Beyond Limits (Plymouth)

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 100 (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 ensuring people were treated with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff demonstrated a genuine commitment to understand people as individuals and took the time to build trusting, meaningful relationships. One relative described how staff had supported their family member through a particularly challenging time, telling us, “They were in a very dark place, and the team leader checked in with them every day. They go above and beyond.”

The culture of the service provided a strong foundation for delivering care that consistently promoted people’s dignity, respect and human rights. These values were embedded throughout the organisation and reflected in both the attitudes of staff and the systems used to support people.

Staff demonstrated a person-centred and compassionate approach in the language they used and in their understanding of each person’s individual experiences. There was a strong awareness of the impact previous trauma could have on people’s emotions, behaviours and communication. Staff recognised behaviours often reflected a person’s experiences, unmet needs or attempts to communicate distress, and adapted their support accordingly. This trauma-informed approach helped them respond to people with empathy, understanding and respect, reducing the risk of people feeling judged or misunderstood.

Staff also understood the wider impact traumatic experiences could have on people’s families and those closest to them. Relatives spoke positively about the reassurance they gained from the staff teams, and from knowing their family members were receiving consistent, high-quality support from staff who understood their histories and needs. One relative described the peace of mind this gave them, telling us,“I wouldn’t want it changed, after all [family member] has been through. I just want to know that when I’m gone, they are still happy and everything’s alright.”

The provider was exceptional at treating people as individuals and tailoring support around their preferences, needs and aspirations. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People were actively involved in designing their support and had a genuine influence over who provided their care. This helped to ensure support was highly personalised and reflected what mattered most to each person. People were enabled to participate meaningfully in discussions about their support, regardless of their communication style or level of need. Staff adapted information and approached conversations in ways that were accessible, helping people to express their views, make choices and influence the ongoing development of their Individual Service Design. As a result, support was tailored around each person's unique circumstances and ambitions rather than being shaped by standardised approaches.

Relatives described how people were empowered to lead the recruitment of their staff teams. One relative told us,“Potential staff come to [family member’s] house. [Family member] has a list and asks them different questions. They show the staff around and train them. The service pays them for this.” Staff also described the recruitment process as being genuinely led by the person receiving support. One member of staff explained they initially met with the team leader and the person's relative before being interviewed by the person themselves. Following the interview, the person informed the staff member they had been successful by sending an email saying, “Yes, you can come on my team.”

Another person had expressed a wish to be supported by members of their own family. The provider worked closely with the person over a period of time to explore how this could be achieved, carefully considering how the arrangement would operate in practice and the impact it might have on the wider support team. The person's views, wishes and preferences remained central to these discussions. The arrangement had since been successfully implemented and was producing positive outcomes for the person. This demonstrated the value the provider placed on people's expertise about their own lives and support needs, ensuring they were actively involved in shaping support arrangements that mattered to them.

Staff demonstrated a detailed understanding of the people they supported, including their interests, aspirations and preferred ways of communicating and engaging with others. For example, one person enjoyed bringing people together and hosting regular social events in their home. Staff supported them to pursue this passion and described how they organised cream teas, Christmas parties and barbecues every two to three months. A member of staff told us, “They decide who they are going to invite, including neighbours, friends and the directors. There is entertainment, songs. They really enjoy it.” This demonstrated how staff enabled people to lead meaningful and fulfilling lives, maintain important relationships and remain connected to their local communities.

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 were empowered to make decisions about their lives and were supported to pursue goals and aspirations that were important to them. The service worked alongside people to identify meaningful outcomes and develop tailored support to help them achieve these. Staff focused on enabling people to make informed choices, build confidence and develop greater independence.

For example, where people expressed an interest in developing relationships, the service recognised the need for accessible information and education to support informed decision-making. In response, they developed a Sexual Health Awareness Course, which was co-produced by people using the service and staff. The course covered a range of topics including gender identity and expression, sexual orientation, consent, personal boundaries, menstruation and menopause. This ensured content was relevant, meaningful and accessible to the people attending.

The provider also recognised some people lacked confidence in understanding and responding to health-related situations. To address this, they developed a Basic Life Support Course that had been adapted to maximise accessibility and engagement. This enabled people to increase their knowledge and understanding in a way that reflected their communication and learning needs.

These initiatives demonstrated an innovative and proactive approach to helping people gain the knowledge, skills and confidence needed to exercise greater choice and control over their lives. The provider reported people found the courses empowering and they had supported individuals to make more informed decisions about their relationships, health and wellbeing.

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.

Some people supported by the service had highly complex needs and required skilled, specialist support to remain safe and achieve positive outcomes. The service worked proactively with health and social care professionals to ensure support was coordinated, responsive and tailored to each person's individual needs.

