Roxhsana Ltd Also known as Visiting Angels Manchester East’

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 82 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care was planned and delivered in a person-centredway. Care records clearly demonstrated people’s needs, and staff recognised and responded to each individual’s unique preferences, routines and daily presentation at every visit.

People and their relatives spoke positively about the support provided and felt their care was genuinely person‑centred. They told us they felt listened to, and relatives described staff as kind, compassionate and able to “Think around problems” when supporting people with complex or unpredictable needs. One relative told us, “The carers are really nice… when somebody is complex, you don’t have to have every qualification, mostly you need to be kind, compassionate and understanding,” People and relatives consistently reported the care was not task-focused, and staff treated the wider family with kindness and compassion as part of delivering holistic, person‑centred support.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Care was delivered with good levels of continuity and integration,ensuring people received consistent support from staff who understood their needs well. Care plans were clear, up to date and reflected people’s routines, preferences and daily presentation, enabling staff to provide care that felt familiar and well‑coordinated.

People and relatives told us they valued seeing the same carers regularly, which helped build trust and supported smoother, more personalised care delivery. Staff worked effectively with families and external professionals when needed, ensuring information was shared appropriately and care remained aligned to people’s changing needs.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider was committed to providing clear, accessible and meaningful information which supported informed decision‑making, transparency and positive relationships with people, their families and staff. The service maintained accessible information folders within the office containing up‑to‑date newsletters, service developments, achievements, award recognition's, community involvement activities, feedback and testimonials. These folders ensured people could easily see how the service was evolving and how their feedback directly shaped improvements. The provider had a dedicated reading corner for people and staff visiting the office which offered literature on dementia support, hydration, mobility, fraud prevention, local community groups, social activities and specialist healthcare services across the area. Resources were freely available to read, take away or discuss with the team.

The service also met the Accessible Information Standard through multilingual videos created by staff in languages such as Bangla, Hindi, Urdu and Punjabi. These videos provided culturally sensitive, personalised communication that went beyond written translation, allowing people to hear information spoken naturally by staff who understood their culture, communication needs and lived experiences. This approach was particularly beneficial for people living with dementia, where tone, familiarity and reassurance was essential. Videos shared on the providers social media included a translation message, and consent was obtained from people and staff for their participation. The provider used multiple social‑media platforms—including Facebook, TikTok, Instagram, YouTube and Twitter—to share accessible information, celebrate staff achievements, promote community events such as “Down Memory Lane” activities, and highlight inclusive initiatives like the International Day of Friendship.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Staff listened to people and their families and involved them in decisions about care. Relatives told us they felt able to raise concerns directly with leaders, who acted quickly to resolve issues. One relative explained, "If something isn't right, I ring them and they get onto it immediately.",demonstrating a responsive approach to feedback. People and families were involved in care plan reviews, including joint discussions with social services, and staff worked flexibly to accommodate changing needs. For example, when a person wished to remain at home rather than move into residential care, the provider adapted the rota to ensure 2 carers attended key visits, enabling the person’s wishes to be upheld. Families described the service as willing to adjust visit times at short notice, such as when additional support was needed, and said changes were implemented without delay.

Some relatives told us they would prefer shorter visit options for medication support. However, they also reported that staff were kind, reliable and communicated clearly when delays occurred due to traffic or unforeseen circumstances. People felt reassured knowing staff would contact them promptly if staff were running late, and relatives contrasted this positively with previous providers where “no‑shows” were common. Families described effective escalation processes, including carers staying with people during health episodes, contacting the office for guidance and arranging ambulance support when needed.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The provider promoted equitable access to care, ensuring people received support which reflected their individual circumstances, cultural needs and communication preferences. Relatives told us leaders were approachable and acted quickly when additional support or changes to visit times were needed. Staff demonstrated awareness of cultural needs, and relatives reported that leaders checked regularly to ensure both the person and their family felt respected and included.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

The provider demonstrated an exceptional commitment to equity in access and outcomes,ensuring people received timely, personalised and culturally sensitive care regardless of their circumstances. Leaders consistently removed barriers to access by adapting rotas, increasing visit frequency and responding immediately to last‑minute changes, enabling people to remain safely at home even when external agencies suggested residential care. Relatives told us the service “Jump on it straight away” when additional support was needed. Several relatives described how the provider arranged earlier calls, extended visits and increased staffing within days, sometimes within hours, showing a level of flexibility and responsiveness that exceeded expectations.

Information was shared in other languageswhere required, ensuring people and families who spoke English as an additional language could fully understand care plans, reviews and changes to support. Relatives reported that cultural needs were proactively checked and respected, with one family member saying the manager “Has all the time in the world to listen… any issues I have get resolved,” highlighting inclusive communication and personalised engagement.

People experienced consistency positive outcomesbecause the provider ensured equitable access to skilled staff, rapid escalation and safe continuity of care. Families described carers staying with people during health episodes, contacting the office for guidance and arranging ambulance support when needed, with managers immediately reallocating staff to cover subsequent calls. One relative said, “When I shut my door behind me, I know I have left [Name] in good hands,” reflecting deep trust in the provider’s ability to safeguard people with complex needs.

The service demonstrated outstanding equityby ensuring people received the right care, at the right time, delivered in the right way, regardless of language, culture, complexity or changing circumstances. This resulted in highly personalised experiences, strong continuity and consistently improved outcomes for the people receiving care.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider supported people to plan for the futureby reviewing care needs regularly and working collaboratively with them, their families and external professionals. Care plans were updated when needs changed, and relatives told us they were involved in these discussions.

Several people had been able to reduce the number of care hours they received because staff promoted confidence, daily living skills and safe autonomy during visits.

No one was receiving end‑of‑life support at the time of the inspection. However, the provider had ensured staff were trained and prepared to deliver compassionate, safe care when people reached this stage. Staff had completed end‑of‑life care training and demonstrated an understanding of how to support people and families sensitively, including recognising deterioration, escalating concerns promptly and working alongside health professionals.