Roxhsana Ltd Also known as Visiting Angels Manchester East’

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and peoples feedback confirmed this.

This service scored 79 (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 made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider was highly effective in assessing needs and completed thorough, person‑centred assessments to ensure care was tailored, safe and responsive from the outset. Initial assessments captured detailed personal information, cultural identity, legal representation, medical history, allergies, resuscitation status, communication needs, environmental risks and daily living requirements. Assessments for people using the service included comprehensive information on personal care, everyday activities, social support, medication, psychological wellbeing, nutrition and hydration, mobility, and environmental safety, alongside clear documentation of preferred visit schedules and lifestyle preferences. Assessments also recorded family context, interests, routines, equipment used to support independence, and specific risks such as dementia, Parkinson’s, falls, sensory needs and recent injuries. Where people were supported by the local authority, the provider obtained and cross‑referenced the local authority care plan to ensure needs can be met and which informed the development of personalised care plans.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The provider had supported a person with recognised principles of stroke rehabilitation, ensuring support was clinically informed, person‑centred and responsive to the individuals recovery needs. Following the person’s discharge from hospital, staff used best‑practice approaches such as gentle therapeutic exercises and activity, and light massage techniques to reduce stiffness, support comfort and promote functional movement which had affected the individual’s limbs. Care was paced according to the person’s tolerance and adapted daily, based on their presentation. Staff worked collaboratively with the person to set meaningful goals, monitored their progress closely, and adjusted interventions in line with observed improvements. As a result, the person regained significant movement and reduced pain.

Staff aligned a person’s care and treatment with evidenced based practice following their diagnosis of diabetes and eczema. They managed the persons treatment safely, consistently and accordance with best practice. Care plans described treatment instructions and recognised the importance of daily topical medication in maintaining skin integrity for people with diabetes. Staff followed the plan with a high level of continuity and attentiveness, applying prescribed creams safely and monitoring for any changes in skin condition, pain levels or deterioration. Staff demonstrated adherence to clinical rationale by ensuring treatments were applied at the correct frequency and in line with the prescriber’s instructions. This assisted in improving the person’s skin condition and reducing the risk of infection.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The provider worked collaboratively to support people from being fully dependent to being meaningfully independent. We saw for one person, a consistent cohort of care professionals communicated closely with one another, sharing observations, reviewing the individuals’ needs and adapting care delivery in real time. Regular team discussions, handovers and ongoing monitoring enabled staff to recognise subtle changes in the person’s mobility, confidence and daily functioning, ensuring their care package was adjusted safely and proportionately. Staff encouraged the person to express their concerns and worked together to support them in approaching the GP for a medication review, demonstrating strong partnership working between the care team and external professionals. This coordinated approach resulted in the discontinuation of a medicine, which significantly improved the persons physical ability and independence, so much so, the person was able to manage their daily routines and achieve meaningful personal goals, including travelling abroad to visit family.

We found the provider had been proactive and worked with health care professionals to manage concerns around skin integrity. Care staff identified early deterioration, communicated promptly with the office team and sought clinical guidance without delay, ensuring a seamless escalation pathway. The office team liaised immediately with the person’s family and the District Nurse, enabling rapid assessment and commencement of prescribed treatment. Throughout the episode, staff maintained consistent communication, monitored the condition collaboratively and ensured accurate documentation of actions taken. This coordinated approach from the provider linked family members and healthcare professionals which resulted in timely intervention, effective treatment and a clear improvement in individual’s comfort, wellbeing and recovery.

One person told us, “It started out, I used to have 3 calls a day but I have got a lot better now, so I just have morning calls. They ask me what I want and what I need, and we work together.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider supported people to live healthier lives by delivering personalised, evidence‑based care which promoted wellbeing, prevented deterioration and encouraged positive daily routines. Staff worked with small, consistent cohorts, enabling them to recognise changes quickly. Care plans included clear information on nutrition, hydration, skin integrity, mobility, medication and long‑term conditions, ensuring people received support that was proactive and aligned to clinical best practice. Examples such as improved skin integrity, reduced pain and an improved quality of life demonstrated how structured interventions, consistent monitoring and adherence to prescribed treatment can lead to measurable health improvements. Staff also worked closely with specialist nurses and pharmacy partners to ensure people received accurate advice, timely escalation and condition‑specific support.

A relative told us, “There is an app that you can look at every day. There is a report from each visit. It is quite helpful to get an overview, particularly with Parkinson’s to gauge the deterioration, it’s very useful.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Care plans were reviewed regularly and updated promptly when needs changed, ensuring support remained aligned to clinical guidance and personal preferences. Outcomes were monitored through daily notes, reflective practice, spot checks and supervision, allowing leaders to identify themes, track progress and implement targeted improvements. Examples such as significant reduction in pain and improved skin integrity showed how consistent monitoring led to measurable, positive outcomes. Partnerships with specialist nurses and pharmacy professionals further strengthened clinical oversight, ensuring staff received up‑to‑date guidance that supported safe escalation and effective management of long‑term conditions.

Relatives confirmed, care and support was regularly reviewed and the provider was positive about listening to their feedback.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People received care and treatment only with their valid, informed consent,in line with the Mental Capacity Act (MCA). Staff explained they always sought consent before delivering any aspect of care, including personal care, medication support and the application of prescribed creams, and they adapted their approach if a person declined or appeared unsure. Care plans clearly recorded people’s preferences, communication needs and any relevant legal arrangements, ensuring staff understood how each individual wished to be supported. When people’s capacity fluctuated, staff used a proportionate approach by offering information in accessible ways, checking understanding and involving family or professionals where appropriate. Leaders ensured staff received MCA training to underpin their knowledge.