Integrated Crisis Response Service

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care

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 had a very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The provider, registered manager, management teams and staffs’ commitment of a shared vision, strategy and culture were measured by the positive outcomes people experienced, which was evidenced in part by data. The provider’s analysis of data for 2025 found the Integrated Crisis Response Service had received 6,100 referrals, of which 1,726 were for people who had fallen at home.

Staff were passionate about their role, and of its impact on people, and on them. A member of staff told us, “I feel ICRS needs to be shouted about, seeing how it supports people (with safe discharge) and outcomes they achieve, ICRS is the place to be – it’s rewarding. I’m enjoying being here. I’m always learning.”

The data made clear the positive impact on people in response to ICRS involvement, which found 79% of people avoided admission to hospital, 90% of people who had fallen at home did not require any ongoing care. The involvement of ICRS could equally be measured by its impact on the wider health and social care landscape, with only 1.1% of people having to be readmitted to hospital, thus reducing the demand on hospitals.

A health care partner told us, “ICRS proactive involvement helped to minimise delays, reduce unnecessary hospital stays, and that people with more complex needs were discharged safely with the right support in place.”

The key values and strategic goals of the service were fully understood by the management team and staff, who worked continuously with partner services and agencies to deliver a responsive and good quality service. The culture of the service was positive, and the staff team’s commitment to the delivery of the visions and values was tangible in their conversations and discussions.

Key stakeholders were equally positive about the culture of the service, and the delivery of its values. A social care partner told us, “At a senior management level, regular discussions take place about service needs, changes/developments, pressures etc., that all services can support and co-operate and inject ideas into the forward movement of the local authority. Front line managers have also worked together to develop practices to support better ways of working and encourage positive working relationships”.

Equality and diversity were actively promoted across the service and embedded into everyday practices, which included staff recruitment and training. Assessments of people’s needs considered protected characteristics as defined by the Equality Act. Key information was available in a range of languages, and formats and reviewed independently with consideration to people’s communication needs.

The registered manager and management teams’ oversight and monitoring ensured any risks to the delivery of the strategy, including local factors were understood and planned for as documented within the provider’s contingency scenarios and response plans, and through meetings with key stakeholders and partner agencies to plan and respond to wider system pressures.

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

The Integrated Crisis Response Service was led by a registered manager who had been in post for nearly a decade, evidencing sustained leadership. The registered manager kept up to date with good practice and the changing landscape of health and social care through ongoing learning and development, and engagement with key stakeholders. The registered manager had kept under review the requirements of the service and had made changes, which included the appointment of an occupational therapist to support staff in the delivery of the service.

The registered manager and management team were highly visible and led by example, modelling inclusive behaviours. They had the experience, capacity and capability to ensure the organisation’s visions were delivered, and risks were managed well. The registered manager was proactive in responding to information which could be indicative of a poor culture and potentially affect the quality of people’s care or have a detrimental impact on staff. This was facilitated by responding to concerns, incidents or feedback, and by taking appropriate action where required, through the implementation of the provider’s policies and procedures.

Staff were consistent in their praise of the registered manager and management team, and of their visibility and availability to provide support and guidance. A member of staff told us, “There is always someone on call as a manager. We are never alone out of hours.” A second member said, “A 100% well-led service. There is always a point of call for support.” Staff were equally positive as to the culture of the service, including open and supportive communication. A member of staff told us, “There’s open communication. Communication amongst the team is really good, there’s no one that is off-limits to speak to.”

Key stakeholders spoke of the shared vision, values and strategy, which had been developed through planning in collaboration with all parties. A social care partner said, “All services routinely come together for learning opportunities, forums etc., to network, share knowledge and expertise and contribute towards development of strategies, and practice quality improvements. Forums for managers to get together and build working relationship are encouraged.”

The registered manager and management team, work with health and social care partners to review progress against delivery of agreed strategies in line with local plans. A social care partner told us, “ICRS regularly seeks feedback from colleagues, partners, and people to identify opportunities for service development and continuous improvement.” A key health care partner told us, “The service maintains strong links, bringing a clear evidence base to discussions through activity reporting, outcome measures and learning from practice. This shared oversight supports a responsive approach to demand, enabling timely adjustments to pathways ensuring individual receive the right support within their community.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The provider and registered manager acted with openness, honesty and transparency. They promoted staff empowerment and encouraged staff to raise concerns. This was facilitated through staff supervision, meetings and the availability and approachability of the management team. Staff’s views were sought in relation to people’s care and progress, which enabled them to directly affect and improve the quality-of-care people received.

We noted a culture of openness, evidenced by staff’s demeanour and confidence in speaking with and sharing their views and opinions with the management team. A member of staff told us, “We all know the whistle-blowing procedure, we go to management and are kept well-informed of what’s going to happen.” A second member said of the management team, “There door is always open.”

The provider had a whistle-blower policy, which staff could use to share information of concern, which was accessible to staff.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

The provider had a corporate equality and diversity strategy, which focused and reviewed the culture of the organisation, in the context of equality, diversity and inclusion. Policies and procedures relating to the work force which included employment and ongoing accountability were written with consideration to equality, diversity and inclusion and the protected characteristics as defined by the Equality Act.

