One to One Support Services

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 good. At this assessment the rating has changed to outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of 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 was exceptional at making sure people were at the centre of their care and treatment choices.

People and their relatives were fully involved in the delivery and ongoing review of their care needs, ensuring support was highly personalised, well‑coordinated and responsive to any changing needs. Comprehensive assessments captured people’s physical, mental, emotional and social needs, including any specialist interventions as required. Where people had specific needs related to protected characteristics, these were clearly identified and proactively addressed.

Care plans were regularly reviewed in partnership with people, families and relevant professionals and were accessible in both digital and paper formats, promoting transparency and shared ownership of care. Regular reviews and check‑ins ensured people and their families could provide ongoing feedback, keep informed and influence any changes to care. One professional shared, “The person they are supporting has specific needs and there are complex elements regarding their care, and they are managing this very well.”

The provider demonstrated exceptional responsiveness through strong multidisciplinary working and skilled leadership. Service managers with specialist knowledge supported both people and staff when needed, and other professionals described communication as, ‘Effective, respectful and well‑managed’ another shared how they, “Consistently listened to concerns raised by professionals and worked proactively to provide appropriate resolutions.”

The provider demonstrated a strong understanding of the diverse health and social care needs of the people they supported, including needs arising from protected characteristics and those at risk of poorer care experiences. As a result, people were consistently at the centre of all decisions, supported to achieve outcomes that mattered to them, and experienced care that was highly responsive, inclusive and genuinely person‑centred.

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 and their relatives consistently told us the provider responded quickly and effectively when their needs changed, including in situations requiring urgent or complex support. Timeliness, reliability and clear communication were central to the care people received, helping families feel reassured, informed and fully involved.

Staff and managers demonstrated an exceptional and nuanced understanding of people’s individual strengths, aspirations and support requirements, ensuring that care was not only responsive but truly person centred. Where individuals received support from multiple services, staff worked with a high degree of transparency and professionalism, fostering strong, collaborative partnerships that promoted seamless joined-up care. This approach enabled people to experience well-coordinated holistic service empowering them to pursue meaningful lives with confidence and stability.

The provider communicated appropriately and timely with other healthcare professionals, commissioners and other services to ensure care provided was coordinated and responsive, even where people’s needs were highly complex or changeable. This integrated approach ensured people experienced continuous, consistent, responsive care that adapted around their lives and changing needs.

Professionals praised the service’s communication, flexibility and responsiveness, describing how managers and staff worked alongside them, to plan and implement changes to care promptly and safely. They told us, “Care was delivered in line with agreed support plans while remaining flexible to individual preferences.” They also commented the provider showed particular strength in recognising that mental health needs could fluctuate and when they did, they responded proactively to concerns raised, achieving timely and effective resolutions.

The provider consistently delivered appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s individual communication needs were clearly identified and actively used to ensure information was shared in an accessible and appropriate way. The provider had a clear commitment to identifying and responding to people’s individual needs. Information was adapted and tailored, helping people to understand their care and make informed choices.

People’s preferred methods of communication were considered when sharing any information, including questionnaires, updates and care planning documentation. People and relatives told us they were kept informed and they were actively involved, with access to real time updates through the online systems. They contacted the office or managers in different ways, such as email, phone or video calls or by asking a family member to support them. People were involved in decisions about how their information was shared, and their wishes respected and clearly documented. This ensured people and relatives had ongoing opportunities to share their views and influence how information was provided and communicated.

Staff supported people to access information from external services and, where barriers existed, advocated on their behalf. Communication needs were reviewed in line with the Accessible Information Standard with information available in a wide range of formats, and interpreters or specialist support arranged promptly when needed. Several staff were fluent in BSL and deaf blind communication (deafblind is used by individuals with combined sight and hearing loss) and were able to communicate effectively and efficiently, helping people fully understand and engage.

Staff received guidance and training to help them meet people’s communication needs and demonstrated an understanding of information governance and confidentiality. Policies were in place and aligned with best practice guidance, including GDPR and the Accessible Information Standard. The provider told us they held the Matrix Award (an accreditation which confirms the organisation meets a quality framework for Information, Advice, and Guidance).

Overall, the provider’s inclusive and responsive approach to providing information ensured people were empowered, fully informed and able to exercise genuine choice and control.

The provider demonstrated a clear commitment to listening to people and actively involving them in decisions about their care. The provider advocated strongly for people’s autonomy, what mattered most for them and ensured people were empowered and supported to make informed choices about their care.

People and their family confirmed they understood how to give feedback, share ideas or complain about care, support and treatment. People told us they were confident that their views or concerns would be taken seriously and treated compassionately, without fear of any negative repercussions. They confirmed staff always involved people in decisions made about their care and told them what had changed as a result.

