Integrated Crisis Response Service

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.

At our last assessment we rated this key question good. At this assessment the rating has changed to 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.

People and family members spoke positively of how staff treated them with kindness, empathy and respect. A person told us, “The carers were excellent and very friendly, very professional and knew what they were doing, they were observant and noticed if I was in pain.”

People spoke of how staff’s understanding, knowledge and empathy enabled them to support those who were reluctant to engage or had specific needs. A family member said, “My [relative] has bi-polar and the 2 carers were really understanding, they were very professional, they built rapport quickly and were very caring.” Another family members said, “The carers were so good. It was the first time [relative] had accepted care. Staff were tidy, clean, friendly and so good with them. They were great with the dog too.”

People’s care records were written by staff with consideration as to people’s dignity. Staff detailed the care provided, and any issues were recorded sensitively without bias or judgement. Staff had received training on equality, diversity and inclusion, which they implemented in their everyday interactions and practice. A member of staff told us, “One of my main roles as a coordinator is to ensure people are supported by the gender of staff they prefer. Staff also consider people’s cultural and religious needs and requirements, for example if we are shopping, we may to go a Halal shop. I have learnt about the requirement to be mindful about sweets because some have gelatine.”

Where possible people were supported with staff whose gender was as they preferred. However, this was not always possible as staff were responding to people who were in crisis, and therefore the number of staff, their availability and the number of people being referred and supported was continuously changing. A family member told us, “In our culture we needed a male carer and that is exactly what they provided, 2 male carers who were wonderful. I had to get my [relative] on board (culturally) and that was difficult and the ICRS staff really supported me to do that.”

Key health and social care partners were unequivocal in their praise of the professionalism of the Integrated Crisis Response Service, and how the impact this had on their services as well as the people who received support and care. A key social care partner told us, “The service works closely with the hospital discharge team, reablement social work team and locality teams on a day-to-day basis to ensure smooth transfer of care as people transfer between services. It has built incredible trusting relationships over the many years.”

The registered manager spoke of opportunities for reflective supervision and multi-disciplinary discussions, which provided a space to challenge assumptions, consider how to offer choice, and recognise the small adaptations which can preserve someone’s dignity or autonomy in moments which matter, from dressing routines to medication decisions or cultural observance.

The provider 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.

People and family members were positive about the communication between themselves and staff, and of the impact this had. A person told us, “The carers were all very good and we communicated very well. They were very encouraging and told me that each day things would be a little better.”

People were supported by a diverse staff team, which enabled them to meet people’s cultural and religious needs. People’s care records detailed their preferred language of communication. Assessment of people’s needs and Care Act Assessments consistently referred to people’s communication needs and documented where staff had conversed with people in their preferred language.

A key social care partner told us, “The ICRS make-up in terms of staffing is very diverse, reflective of the needs of the City, with people from different backgrounds and ethnicity. The service is very proactive to the cultural and religious needs of people living in Leicester and strives to act accordingly and make reasonable adjustments so that people can access the service in a manner appropriate to them. ICRS staff work with other services, looking at how to personalise their interventions in terms of language spoken, meals and any cultural/religious practices.”

Assessments and Care Act Assessments were undertaken with consideration to the protected characteristics as defined by the Equality act and were personalised and individual to their needs and circumstances. All aspects of people’s needs were considered, including physical and mental health, and environmental factors including housing. Staff in their interactions with people, considered their personal, cultural, religious needs and social circumstances.

A key health care partner told us, “ICRS staff demonstrate a strong commitment to upholding people’s human rights, embedding the principles of the Mental Capacity Act and Equality Act within everyday practice.”

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.

People and family members shared how the service influenced and had a positive impact on their independence, and how staff had fully involved them in all decisions. A person told us, “They helped me with things I didn’t know I needed help with, they got me equipment to help me get from the chair to standing, all sorts of things they helped me with.” Another person told us, “They have helped me to regain my confidence. I had 4 days of support, by the end I was able to get up, shower, dress and have breakfast. The staff made sure I could manage; I talked it over with them and we agreed I would like to finish.”

People’s assessments included identifying any equipment which could be used to maintain or increase their independence, and making the appropriate referrals to source this, with the person’s consent. The Integrated Crisis Response Service had direct and day to day working practices and arrangements with agencies and services which meant equipment could be sourced quickly. Referrals from ICRS to other services was given priority, as the nature of ICRS meant they have a 2-hour response time. Where necessary, staff had collected equipment and taken it to people’s homes and demonstrated its use.

Staff fully understood the importance of involving people and promoting their independence. A member of staff told us, “We assure people we are not there to take over, but to promote independence. It’s about enriching and making the family feel at ease with it all.”

