One to One Support Services

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 89 (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. They had a well communicated vision focused on providing high quality, safe and compassionate care.

There was a culture throughout the service of positivity, respect, ambition and shared responsibility. The involvement of the registered manager on a day-to-day basis, as well as a strong, supportive management structure, positively impacted the service. The provider’s onsite training facility offered face to face training and a strong commitment to effective learning and maintaining high standards of practice. This approach helped staff develop the confidence, competence and practical skills required to deliver good quality care especially where elements of specialist communication was key.

The registered manager told us they believed in investing in and supporting staff to ensure they maintained the vision of providing high-quality care and support for everyone. There was strong collaboration across all areas, focusing on improving quality of care and people’s experiences. They also shared learning with other organisations, and utilised external learning resources themselves, to stay informed about changes to the care sector and best practice.

The provider evidenced exemplary partnership working with health and social care professionals and a wide range of external organisations, consistently prioritising collaborative outcome- focused practice. The provider demonstrated highly effective and visible leadership, underpinned by a clear and compelling strategic direction that was understood and embedded at all levels. An inclusive and values driven culture was evident throughout, where staff were actively engaged, listened to and supported with a strong emphasis on wellbeing and professional development. This collective approach fostered innovation, accountability and continuous reflection, ensuring the service not only sustained high standards but proactively drove meaningful and sustained improvements in the quality of care provided.

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 provider was well organised and people, at all levels, were empowered to lead others to support a culture of quality and improvement. The registered manager and the management team developed and supported a culture of continuous service improvement through modelling excellence in their expectations, leadership and outcomes for people. For example, members of the management supported staff teams to overcome challenges when delivering complex packages of care through practical support and exploring creative solutions to ensure appropriate and effective care which supported improved outcomes for people.

The management team demonstrated a deep understanding and connection with the people receiving care. They spoke with compassion and pride when describing many of the goals, aspirations and outcomes they had achieved with people. We saw regular review processes in place for people, where individual goal setting and expected progression was utilised, which demonstrated the high-performing culture which focused on exceptional, person-centred results.

Members of staff were supported by the registered manager and the management team to learn, grow and develop so they were able to excel in their roles. Staff reported feeling valued, supported, and treated fairly by the registered manager. One staff member told us, “Countless times have I seen [the registered manager] take time out from their day to see clients and staff – they don’t need to do this, but they do this, because they know it matters” and another shared, “The opportunities for progression within the company are excellent and I have consistently felt well supported throughout each transition.”

Leaders worked together providing information to cascade to others into what actions management had taken; updates to practices, systems or procedures and other general behind the scenes work that management had undertaken. Staff confirmed this helped to provide insight into the work office staff and management completed and why the feedback and information they provided mattered. This created a positive culture where staff felt supported, people felt listened to, and the provider continually worked to deliver quality care.

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

New staff received structured shadowing, knowledge checks and observations, which helped them feel prepared and supported. Leaders monitored suitability and values throughout the recruitment process, ensuring new staff aligned with the provider’s expectations and commitment to safe, person‑centred care.

Staff consistently reported feeling valued, informed and supported. Staff spoke very positively about both the registered manager, and other leaders, describing them as approachable, communicative and genuinely committed to staff welfare. This created a safe environment for open and honest communication and ensured every staff member received equal access to support regardless of their background or role.

The service had a freedom to speak up policy and procedure which staff were aware of and helped embed a culture where staff felt safe to speak up, raise concerns and contribute openly to improvements. Robust processes monitored staff wellbeing and safety, including tracking sickness, vacancies and turnover. Staff had clear access to information through a comprehensive handbook, and dedicated HR (Human Resources) team.

The managers understood their duty of candour responsibilities and acted with openness and transparency when things went wrong. Relatives and professionals told us the managers were quick to communicate any issues which arose for people.

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

Recruitment and workforce decisions were fair, transparent and values-based, they supported equality of opportunity regardless of protected characteristics. Leaders held regular staff and team meetings, regular staff surveys, supervisions and appraisals, which provided structured opportunities to discuss workload, wellbeing, inclusion and any concerns.

Members of the management team conducted ongoing work–life balance checks for members of staff which allowed identification of early signs of fatigue, stress or competing pressures. This approach helped to ensure members of staff felt listened to, supported and able to maintain a healthy balance between work and their personal lives. The provider was committed to workforce diversity and inclusive practice.