Staff shared examples of how they had been involved in different opportunities to improve and develop the service, Some held specialist roles (such as champions for safeguarding, epilepsy, nutrition and hydration, behaviours that challenge and neuro diversity) and they were committed to elevating and improving outcomes for people, by reviewing best practice guidance and developing knowledge and expertise across the service. The provider had developed anintegrated systemic approach to delivering training, scheduling meetings, and using themed observations and supervisions to ensure theoretical knowledge was translated into individual competency and high-quality care provision.

This helped to shape the way care was delivered and ensured that what mattered most to people was being recognised. For example, following any meetings or reviews, there were increased ‘cluster meetings’ held with the whole of the persons staff team. This was to discuss any causes, natural trends or occurrences, and supported staff to better recognise any triggers and consider the use of preventative actions which had previously been successful. This ensured staff were raising awareness and delivering better outcomes for people.

The provider shared their analysis and oversight with people, communicating what was happening and being open about the outcomes and any actions being taken. Their analysis, aligned with CQC’s expectations of high-quality care helped them to identify any areas where improvement or change was required and helped to demonstrate the impact for people where changes had already been introduced.

The provider had a clear complaints policy and compliments procedures which were available in different formats to support all people who were using the service. Everyone we spoke with knew how to raise a complaint and felt confident any issues would be dealt with promptly.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People were consulted about potential barriers to treatment and care plans were made to support them. Reasonable adjustments people needed were recorded in their hospital passports. These were used to help external professionals understand how people wished to be supported and what their key needs were. For example, they provided clear guidance about effective communication. This ensured the best possible chance of effective communication when people attended health appointments to help them make the best of their experience.

To support ongoing access to information, the provider ensured all clients had access to an online client portal. Through the portal, people could view their care package notes, helping them stay informed and engaged in their care. For those who preferred not to use digital systems, or were unable to use them, the provider ensured equally comprehensive access thorough paper records, tailored to the person’s communication needs. Leaders routinely checked that people remained fully involved and that the format continued to work for them. This meant no one was disadvantaged due to digital literacy, disability or personal preference.

Across all interactions, we were told staff were professional and shared relevant information promptly and communicated effectively with both people and their families and healthcare professionals. Leaders responded to issues in a timely manner, documented concerns thoroughly and escalated matters appropriately when needed.

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.

To promote inclusive access to information, the provider offered a customised online client portal, which could be adapted to meet individual needs for example, adjusting font size, colours or layout. This ensured people and their advocates could access information in a format that suited them. Recognising that many people preferred physical documents, the provider also ensured that key information, was printed and placed in people’s homes. This helped ensure everyone could access their information easily.

People were encouraged to discuss and share any updates, concerns or queries at any time, supporting open communication and shared decision‑making. Care plans and documents were reviewed at least annually, giving people a formal opportunity to provide feedback and ensure their information remained accurate, relevant and reflective of their wishes.

Staff were also supported with independent interpreters where required and many staff praised leaders for being value-led describing how staff really supported one another, dignity and respect were prioritised, and the leadership was committed to both high quality care and staffs wellbeing. Staff received clear guidance and training on inclusive, person-centred practice and were empowered to challenge assumptions, adapt their approach and ensure every interaction respected the individual.

The provider’s commitment to equality, inclusion and diversity was evident throughout the service for both people and staff. They had an onsite training academy which was supported by industry experts in sensory impairment and specialist service delivery, offering development opportunities for both staff and people. People confirmed they felt fully included in care delivery for example one family shared how despite significant communication challenges including where adapted sign language was being used for the person in receipt of the care, still meant they had full control, as staff were specifically trained explaining; “All of the decisions made about care are ours – that’s what is so important to us”.

Leaders modelled best practice, responded promptly to emerging needs and ensured systems and documentation evolved to reflect the diverse community they supported. This approach supported fairness, transparency and a positive experience for all individuals receiving care.

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.

Guidance for staff detailed decision making with those people who might need support and staff had a good understanding of this. Staff supported people to make their own decisions whenever possible, about their future goals and plans.

People’s care records detailed what was important to them and they were supported by staff who knew their needs wishes and preferences well. People were supported to gain greater independence and rely less on staff and care interventions. We saw many examples of people being supported to achieve their goals, gain more independence and make plans. Records included details about important life changes, including transitions in care and people’s end of life considerations.

Although there was no one currently receiving end-of-life care, the service recognised the need to be led by people's wishes when taking an involvement in this area. Sensitive conversations about end-of-life care were held, where appropriate, with people and their relatives. We were informed of creative approaches made possible, for people who had made specific requests or wishes – such as requesting to hear a specific piece of music and despite barriers in place, these opportunities were created.