Roxhsana Ltd Also known as Visiting Angels Manchester East’

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this service. This key question has been rated outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Staff consistently spoke about the people they supported with dignity, respect and compassion,demonstrating a genuine commitment to person‑centred care. Staff described how building meaningful relationshipswith people and their families was central to their role and one of the reasons they enjoyed their work. One staff member said, “The best thing is the feedback and the relationships built both with the people I support and with the team. I enjoy making a difference in someone’s day, even with small things like a chat or a smile. Knowing my support directly improves someone’s comfort, dignity, and day-to-day wellbeing. I see the difference I make immediately, and that sense of purpose stays with me.”

Staff demonstrated kindness, empathy and compassion by recognising subtle changes in the person's confidence and wellbeing through regular discussions, handovers and ongoing engagement. Rather than dismissing the person's concerns, staff took the time to listen, encourage them to express how they were feeling and worked alongside them to access support from their GP. This approach showed that staff understood the person as an individual, valued their experiences and concerns, and treated them with dignity and respect by involving them in decisions about their own health and wellbeing.

People and their relatives confirmed staff went above and beyond when delivering personal care. Comments included, “[Name] went into respite last week so therefore we postponed the current carers, yet two of them turned up on Sunday with flowers and chocolates for her in their own time, and it was very much appreciated by [Name], she loves them, they are very amenable”, and “I can honestly say, hand on my heart, [registered manager] is the one who has kept [Name] out of hospital and a nursing home. He listens to me, he knew my needs and he wrote it all down, and he acted on it.” This reflected the providers commitment of maintaining meaningful relationships and continuity of care for people using the service and their families.

We also saw the provider had considered wider family dynamics when supporting people in their own homes. A relative told us, they were going through a stressful period in their lives and the provider told them, “Don’t worry, we’ll help you, we are here to support you.” The relative went on to say, “I really don’t know what I’d do without him, he has really listened to our needs, a lot.”

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff consistently treated people as individuals, recognising and valuing what mattered most to each person they supported. Staff described how working with small, consistent cohorts enabled them to understand people’s routines, preferences, personalities and communication styles, allowing care to be delivered in a way that felt personal and meaningful. Staff spoke warmly about the relationships they built with people and their families, explaining that these connections were central to providing care that respects identity, promotes autonomy and upholds dignity. People were supported in ways which reflected their unique needs, choices and daily presentation. A relative told us, their relation was “Very depressed”, and the provider employed a staff member who could communicate in the person’s first language. They told us, “It has really made a big difference for [Name] where they are eating more, and are smiling more, I think he [registered manager] relates, he doesn’t just provide care, he provides the socialisation bit, he sees everything.” People and relatives told us the provider excelled at matching individuals with staff who complemented their personalities, preferences and support needs,and staff said they felt equally well‑matched to the people they supported, creating natural, trusting and meaningful relationships.

Another relative told us, “Some of the girls just become like family, you know they go there, three times a day and they have built up a relationship with [Name], and sometimes their behaviour can be challenging and they know, they know him, they don’t take it to heart, as he can be really cranky and they know how to deflect from that.”

A staff member told us, the best thing about working for the organisation was “Definitely the clients, all clients are so lovely and grateful for the work that we do and it is such a rewarding job to see how happy they are when we come to visit and knowing that we care for them and ensure they are able to live safely and independently.”

The provider was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

The provider responded exceptionally well to a person following their discharge from hospital. After a lengthy admission and significant loss of function to a limb, staff recognised the individual required timely, personalised and consistent support to regain confidence and independence. The staff team adapted their approach each day based on the person’s presentation, providing gentle massage, guided exercises and encouragement to promote movement, reduce discomfort and rebuild functional ability. The responsiveness of staff enabled the person to make steady progress, including being able to hold a cup independently.

The staff team had supported a person to improve their diet and overall health. We found staff supported the individual to plan a personalised menu based entirely around their favourite meals, preferences and nutritional needs. Staff encouraged the person to take an active role in meal preparation wherever possible, offering gentle guidance and involving them in decisions to build confidence, autonomy and meaningful participation. This assisted the individual to regain control over an important aspect of their daily life while improving their health and wellbeing. There was an improvement to the person’s weight management and an overall improvement in health. The person had consented to share photographs of the dishes they had assisted in planning and preparing which highlighted how mealtimes had become a positive part of their routine.

The provider was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

When a staff member noticed a person was not their usual self, they did not rely solely on the person’s verbal reassurance but acted on professional judgement, recognising signs of concern such as unusual sleepiness and reduced fluid intake. The staff member responded immediately by contacting the GP and clearly communicating the symptoms observed. Following clinical advice to call emergency services, they escalated without delay, remained with the person to provide reassurance, and handed over all relevant information to paramedics to support safe and timely treatment. This reflected a highly responsive service where staff act quickly, adapt care in real time, and prioritise people’s safety and wellbeing through prompt escalation and coordinated intervention.

The service responded exceptionally well to a person’s immediate needs following their discharge from hospital after a significant health event. Staff recognised, the person required timely, personalised and emotionally supportive intervention to rebuild confidence, mobility and communication. The staff member adapted support each day based on the person’s presentation, responding to changes in physical ability, speech and emotional wellbeing. When it became clear, reconnecting with nature was central to the person’s identity and recovery, staff acted promptly to facilitate safe access to the outdoors, introducing visits to a local park at a pace that reflected the individual’s comfort and capability. These outings provided therapeutic benefit, motivation and meaningful engagement, and were sensitively coordinated to include family members, supporting important relationships and emotional connection.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The provider demonstrated a clear commitment to promoting workforce wellbeing,and most staff told us they felt supported in their roles. Many staff described managers as “Regularly checking in with us, listening to any concerns and always willing to provide support,” reflecting positive day‑to‑day relationships. A small number of staff reported occasions where they did not feel fully listened to when personal issues arose. However, this had not affected the safety or quality of caredelivered to people using the service. Leaders showed appreciation for staff through thoughtful gestures, including gifts for ‘World Kindness Day’ and personalised sweet cones for Eid. Staff feedback was gathered through meetings, courtesy calls and open dialogue, although some staff said they would value more frequent supervision.

When staff raised practical concerns—such as gloves tearing, lanyards obstructing personal care, or feeling vulnerable during darker winter months, the provider responded promptly. Improvements included upgraded gloves, redesigned safety‑focused lanyards and personalised Winter Care Kitscontaining torches with panic alarms, ice scrapers, reusable water bottles, snacks and branded tote bags. Workforce wellbeing was further supported through an Employee Assistance Programme, mental health signposting, pension auto‑enrolment and clear guidance on financial entitlements. Staff were enabled to develop professionally through structured training, the provider’s 'Living our Values'programme and specialist champion roles such as Dementia Champion and Learning Disability Autism Champion.Clear progression pathways supported development with vocational qualifications from Level 2 to Level 5, senior roles and leadership opportunities. A robust on‑call system ensured staff had access to immediate guidance outside of office hours.