Equipment provided was varied, and dependent upon people’s needs as assessed by ICRS and the referrals they made. Referrals for equipment were for the purpose of both promoting safety and independence, which included sensor equipment to identify people’s movement, from their bed or chair, or when leaving the house, or falling. Sensors could also detect if a person was having a seizure or had been incontinent, in some instances if a sensor was triggered, the referral for assistance went to the ICRS team to respond.

Specific tasks, including medicine management formed part of the assessment, and if required a referral for a medicine compliance aid was made. Assessments considered people’s cognition, and where it was identified, they were struggling to understand day to day activities, referrals to support them were made. For example, clocks and devices, including talking clocks which made clear whether it was day or night, and the time.

In some circumstances a person’s assessment identified they would benefit from a period of reablement, rehabilitation and recovery, and were referred to the Reablement Provider Service. ICRS and the Reablement Provider Service, worked collaboratively from an office, which they shared with other key services, which enabled and facilitated smooth transfer to other services to support people’s independence.

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.

People and family members experiences reflected the nature of the service, of crisis intervention. A family member told us, “The service was very helpful for us. I can’t speak highly enough of the team and how positive it was for as a service user.”

In circumstances where ICRS were requested to provide on-site support at hospital, staff always took the opportunity to engage with people, to seek their views as to what if any support they wished to receive to prevent their admission to hospital or facilitate their discharge. Again, a further example of working with people, understanding their needs and acting on their wishes.

The provider kept oversight of ICRS engagement with people, which included data to evidence where people chose not to engage with ICRS, or chose not to receive further support where their assessment evidenced, they were eligible, ensuring people’s views and wishes were respected.

The services commitment of responding to referrals within 2 hours, over a 24-hour period facilitated the minimising of people’s distress and comfort. This was achieved in a range of ways. For example, by responding to people who had fallen at home. The provider’s data showed, of the 1726 people ICRS responded to in 2025 who had fallen, 69 were admitted to hospital, which meant most people were able to remain at home, reducing their discomfort.

The ability of ICRS to undertake a dynamic risk assessment of people’s needs and provide support in a timely way reduced the need for people to be admitted to hospital. Training attended by ICRS staff, delivered by external health care professionals referred to people experiencing depression and anxiety in response to prolonged hospital admissions, and was another example of how the service was able to reduce anxiety, distress and discomfort, by facilitating people’s return to their own home.

Key partners were consistent in the praise of ICRS and its impact on people, evidencing how the involvement of the service reduced distress and discomfort for people, by providing support as well as making referrals to services and agencies who can provide targeted and specialise support. A key social care partner told us, “The initial referral contact into the service, and the undertaking of the dynamic risk assessment, means the service acts on the risks identified, and may include arranging an urgent GP review, contacting mental health teams, and escalating any safeguarding concerns.” A key health care partner told us, “ICRS supports early intervention, and ensures that deterioration is identified and addressed at the earliest opportunity. Their ability to combine rapid crisis response with forward planning and strong partnership working helps ensure community-based support remains, effective, person-centred and sustainable.”

The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

The registered manger was committed to recognising and valuing the cultural and religious diversity of both people who used the service and staff. Personal beliefs, traditions and practices were supported. Language and gender preferences were considered, including when scheduling care calls. The office had a room dedicated to facilitating staff in practicing their faith through religious observance, including prayer.

Staff rota schedules were developed to ensure sufficient travel time for staff between care visits. Rotas were developed with consideration to the cultural and religious needs of staff. Staff workforce diversity was monitored to ensure the team was reflective of people’s demographic and needs.

The registered manager demonstrated their commitment to the well-being of staff. All staff were proactively being encouraged to participate in workshops which had been planned over the next few weeks, which were to be facilitated by an external organisation, with the purpose of encouraging staff to explore their own spirituality, learn skills of reflection and meditation in support of well-being.

Staff spoke positively of the support they received from their line manager. A member of staff told us, “Most days I have been asked if I need anything. Managers have an open-door policy. They are very good at giving feedback, which is very good for wellbeing. Any queries have been responded to quickly. I can see the working relationships they all have, which makes me feel confident.”

The provider’s policies further underpinned staff well-being, including well-being passports for staff. A staff member spoke of the reasonable adjustments made, which included flexible working patterns, based on their caring responsibilities.

An employee assistance programme, and an occupational health team further supported staff where required. A reward scheme acknowledged individual achievement and recognition. Information around human resources, including all forms of leave and safety were underpinned by the provider’s policies and procedures. A member of staff told us, “We have access to occupational health support, counselling, stress training and wellbeing workshops.”