An assessment of Manx Care by the Care Quality Commission (CQC) found the service was 'not always well led.'
The report says the body had not established a universal culture of high quality and sustainable care, with staff not always feeling confident in raising concerns.
The CQC outlined senior leaders had the skills, knowledge and experience for their roles - however, there was no strategy to develop future leaders or implement a succession plan.
It was also found staff 'did not always feel valued or supported' by senior leaders, and it's recommended that Manx Care develops an equality, diversity and inclusion strategy to make sure all staff and patients are treated equally.
Further, the commission identified recruitment procedures 'did not ensure that only persons of good character were employed,' or that potential employees had the necessary qualifications or skills.
As a result, that area has been escalated to the Department of Health and Social Care.
In addition, a number of other recommendations have been made, including reviewing staff levels, training and patient-centred care.
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