salis CareCARE PROVIDER / COMPLIANCE AND HR
Common mistakes
- Trying to fix everything at once, instead of what matters first.
- Writing an action plan nobody has the time to deliver.
- Sending the regulator promises before the improvements are real.
- Taking an adversarial line with the regulator without strong evidence behind it.
- Letting audits and supervisions stop while everyone firefights.
- Leaving the Registered Manager to carry it all alone.
Who we do this for
Crisis and turnaround: common questions
How quickly can you get someone into the service?
Will you replace our Registered Manager?
What's the difference between crisis and turnaround and interim Registered Manager support?
What's the difference between crisis turnaround and managed care services?
Do you deal with the legal side?
Do you work with children's homes?
Served a notice? Call now.
020 8090 5346Speak to one of our experts
Clinicians, a former CQC inspector and a former Registered Manager.
What happens on the call
- Pick a time that suits you. The call is free and takes 15 minutes.
- You speak to one of our experts about your situation.
- You leave with a clear next step, before any big commitment.
A clear next step, before a big commitment
Service in crisis? Call us now.
The sooner the response has structure, the more options you keep. Call now, and we'll tell you how we can help and who we can put in the service.
Speak to one of our experts
Clinicians, a former CQC inspector and a former Registered Manager.
A 15-minute introductory call to explain your situation, explore the right support and discuss the next step.