Working with CQC-Registered Care Agencies for Complex Care in the North of England

When Care Packages Begin Without the Full Picture

Complex care packages rarely begin with the full picture in place. Needs evolve, risks emerge, and decisions often have to be made before every detail is known. That is simply the reality of working in this space.

In that environment, it is not unusual for care models to need adjusting as real-world complexity becomes clearer. Everyone involved is working under pressure, and the challenge is building something flexible enough to hold when circumstances change.

That is where many packages either stabilise or begin to struggle. Not because anyone has done anything wrong, but because care needs often evolve faster than the paperwork.

We don’t always get everything right first time, especially when information arrives in stages, but we correct quickly and transparently. That mindset is essential if a package is going to last.

Complex care is rarely straightforward. Anyone who says otherwise probably hasn’t delivered it.

What We Mean by Complex Care

At Thriving, we are a CQC-registered complex care provider focused on mid to long-term care packages across the North of England (and expanding). Most of the individuals we support live with complex physical and mental health needs, including acquired brain injuries, cerebral palsy and post-accident trauma.

Many of our packages involve 24-hour care, often delivered on a two-to-one basis. We also provide non-regulated support where personal care or medication administration is not required, and we are experienced in managing transitions between regulated and non-regulated support as needs change.

That flexibility matters. Complex care rarely fits neatly into a single category, and rigid models tend to struggle when reality intervenes.

Why Cost Alone Is the Wrong Starting Point

One of the biggest challenges in complex care commissioning is that early cost models are often built before the full picture is clear. That is understandable. Case managers and solicitors are under pressure to act quickly and responsibly in the best interests of the client.

The problem arises when those early assumptions become fixed, even when it becomes clear they no longer reflect the reality of the package. We have inherited enough struggling services to recognise this pattern.

Rates that didn’t balance with the complexity of the work are one of the most common underlying issues.

If carers don’t feel valued, the package won’t last. It really is that simple.

When staff are underpaid for the level of responsibility expected of them, turnover increases, continuity disappears and the service user feels the impact first. The true cost is not financial. It is emotional, behavioural and often clinical.

What a Good Partnership Looks Like in Practice

Strong partnerships are not built on perfect referrals or static care plans. They are built on communication, trust and shared goals.

From our side, that means being accessible, honest and prepared to challenge assumptions when something is not working. Senior management are always available, and we do not stretch ourselves thin. We operate with a dedicated recruitment team that has years of experience in complex care, allowing us to respond quickly without compromising standards.

We also understand the administrative pressures case managers and solicitors face. Keeping things simple matters. We operate consolidated monthly invoicing, GPS-verified clock-ins and digital care records so that time is not lost signing paper timesheets or chasing approvals.

Reduced admin allows more focus on meaningful oversight and less unnecessary cost being passed on to the service user.

Oversight, Supervision and CQC Compliance

CQC compliance is not something we treat as a minimum threshold. It is the framework that supports quality.

Supervision is led by our Registered Manager (Dawn Kelly) and we are actively expanding our coordination team to keep supervision ratios well below half of the CQC guideline. That allows issues to be identified early, rather than after they have escalated.

We invest heavily in technology, including onsite tablets and modern care management software, so staff remain aligned with support plans and risk management processes without being buried in paperwork.

Compliance matters, but it should support care, not distract from it.

Case Study: Rebuilding Stability Through Fair Pay and Realistic Models

One of our early packages was in a rural location where staff were driving over an hour each way. The previous provider had struggled to retain carers, and turnover was constant.

When we reviewed the situation with the case manager, it became clear that the existing rates did not balance with the complexity of the work or the realities of the location. Recruitment was always going to be difficult under that model.

Rather than increasing the charge rate, we held it at the previous level and restructured how the package was delivered. By leveraging our payroll infrastructure and reducing overheads, we were able to pay carers properly without inflating costs.

The difference was noticeable within weeks. Staff stayed, rotas stabilised, and the service user finally had the same faces turning up consistently.

That is what sustainable care looks like in practice.

Where Packages Commonly Break Down

We have taken over packages from established agencies where, on paper, everything appeared compliant. In reality, families were frustrated, staff were rotating constantly and trust had quietly eroded.

These situations are rarely caused by a lack of effort or good intent. More often, they stem from systems and assumptions that do not reflect how complex care operates day to day.

Consistency is not a nice extra. It is fundamental.

People stay where they feel respected. In complex care, that is what continuity is built on.

The Role of Technology and Human Relationships

Technology plays an important role in compliance, visibility and accountability. GPS-verified attendance provides reassurance when families or case managers are not onsite, and digital records reduce disputes and unnecessary administration.

However, technology is not a substitute for human relationships. Care is still delivered person to person, and trust is built through communication, responsiveness and reliability.

That balance has been central to our long-standing relationship with organisations such as Irwin Mitchell. Strong working relationships are built over time through transparency, consistency and mutual respect.

Delivering Complex Care Across the North of England

Our current focus is the North of England because it is the region we know best. Rural areas present additional staffing challenges, particularly in places like the Lake District, where travel and isolation affect recruitment and retention.

Our partnership with Priority Recruitment allows us to access a wide and experienced talent pool, supporting continuity even in harder-to-staff locations. Priority operates as a partner, strengthening our ability to respond without compromising quality.

Looking Ahead

If complex care is going to improve over the coming years, it will not be driven by tighter spreadsheets or faster processes alone. It will be driven by valuing the people delivering the care.

Better pay, proper supervision and realistic models create stability. Stability builds trust. Trust improves outcomes.

CQC registration and technology matter, but they are not the point. What really matters is whether the same people turn up, understand the individual, and stay. Everything else should support that, not get in the way.