HTG-UK East – Norwich

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this newly registered service. This key question has been rated requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 2. The evidence showed some shortfalls. Staff mostly treated people with kindness, empathy and compassion, and respect their privacy and dignity.

Staff did not always feel safe or supported to raise concerns. During the inspection, we observed occasions where leaders dismissed staff concerns, which caused visible distress. This did not reflect a consistently kind or respectful culture and reduced staff confidence to advocate for patients.

Staff were not always given the information they needed to understand people’s individual circumstances before journeys began. When the control room did not provide full or accurate risk details, staff were less able to prepare appropriately. This affected how confidently and consistently they could offer personalised, compassionate support, particularly for people with complex needs or those requiring time‑sensitive care.

Despite these concerns, we observed staff interacting with patients in a kind, respectful and discreet manner. They were responsive and supportive, offering emotional reassurance and practical help when needed.

Staff described understanding people’s personal, cultural, social and religious needs and shared examples of how they considered these in practice.

Staff worked considerately with people who were elderly, experiencing mental health challenges or facing social issues; they maintained patient confidentiality, and leaders had taken some steps to investigate concerns raised and share outcomes with staff.

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff adjusted for patients wherever possible. For example, staff met patients’ specific communication needs. By using online translation tools to support conversations in other languages and visual aids to assist those facing language barriers. Staff gave examples of how they worked with family members to understand individual requirements; for example, where a patient may have learning disabilities or autism. Staff described how they how they responded accordingly.

Managers ensured that both staff and patients could easily access interpreters and sign language support when necessary.

Staff made sure patients had access to information about local services, their rights, and how to raise concerns or make a complaint.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff demonstrated an understanding of people’s rights, including those detained under the Mental Health Act. They checked legal documentation and ensured they were familiar with processes to uphold people’s rights.

Staff encouraged independence and choice during journeys and described how they supported wellbeing through offering options when transporting patients.

We scored the service as 2. The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff delivering care at the point of contact were able to respond to people’s immediate needs. However, staff told us they did not always feel empowered or prepared to do so effectively because a thorough assessment of need and risk was not consistently carried out at the outset.

Staff were not always provided with the information required to understand or plan for specific risks. For example, while they routinely asked about general risks such as dementia or stroke, they did not consistently receive or seek more detailed information that would support safer care planning and help mitigate potential risks.

Frontline staff expressed concern that they did not always receive the right information from the control room assessments to help them keep people safe. Despite these gaps, staff were able to identify and respond to changing risks during journeys, which we observed in practice and heard reflected in accounts of how they managed dynamic situations.

We scored the service as 1. The evidence showed significant shortfalls. The service did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff told us they did not always feel respected, supported or valued. They shared examples of challenging interactions with leaders, including occasions where they felt their views were not heard in a constructive or respectful way. We also found that incident investigation processes did not always demonstrate a just culture. In some cases, leaders did not fully reflect principles of openness, fairness or learning, resulting in staff feeling their concerns were not always considered appropriately.

Most staff we spoke with said they did not feel positive or proud about working for the provider. However, we did not speak with everyone, but those we did speak with expressed a desire for change. They wanted greater support to help improve their outlook and attitude toward their work.

Despite their concerns, all the staff we spoke with were patient-focused and took their responsibilities seriously. They shared that with the right resources and support, they would feel more motivated and find greater satisfaction in their work.

Staff had access to support for their own physical and emotional health needs, and leaders could access support from a psychotherapist.

However, some staff were not always supported in a compassionate way. For example, concerns about staff mental wellbeing were sometimes met with punitive action rather than appropriate support.

The provider acknowledged staff achievements within the service, for example, through staff awards. We saw numerous examples where staff had received praise for their hard work and for managing challenging situations effectively.