One to One Support Services

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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

People confirmed staff had a caring attitude and felt relationships were positive. Where there had been any concerns raised, thorough investigations were carried out by leaders to ensure matters raised were addressed. Records about people were written with care and respect and the guidance always promoted people’s dignity.

People felt staff listened and communicated with them in a kind and respectful way and told us they looked forward to seeing familiar carers. One person described them, “Honestly and truly lovely - like friends or family they really are.” A relative shared, “They [staff] are excellent, they are very caring, very good at their job” another said, “Staff are friendly, caring, approachable, trustworthy and always respectful.” This demonstrated how staff’s kindness and commitment directly affected people, for whom that connection may be the only people they see.

We received positive feedback about the staff and managers from professionals we spoke with. One professional told us, “[They] share any concerns appropriately and communicate any concerns effectively. There have never been any issues, their response time and general communication has always been good.”

Staff confirmed they had training in dignity and respect and that there were dignity champions who challenged poor practice and were role models in expected behaviours. The provider had dignity champions amongst their staff who were working toward the Silver dignity award, a national campaign which recognises providers that go above and beyond to provide person-centred care, fostering dignity, respect, and compassion.

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s preferences and personal identities were clearly understood and reflected in their care and support. Staff demonstrated strong awareness of people’s personal, cultural and social needs and supported them fully. People’s strengths, abilities, goals and aspirations were actively encouraged, helping them grow in confidence and achieve their potential.

The provider and staff had an exceptional understanding of diverse communication needs, central to its specialist multi‑sensory approach. Staff used a wide range of communication methods, including BSL, visual tools, sensory cues and adapted communication aids. Several staff were BSL trained, including some who were deaf themselves, creating a powerful sense of connection, shared experience and understanding. This enabled people to fully engage in their care, express themselves freely and experience meaningful interactions that enhanced their wellbeing.

Care plans were highly personalised and detailed, capturing people’s life stories, routines, preferences, cultural identity and aspirations. This insight enabled staff to build strong, trusting relationships and deliver support that genuinely aligned with who each person was. Staff consistently used this knowledge to tailor their approach and interactions.

People and those closest to them could access real‑time information through the provider’s digital system, including rotas and which staff would be attending. For people with specific communication needs, managers offered FaceTime calls to support clearer communication and reduce anxiety.

External professionals consistently praised the service’s personalised and culturally competent approach. One partner told us, “The support has always been within specification and their passion for supporting children and young people is clear. They have a very comprehensive suite to document the child’s, young person’s and family’s needs, wishes, level of support, voice and journey.” Another highlighted the team’s exceptional communication skills: “The personal assistants they employ are able to communicate to a high standard in British Sign Language, and some are deaf themselves, which is extremely beneficial. They bring lived experience of being deaf in a predominantly hearing world.” This feedback demonstrated the provider’s deep understanding of identity, culture and communication, and how this enriched people’s experiences.

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 supported by staff to make sure they understood their rights, using each person’s preferred communication method. They recognised that people’s understanding could fluctuate, so staff regularly checked people’s comprehension and adapted their approach sensitively and when required. This meant people were empowered to make informed decisions and remain at the centre of their care.

People were supported to maintain and develop relationships with those important to them, including the wider community. The provider proactively created opportunities for social connection, particularly for people whose communication or physical needs had previously limited engagement. Families told us these initiatives had been, “Incredibly positive” and had strengthened relationships that were important to people’s wellbeing. This demonstrated the provider’s commitment to promoting independence and emotional wellbeing, regardless of a person’s level of communication or physical ability.

People were encouraged to take part in hobbies and interests, where this was included as part of their arranged care and support plan. Families shared different examples where people were supported by physical, sensory or music‑based activities, even when they did not initially respond to such, recognising the importance and value of that stimulation and connection. This demonstrated that the service delivered truly person-centred care that maximised a person's wellbeing and emotional connections.

