Integrated Crisis Response Service

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.

At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility and choice.

This service scored 93 (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 making 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.

People were at the heart of all decisions relating to their referral to the IRCS. They were fully involved in determining the support to be provided, including any referrals to other services or agencies, which were identified through the dynamic risk assessment carried out by ICRS staff. A person told us, “The carers were brilliant, I was always in control of my care and always involved in any decisions.”

People’s care records provided clear information of the circumstances which had necessitated the referral to ICRS. The dynamic risk assessment completed by ICRS involved the person, and in some circumstances family members, and provided clear and comprehensive information about the person’s physical, mental, emotional and social needs. In circumstances where referrals to other services and agencies had been identified, the rationale for such recommendations and people’s involvement in decision making were documented in full and reflected their unique circumstances.

The provider’s processes facilitated and encouraged an inclusive and person-centred approach to care, which fully recognised protected characteristic as defined within the Equality Act, with staff fully understanding the needs of people within the community. A key health care partner told us, “The ICRS team has a strong understanding of the community they serve and consistently demonstrate a person-centred approach to care. On many occasions, they have supported people with highly specific individual needs and preferences, ensuring these are respected and incorporated into care plans. For example, a person relied on drinking sweet warm milk after 6pm, as a key part of their nutritional intake. The ICRS team recognised the importance of this routine and ensured it was accommodated as part of their care. This level of detail reflects their commitment to delivering holistic, individualist care that maintains dignity, promotes wellbeing, and supports positive outcomes for people at home.”

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

People received support from staff who had a good understanding of their local community, which included supporting people with protected characteristics as defined by the Equality Act. Staff fully understood people’s cultural and religious needs and had the necessary training and skills to understand and support people’s health care needs. For example, staff’s understanding of people’s culture and the considerations required when supporting with personal care.

Staff liaised with health and social care professionals as part of people’s support, to achieve the best outcomes for people. A family member told us, “Staff from ICRS arranged for a geriatrician to come to the house to assess [relative].”

Staff’s collaboration with a wide range of health and social care partners ensured people’s care and treatment was co-ordinated and provided continuity of care. A person told us, “I had support from ICRS for 2 weeks, and then another company took over. ICRS passed on all my information to the new service, it was very good.”

Effective collaboration was acknowledged by key health and social care partners, who told us. “Seamless handovers are a core part. The team works closely with community nursing, primary care, adult social care, mental health, voluntary sector partners and other providers, facilitating virtual or face-to-face handovers where appropriate. Assessments and care plans are shared promptly to avoid duplication and ensure continuity, with family and people kept informed throughout the process. This coordinated approach reduces the risk of gaps in provision and supports safe, person-centred transitions between services.”

The registered manager facilitated weekly meetings, forums, with key stakeholders and partner agencies, which included sharing information as to the individual pressures specific to each partner and service type, and how they were to be individually managed. The ICRS was able to respond to these changes in the wider health and social care landscape, The registered manager and management team through robust planning and managerial oversight fully understood the resources available to ensure the service responded within the 2-hour following receipt of the initial referral. Key health care partner told us, “Forums bring together partners from across health and social care to review current pressures, identify bottlenecks, and address emerging issues within discharge pathways.”

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

People’s care records were accessible to the person and family members where the person had given consent. A family member told us, “We had a communication book, and they left a folder with all their information in, everything was written down.” People’s communicated needs, including preferred language was documented within their records. Staff recorded the language in which they spoke with people when undertaking the dynamic risk assessment and Care Act Assessment.

People had access to key information in formats which met their communication needs, which included protected characteristics as defined by the Equality Act. For example, information about the service, was available in a range of languages, including large print versions. The colour contrast, layout and font were also considered to support people with dyslexia or visual impairments.

People were supported by staff who were able to communicate effectively with them in their preferred language. In addition, staff had access to an on-line translate and text-to-speech tool. Flashcards, pictorial guides and communication boards were available to support people with cognitive or speech challenges.

All information generated by the Integrated Crisis Response Service, which was made available to people was reviewed by an independent group of people, who looked at the quality of the information, whether the information was easy to understand and was free from jargon. This independent review helped the provider meet the accessible information standard. The accessible information standards ensure people who have a disability, impairment or sensory loss are provided with information they can easily read or understand with support so they can communicate effectively with services.

Health and social care partner spoke positively of the service’s ability to communicate effectively with people. A key health partner told us, “The service promotes equitable access using language support where required, enabling people to communicate their needs and preferences effectively.”

The provider and staff worked with health and social care providers and shared necessary information in support of people’s health and welfare. All personal information was managed consistent with the General Data Protection Regulation (GDPR) and Data Protection Act 2018. A member of staff told us, “Our training includes cybersecurity and data protection.”

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.

People and family members were knowledgeable as to how they could provide feedback about their experiences of the care and support they received, including how to raise concerns. A family member told us, “No concerns, but if I had I would just have phoned the office.”