The registered manager celebrated the diversity of the workforce recognising the value and importance of a diverse team in enabling the service to achieve positive outcomes for people, facilitated through staffs understanding knowledge and understanding of the diversity of the population it supported.

The registered manager shared how staff rotas and working patterns were adjusted to respect religious observance, such as Ramadan and Diwali. Wherever possible, duties were redistributed or adapted to ensure staff were not placed in conflict between their work and their beliefs. They advised these adjustments had minimal impact on service delivery but had strengthened trust and staff retention.

Staff who required additional support due to disability, health, neurodivergence or personal circumstances were supported by tailored wellbeing plans, and where required, included referrals to occupational health or mental health resources. A member of staff we spoke with confirmed they were supported through flexible working arrangements.

Wellbeing was considered to be of significant importance by the registered manager. Workshops had been organised for staff to attend, facilitated by an external organisation.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had clear and effective governance, management and accountability arrangements in place. This was achieved through ongoing monitoring across all areas of service delivery. For example, feedback from key stakeholders and partner agencies, people who used the service, and its staff. Ongoing monitoring of systems and processes, which included the auditing of records, systems and processes, enabled the registered manager to monitor the safety and quality of the service provided.

Staff understood their roles and responsibilities, with managers being able to account for the actions, behaviours and performance of staff. This was achieved by supporting and monitoring staff, through observation, supervision and training and development. A member of staff told us, “I have supervision every 1-3 months, and I can request a supervision if needed, which is always granted.”

The performance of the service was kept under continuous review, working collaboratively on an ongoing basis with key stakeholders and partner agencies to deliver a service which focused on quality, the mitigation of risk and continuous improvement. A key health stakeholder told us, “Feedback is used constructively to amend pathways, improve communication, and enhance responsiveness, ensuring the service continues to evolve in line with people’s needs and system pressures. The culture of continuous improvement further reinforces ICRS as a valued and forward-thinking partner within the wider health and social care system.”

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The registered manager and management team engaged with key health and social care partners and agencies, sharing information as to the role of the Integrated Crisis Response Service, and the positive impact of collaborative working. For example, presentations delivered by the registered manager of ICRS to health and social care partners, provided statistical data as to the number of people referred to the service, the impact of the service on people, evidence to support the reduction of calls to East Midlands Ambulance Service (EMAS) and the financial savings, underpinned by sharing people’s individual journeys, experiences and outcome.

Key health and social care partners were unequivocal in acknowledging the significance of collaborative working, in supporting people’s smooth transition between services, and the positive impact the Integrated Crisis Response Service had on the wider health and social care system. A key health care partner said, “The service is seen as a trusted and valued partner, recognised for its professionalism, responsiveness and committed to delivering person-centred care. This strong partnership working has supported improved people’s experience, safer crisis management within the community and reduced reliance on acute services, EMAS and Primary Care reflecting a mature and cohesive approach to integrated working.”

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider, registered manager and management team were committed to ongoing monitoring to measure the outcomes and impact of the service provided. Systems and processes were in place to learn from events when things went wrong and worked in collaboration with key stakeholders and partner agencies to review the effectiveness of the Integrated Crisis Response Service in the context of the wider health and social care landscape. A key health partner told us, “ICRS leadership engages openly to test new approaches, identify improvement opportunities and respond to emerging challenges. Where gaps or pressures are identified, the service works jointly with system partners to co-design solutions, strengthen referral routes and improve people’s flow across services. This collaborative approach demonstrates a shared commitment to innovation, continuous improvement and delivering high-quality community bases crisis support.”

Another key health care partner provided an example of how ICRS had supported service development by enabling the expansion of a health care partners service, to include a Frailty Same Day Emergency Care, by accepting referrals immediately, without barriers, enabling hospital based staff to focus on the clinical needs of others, having full confidence that staff from ICRS would support people with their onward journey by meeting their social care needs.

The provider and registered manager were committed to the continuous learning and development of staff, through the provision of training, which included commissioning of training from external health care partners. For example, the recent training provided to support staff in responding to people who had fallen at home. A key health care partner told us, “Staff receive targeted training to support a wide range of health and social care needs and regularly shadow partner professions to enhance skills, knowledge and collaborative working. Where new or complex situations arise, management works closely with system partners to see advice and embed learning into service development, which demonstrates a strong culture of continuous improvement.”

The Integrated Crisis Response Service staff worked collaboratively with the provider reablement service, providing a second member of staff where a person receiving support via the reablement service required 2 members of staff. In addition, ICRS, where required, provide staff to support the emergency call and handling service and the installation of equipment.

As part of the provider’s commitment to the development of the service, funding had been approved to facilitate the expansion of the team to include an occupational therapist, and the post was currently being recruited to.

The provider had introduced the ‘OneTouch electronic care monitoring system’, which provided accessible electronic data and information about people’s care needs, which could be accessed by key partner and agencies within the social care sector. This had contributed to effective sharing of information, improved communication, directly affecting the service people received as it facilitated timely referrals, including requests for additional resources and equipment.