Mariana Costea
Care Governance & Operational Improvement Specialist • Mareric Limited
United Kingdom •
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About
I don't speak about care from theory. I have lived it from the frontline to senior leadership. Over 17+ years, I have worked across domiciliary care, care homes, nursing, registered management, regional clinical leadership and independent consultancy. I have seen what good care looks like, what happens when services begin to drift, and how easily paperwork can tell a very different story from reality. I bring those experiences into the room honestly and practically. I use real situations, challenge assumptions and ask the questions that leaders do not always think to ask. My aim is not simply to inspire an audience for an hour. I want people to leave seeing their services differently, questioning the assurance they rely on and knowing what they can do differently when they return to work. No corporate theory. No perfect-world solutions. Just the reality of care, the lessons it teaches us, and practical ways to make it better.
Speaking Topics
Signature Programs (3)
Care services rarely move from good to failing overnight. More often, small gaps in practice, leadership and governance gradually become accepted as normal. Drawing on 17+ years across frontline care, nursing, service leadership and independent consultancy, Mariana explores how operational drift develops, why conventional assurance can miss it, and what leaders can do before small problems become organisational failure. This practical and challenging session helps audiences recognise the early warning signs of drift, question the assurance they rely on and reconnect governance with what is actually happening for people receiving care.
Key Takeaways
- Recognise the early warning signs of operational drift before they become serious failures.
- Understand how apparently compliant systems can create false reassurance.
- Identify gaps between documented assurance and the reality of frontline care.
- Ask better governance questions and strengthen leadership visibility.
- Understand how to turn findings into improvement that is sustained, not simply completed.
Audience
Care providers, owners, directors, nominated individuals, registered managers, regional and operational leaders, quality and governance teams, clinical leaders, commissioners and health and social care professionals.
Format
Duration
45 to 90 minutes | Half-day workshop available
Delivery
Audits can be green. Action plans can be complete. Policies can be current. Yet the reality experienced by people receiving care and the staff supporting them can tell a completely different story. This session challenges leaders to examine how they know what is really happening inside their services. Mariana explores the limitations of paper assurance, why problems can remain hidden within apparently functioning governance systems, and how leaders can triangulate information, listen differently and get closer to operational reality. The session centres around one leadership question that has shaped Mariana's own approach to governance: What am I not seeing?
Key Takeaways
- Recognise the difference between having assurance systems and actually being assured.
- Identify where dashboards, audits and action plans may hide rather than expose operational risk.
- Use triangulation to test whether documented information reflects frontline reality.
- Ask better questions when information appears reassuring.
- Build leadership visibility that reaches beyond reports and into people's actual experience of care.
Audience
Senior leaders, directors, nominated individuals, registered managers, regional managers, quality and governance professionals, clinical leaders, commissioners and anyone responsible for organisational assurance.
Format
Duration
45 to 90 minutes | Half-day workshop available
Delivery
Poor care does not always begin with people who do not care. Good staff can work inside systems where pressure, weak communication, inconsistent leadership, workarounds and poor oversight gradually become normal. Over time, people adapt to the environment around them and practices that once would have caused concern can become simply "how we do things here." Mariana explores how culture and operational drift interact, why blaming individuals rarely fixes systemic problems, and how leaders can recognise when good people are being undermined by broken systems. This session brings together frontline reality, leadership, governance and organisational culture to show how leaders can create conditions where good staff are able to deliver genuinely good care.
Key Takeaways
- Understand how good staff can become part of poor systems without recognising the gradual change.
- Recognise cultural and behavioural signs that operational drift is becoming normalised.
- Distinguish individual performance problems from wider system and leadership failures.
- Understand how leadership behaviour influences what teams accept as normal.
- Create practical conditions that help staff speak up, challenge poor practice and sustain better care.
Audience
Care leaders, registered managers, deputies, clinical leaders, team leaders, quality teams, providers, HR and learning teams, and organisations working to strengthen culture, leadership and care quality.
Format
Duration
45 to 90 minutes | Half-day workshop available
Delivery
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