There were policies and processes in place which ensured members of staff were treated fairly, equitably and with respect at all stages of their employment. Leaders were committed to upholding staff human rights and ensured everyone felt valued, safe and supported at work.

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.

Staff had received bespoke training, guidance and support and therefore understood their roles and responsibilities well. Systems were in place to ensure the quality and safety of care provided to people remained consistent. Plans were in place to help mitigate foreseeable risks.

Data or notifications were consistently submitted to external organisations as required. Information was shared effectively and consistently as needed. Professionals praised the standard of the information shared by the management team. For example, “I have typically been informed of any significant changes to packages of care or identified risks in a timely manner. Rationale and justification for any changes made have been shared appropriately.”

The management team had liaised with other professionals where necessary and conducted investigations into what could be done differently, when things did go wrong. This information was shared with the whole team as lessons learned for future practice to reduce the risk of such incidents happening again. There was a structured and quality-focused approach to risk management and continuous service improvement.

The leadership team reviewed all policies annually as standard, and more frequently if incidents or updated regulatory information required an earlier review. The management teams attended regular meetings with the registered manager to review quality and performance. There was an annual management review process where overall performance of the service was discussed and objectives for future development agreed. The combination of effective governance and management oversight had led to a service that was providing outstanding levels of care to people

The provider understood their duty to collaborate and work in partnership with people, other organisations and services, so the services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. 

The provider maintained constructive relationships with healthcare and specialist services. By working closely with these professionals, staff helped ensure people accessed appropriate support quickly, which contributed to positive outcomes and safe care. Processes were in place to ensure suitable referrals were made to other community partners or agencies to evidence joined up working. They used these networks to identify new or innovative ideas leading to better outcomes for people.

Policies were continually reviewed on a rolling basis, to emphasise a collaborative approach and ensure continuous improvements were made for people using the service and staff. Business action plans were in place across the service, to review responses and consider improvements for the coming year. For example, ‘How am I doing’ surveys were sent monthly to people which helped identify any themes, or areas for improvement. In relation to staff, targets and outcomes were reviewed and reset regularly. These considered areas of employment such as annual leave or sickness, supervisions, wellbeing, incentives, pay and rewards, as well as exit interviews to identify if there were any trends.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation. They promoted creative approaches to ensuring equality of experience, outcomes and quality of life, and actively contributed to safe practice and sector-wide learning.

Staff and leaders had a good understanding of how to make improvement happen. The approach was consistent and included measuring outcomes and impact. Robust oversight systems were in place, with regular audits reviewed promptly and translated into clear action plans. This supported ongoing improvements and embedded a culture where quality and safety were continuously strengthened. For example, incident reports were collated to analyse any themes or trends, demonstrate actions taken and identify any further recommendations. The level and quality of incident reporting and analysis by the leadership team demonstrated a robust picture of quality where events were used to drive improvements.

Leaders genuinely welcomed feedback, even if it was critical, and were able to demonstrate what action had been taken in response. We saw several examples of leaders taking direct action and their engagement with other involved agencies. For example, when issues had been raised in relation to specific incidents in care provided and the providers’ comprehensive records demonstrated the actions taken, and how subsequent outcomes were also included to allow for reflection and shared with the wider team. Regular feedback from clients, staff and managers was used to adapt systems and respond quickly to emerging needs. Learning from incidents was consistently incorporated into practice, strengthening systems and supporting a culture of reflection and improvement. Continuous improvement was embedded in daily operations.

Leaders and staff actively sought out learning opportunities, attending specific sector learning events to strengthen person‑centred practice. Senior staff were supported to prioritise time to develop their skills around improvement and innovation. Knowledge and information were shared across the teams and used to inform future practice. Several staff commented on how they were well supported to progress, with several promoted based on performance and capability, demonstrating the provider’s commitment to developing talent.

The management team demonstrated a highly progressive and reflective approach to leadership, actively seeking external expertise from professionals across a range of disciplines to rigorously review and challenge existing ways of working. This outward‑looking mindset fostered a culture of curiosity and innovation, enabling the service to gain rich insights, identify emerging areas of focus, and continuously expand opportunities for learning and development. Managers articulated a clear and unwavering commitment to excellence, embedding continuous improvement into the fabric of the service. As a result, people consistently benefited from care that was not only safe and effective, but forward‑thinking, responsive, and continually evolving to meet their changing needs and aspirations.