Staff received specialist training relevant to the people they supported, including epilepsy management and positive behaviour support. This equipped them with the knowledge and skills needed to respond effectively during periods of crisis while delivering care that was safe, consistent and person-centred. The registered manager described an approach that focused on understanding the individual and recognising all behaviour as a form of communication. Staff were encouraged to look beyond behaviours and consider the person's experiences, emotions, preferences and any unmet needs. This enabled them to respond with empathy, curiosity and understanding, helping to reduce distress and improve outcomes.

Staff demonstrated a detailed understanding of the people they supported and the factors that could affect their wellbeing. For example, one person enjoyed spending time in their community and interacting with others but could experience distress when exposed to certain triggers. Staff had a comprehensive understanding of these triggers and were able to describe the personalised strategies they used to support the person. By recognising early signs of anxiety and responding using approaches tailored to the individual's needs, staff were able to successfully redirect the person and reduce their distress, enabling them to continue participating in activities they enjoyed. This demonstrated how staff used specialist knowledge and person-centred approaches to promote positive outcomes whilst minimising restrictions on the person's lifestyle and independence.

Each person had a detailed Individual Service Design, supported by a Working Policy that provided practical, step-by-step guidance on how they wished to be supported in a range of real-life situations. These documents contained comprehensive information about the person's life history, communication style, aspirations, strengths, preferences and support needs, as well as the impact of any health conditions they experienced. Guidance was highly personalised and included examples of situations staff might encounter, enabling them to provide support consistently and in ways that promoted safety, wellbeing and positive outcomes.

The Working Policies reflected a strong trauma-informed approach to care. They provided staff with detailed guidance on understanding the reasons behind a person's behaviours and responding in ways that reduced distress, preserved dignity and maintained positive relationships. Staff were encouraged to adopt approaches based on playfulness, acceptance, curiosity and empathy and were provided with clear information about potential triggers, early indicators of anxiety or distress, and agreed strategies for offering support during periods of crisis. This ensured staff responded consistently and compassionately, helping people feel understood, safe and supported.

Where people had particularly complex needs, the provider had developed individual continuity plans to ensure support remained safe, effective and consistent during emergencies or unforeseen circumstances. These plans contained detailed guidance for responding to situations such as infectious disease outbreaks, adverse weather conditions and utility failures. This helped to minimise disruption, maintain continuity of care and ensure people continued to receive support in a way that met their needs and reflected their individual preferences, even during challenging circumstances.

The provider demonstrated a strong and consistent commitment to staff wellbeing, development and inclusion, creating a workplace culture that enabled staff to deliver high-quality, person-centred care.

Staff described the organisation as exceptionally supportive, highlighting regular supervision, extensive training opportunities, and personalised development plans that focused on both professional growth and individual wellbeing. One staff member commented they had “never had so much training,” while others praised the supportive and inclusive culture. Leadership was highly visible and approachable, with staff describing the service as “extremely well led” and stating that directors were always available to listen and offer support.

A comprehensive approach to staff wellbeing was embedded throughout the organisation. This included wellness action plans, personal development plans, annual appraisals, counselling support, mental health resources, support forums and wellbeing workshops. Wellness action plans encouraged staff to identify how they perform at their best and the support they may need during periods of poor mental health, helping to improve self-awareness and resilience. The service had recognised the impact of domestic abuse on staff wellbeing and performance, and several senior managers had completed training in this area to better support affected staff.

Equality, diversity and inclusion were key organisational priorities. Staff received cultural awareness, sexual harassment and person-centred language training, while initiatives such as social committees and culture-focused development sessions promoted understanding, inclusion and belonging. The organisation also provided significant support to internationally recruited staff through dedicated forums, clear communication, practical financial assistance, and involvement in sector-wide discussions on ethical recruitment.

Leaders actively sought and responded to staff feedback through surveys, forums such as Power Hour, Directors Days and Big Chat sessions, and a staff-led Culture Committee. These mechanisms enabled staff voices to shape organisational priorities and improvements. The ‘Power Hour’ was a safe space for staff to raise concerns and share experiences. Some overseas staff had expressed anxiety about recent protests and proposed Home Office visa changes. In response, the HR team met with them to offer reassurance and issue a clear briefing confirming that racism would not be tolerated in the organisation.

A strong culture of recognition further enhanced staff engagement and morale. Initiatives such as Cheers for Peers, Gemstone Awards, newsletters and celebratory events recognised staff contributions and reinforced positive practice. Overall, the provider fostered a positive, inclusive and psychologically safe culture where staff felt supported, developed and empowered to thrive, contributing to improved morale, engagement and person-centred outcomes.