People and family members were provided with the opportunity to provide feedback about the service, facilitated through phone calls and via a survey when they were discharged from the service. The provider’s analysis of people’s feedback for 2025 demonstrated an exceptionally high satisfaction across all four measured areas: being listened to, person-centred focus, trust in workers, and achieving desired outcomes. A person who had recently completed a feedback form had written. ‘I am writing to express my deepest gratitude to all of you for the incredible care and support you have given me, during such a difficult time in my life. Your professionalism, kindness and reassurance has made a huge difference to me both physically and emotionally. You gave me confidence, comfort and strength when I needed it most.”

Conversations with people and family members, underpinned by content of people’s care records evidence people were listened to and involved in decisions relating to the support they received, including referrals to other services and agencies.

The provider had a robust complaint policy and procedure. Records showed where concerns had been raised, these had been investigated and responded to, which included the adherence to other policies relating to staff, including disciplinary concerns. Duty of Candour requirements were met, with letters of apology being sent where appropriate when something went wrong during care. The outcome of complaints or concerns were used to support the learning culture of the service.

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

People received a timely response, within 2 hours of a referral being made to the service. This promoted their health and well-being, promoted safety by reducing risk, and enabled people to remain, or return home from hospital. A family member told us, “ICRS came out the same day of the referral to assess.” People’s care records provided clear evidence of referrals made to health and social care professionals to facilitate people’s access to a range of services, and of their involvement in the decision process.

The multi-agency approach, co-ordinated by the Integrated Crisis Response Service, ensured referrals to other services such as technology, housing, occupational therapy or nursing were made in a timely manner to ensure ICRS was responsive to people in crisis.

Staff worked in the office alongside occupational therapists and nurses, which enabled them to seek advice and guidance in the best interests of people, ensuring access to care was timely. A member of staff told us. “Nurses are co-located in the office, we have a direct number for DHU where (provides 24/7 NHS frontline services, including NHS111, urgent treatment centres, GP out-of-hours care, and community nursing across the Midlands and surrounding areas) we can always speak to a health professional for advice.”

The provider recognised and understood the potential barriers which some people may face in accessing services, with staff of ICRS being best placed to support people with specific needs. A health care partner told us, “We frequently encounter people with learning disabilities or mental health needs who require more coordinated and individualist discharge planning. In these situations, ICRS play a vital role in supporting safe and timely discharge. ICRS liaise directly with appropriate services including learning disability teams, mental health services and other providers to coordinate follow up care. Ensuring people with more complex needs are discharged safely with the right support in place.”

The ICRS facilitated regular meetings throughout the working week, involving health and social care professionals from a range of disciplines and specialist areas. This meant any requests for the involvement of other services were discussed and agreed, without delay to the person, by removing lengthy referral processes. A key health partner told us, “Through regular engagement, transparent communication and a strong understanding of community pathways, ICRS plays a key role in coordinating care across partners, reducing gaps in provision and improving continuity for people and their families.”

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.

Potential barriers and delays in people receiving care and support, were removed through the responsiveness of staff in responding to referrals to the service. The ability of staff of the Integrated Crisis Response Service, to assess people’s needs promptly, meant referrals to other services and agencies was expediated, optimising opportunities for people to receive co-ordinated support and care, including mental health services, substance misuse, housing and accommodation, and assistive technology.

People benefited from the approach of the registered manager, management team and staff in their understanding of the services key role within the wider landscape of health and social care services, in achieving good outcomes, whilst recognising the potential barriers faced by some who used the service.

The registered manager facilitated weekly meetings with key stakeholders and partner agencies across the health and social care landscape. Challenges to all key stakeholder and partner agencies were discussed, and responses to system challenges were shared. A key health stakeholder told us, “ICRS demonstrates strong system leadership through active engagement across a wide range or local, regional and national forums focused on improving outcomes for people within the community. The service is a valued contributor at key partnership meetings including the Community Care Partnership, End of Life and Palliative Care Taskforce, Urgent and Emergency Care Forums, and collaborative discussion with EMAS, Primary Care and voluntary sector partners. Within these settings, the team brings operational insight, shares learning from practice and works positively with partners to identify solutions that strengthen integrated crisis response and support, supporting better outcomes for people.”

Data collated by the provider demonstrated the service supported people with consideration to equality and human rights requirements, and with regard to protected characteristics, including making reasonable adjustments to support equity in experience and outcomes. Data detailed the gender, age group and ethnicity of people who accessed the service, and information about the service was provided in a range of formats and languages, with personal interactions being provided by staff who were able to communicate in people’s preferred language.

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.

People received support from staff of the Integrated Crisis Response Service with end-of-life care at home, when a referral to the service was received. People who had received support spoke positively of the support provided, which was evidence by feedback provided direct to the provider. A family member had written, ‘I couldn’t be more grateful for the support we’ve received from ICRS carers. We were at a really dark place as a family, who was losing a family member. The staff brought us hope. Suddenly we weren’t alone, there was somebody to support us. I want to thank each of the carers who supported us from the bottom of my heart.’

As part of the assessment and referral process, information was shared as to any known wishes expressed by the person regarding treatment in the event their health deteriorated, which had been recorded on a ReSPECT document or DNACPR (a document which records people’s advanced wishes should they stop breathing).