Staff also supported people to attend appointments and activities, ensuring people remained active participants in their own lives. Staff were trained to support people who may have learning difficulties or additional needs and actively supported them to develop new skills or maintain existing ones. This flexible approach meant people could experience meaningful and fulfilling lives with support tailored to their individual strengths and aspirations.

Partner agencies confirmed how children and young people were also supported to have their voice heard. They commented how comprehensive documentation was, to highlight the child and family voice throughout, to ensure their wishes were captured, their preferences listened to, respected and incorporated into future planning. As a result, children and young people experienced meaningful involvement in decisions about their lives, leading to a more personalised, responsive and effective care that consistently reflected what mattered most to them.

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’s immediate needs, comfort and wellbeing were consistently prioritised. People were supported by a consistent and familiar staff team, which relatives told us made a significant difference. This meant staff knew people well and were able to identify changes in their health or wellbeing, helping people feel safe, understood and reassured.

Staff were highly observant and often noticed subtle changes in people’s behaviour, mood or presentation. They also understood the different ways people communicated discomfort or distress, including non‑verbal cues, sensory responses or changes in routine. When staff identified concerns, they escalated these promptly, recognising that early action could prevent deterioration in a person’s health or emotional wellbeing. Leaders had invested time in observing and talking with people and their families to understand what the early signs of distress or changes in need were.

Senior support workers routinely contacted people following feedback to explore improvements, demonstrating a culture of listening, learning and continuous personalisation. Records demonstrated staff documenting what approaches were effective and what was not. This reflective practice meant people were supported by a team who were continually learning with them and adapting their approach to provide the best possible care.

Care packages could be flexible and responsive, adjusting quickly when people’s needs changed. Staff followed clear escalation procedures, communicated effectively with senior staff and external professionals, and ensured timely responses to urgent situations. One person told us, “We only have to phone if there’s a need for something extra or a different time, and they will do their upmost to sort it. They always ring back if they need to check anything.” Leaders reviewed support regularly and adapted visit times or levels of care in line with people’s preferences and changing needs, reflecting the provider’s commitment to maintaining independence while delivering responsive care.

Information was shared effectively across the team through cluster meetings, documented minutes and agendas, ensuring everyone remained informed and aligned. A 24‑hour on‑call manager was available, providing staff with immediate support and ensuring urgent needs were addressed without delay.

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. Staff wellbeing was clearly prioritised and had a positive impact on the kindness, compassion and consistency of care people received.

Most staff told us they felt valued, supported and listened to, with good access to regular supervision, appraisals and opportunities to provide feedback or raise concerns. New staff were well supported through structured induction, shadowing and ongoing supervision, helping them feel confident and deliver person‑centred care. Staff told us leaders were always flexible around their personal circumstances, and they felt able to approach management.

Staff had access to wellbeing initiatives, personalised support, that recognised diversity and individual needs, including making reasonable adjustments, acknowledging areas of need for neurodiversity, menopause and mental health support. Staff gave numerous examples of flexible working, through reasonable adjustments following illness, pregnancy or surgery, and told us about the compassionate support they had received through personal challenges, including mental health and financial difficulties. Staff reported feeling valued as individuals, with their health, happiness, and personal circumstances taken seriously. Records showed staff were supported proactively and reactively if they were struggling, with tailored support that recognised their individual needs.

The provider recognised and rewarded staff contributions through incentives, bonus and longevity schemes and the celebration of achievements. Staff had access to wellbeing initiatives including healthcare access, incentives such as gift vouchers and spa days, and ongoing access for emotional support.

The provider invested in staff development through in‑house training, personal development plans and clear progression opportunities, helping staff feel involved and valued. Robust policies, training and development opportunities further supported staff wellbeing, contributing to a motivated, stable and caring workforce. Overall, these arrangements demonstrated a strong commitment to workforce wellbeing, resulting in a well‑supported staff team where staff wellbeing and inclusion were prioritised.