Commissioned support
Commissioning 1:1 and 2:1 support for young people
Staffing ratios are one of the most consequential decisions in a commissioned support package — for the young person, for safety and for cost. This guide sets out what the ratios mean in practice, what should drive the choice, and how to keep the arrangement under review rather than fixed for its lifetime.
In short
- A ratio describes how many practitioners are with a person during commissioned hours — not how many staff are employed on the case.
- Ratio should follow assessed need and risk, not availability or habit.
- 2:1 is usually about managing a specific, identified risk safely — not about doing twice as much support.
- Ratios can and should vary across the week, and should reduce as things stabilise.
- Hours, ratio, skill mix and management requirement are separate cost drivers. Changing one does not automatically change the others.
What the ratios actually mean
The ratio in a commissioned support package describes how many practitioners are present with the young person during the commissioned hours. It is a description of the support model, not a headcount of everyone involved in the case.
| Ratio | What it means | Typically used where |
|---|---|---|
| 1:1 | One practitioner working directly with one young person for the commissioned period. | Consistent individual attention is needed for engagement, routine, emotional regulation or ordinary risk management. |
| 2:1 | Two practitioners with the same young person for the same period. | An identified risk means one practitioner could not respond safely alone — to the young person, to staff, or to others. |
| Variable | Cover that changes across the day or week. | Risk is concentrated at known points — school transitions, contact days, evenings, weekends. |
| Shared | One practitioner supporting more than one young person where it is safe and appropriate. | Sibling groups or settings where joint support is clinically and practically sensible. |
The distinction that matters most is between 1:1 and 2:1. They are not points on a single scale of intensity. They usually answer different questions.
When 2:1 is the right answer — and when it is not
2:1 is often requested when a situation feels serious. But seriousness alone is not the test. The useful question is narrower: is there an identified risk that one practitioner could not manage safely on their own?
Reasons that genuinely point to 2:1 include:
- Safety during a foreseeable incident — where a single practitioner could not both stay with the young person and summon help.
- Risk to the practitioner — a documented history that makes lone working inappropriate.
- Risk to others — where the young person may need active support away from other people.
- Movement and community access — where travel or public settings create risks that a lone practitioner could not manage.
- Two distinct functions at once — for example one practitioner maintaining relationship and de-escalation while the other manages the practical situation.
Reasons that usually point somewhere other than 2:1:
- Wanting more support generally — that is usually a case for more hours, not a second practitioner in the same hours.
- Wanting a second opinion or oversight — that is a supervision and reporting requirement.
- Historic risk that has not recurred — worth reviewing rather than assuming.
- Uncertainty — better addressed by a defined review point than by permanently doubling the ratio.
How needs and risk shape the decision
The ratio should fall out of the assessment rather than being set first and justified afterwards. In practice the questions are:
- What is the support actually for? Stability, engagement, routine, education access, community access, keeping a placement viable, or bridging to something else.
- What are the specific risks? Not a general risk rating — the actual behaviours or situations, their triggers, their frequency and what has helped before.
- What would happen if one practitioner were present alone? This is the question that most directly settles 1:1 versus 2:1.
- Where does the support happen? A placement, the community, education, travel — each carries different risk.
- What does the young person want? Support a young person actively resists rarely achieves its outcomes, whatever the ratio.
- What is the intended outcome, and how will it be measured?
A referral that answers these lets a provider propose a model rather than simply quote a rate.
Workforce and supervision requirements
Ratio is only half the picture. Two practitioners without the right skills are not safer than one with them. The design should also state:
- Skill mix — the experience and competence the work requires, and whether both practitioners in a 2:1 need the same level or complementary strengths.
- Continuity — how many practitioners will the young person meet? Continuity usually matters more to outcomes than headcount.
- Supervision — who supervises, how often, and how concerns escalate.
- Contingency — what happens on absence. A package that collapses when one person is ill was not designed properly.
- Briefing — practitioners should know the plan, the risks and the reporting standard before the first shift, not during it.
At Gwennol these arrangements are set at design stage and named in the proposal. See bespoke commissioned support for how a package is put together.
What actually drives the cost
Ratio is the most visible cost driver but not the only one. Treating them separately makes negotiation clearer and usually produces a better package.
| Driver | Effect | Where there is usually room to move |
|---|---|---|
| Support hours | Direct multiplier | Concentrating hours where they matter, not spreading them evenly |
| Staffing ratio | Direct multiplier during those hours | Varying the ratio across the week rather than applying the highest level throughout |
| Practitioner requirements | Higher skill costs more per hour | Matching skill to the task rather than the whole package to the hardest moment |
| Risk | Drives ratio, skill and supervision | Reviewing risk honestly as things change |
| Location and travel | Time and mileage | Local practitioner availability |
| Waking nights / overnights | Significant uplift | Whether the need is genuinely overnight or evening |
| Management requirement | How much of the running sits with the provider | Explicit agreement rather than assumption |
| Reporting requirement | Frequency and depth | Agreeing what is genuinely useful to you |
| Duration | Short intensive vs longer-term | Planned step-down |
Because these interact, complex packages are individually costed rather than sold at a published hourly figure. Our defined service lines do have a published rate card; bespoke packages are quoted against the design.
Reviewing and stepping down the ratio
A ratio set at referral reflects what was known then. Left unreviewed it becomes expensive and, worse, can hold a young person at a level of restriction they no longer need.
Build the review in from the start:
- Set a first review date at design stage, not "when things settle".
- Agree what would justify a reduction — specific, observable changes, not a general sense of improvement.
- Agree what would justify an increase too, so escalation is a planned decision rather than a crisis.
- Step down in stages where possible — reducing hours before reducing ratio, or reducing ratio at the calmest points of the week first.
- Record the rationale each time, so the file shows why the model is what it is.
Referral checklist for a 1:1 or 2:1 package
The more of this you can answer at referral, the faster a provider can tell you whether they can deliver it — and the less likely you are to receive a quote that misses the point.
The requirement
- What the support is for, in one or two sentences
- The outcomes you need, and how you would measure them
- Proposed ratio, or a note that you want the provider to advise
- Hours and coverage pattern, including any waking-night requirement
- Required start, and whether that is fixed or indicative
- Expected duration and whether step-down is anticipated
The situation
- Where the young person is now and whether that is stable
- Age band
- What has been tried and what helped
- Education or activity commitments the support must work around
Risk
- The specific risks, their triggers and frequency
- Anything that makes lone working inappropriate
- Safeguarding context relevant to screening
- Any existing risk assessment or plan
Practicalities
- Location — town or partial postcode is enough at this stage
- Who holds decision-making, and who the provider should contact
- Reporting you need and how often
Send only what is needed for initial screening. If further records are required, we will agree an appropriate secure method for sharing them.
Questions we are asked
Is 2:1 always safer than 1:1?
No. 2:1 manages risks a lone practitioner could not handle safely, but two practitioners can also escalate a situation that one might have de-escalated. The right model depends on the specific risk and what actually helps the young person, which is why the rationale should be written down rather than assumed.
Can the ratio change during a package?
Yes, and it usually should. Ratios can vary across the week and should be reviewed as things change. Agreeing at the outset what would justify an increase or a reduction makes that a planned decision rather than a crisis response.
Do you decide the ratio, or do we?
The commissioner sets the requirement and the outcomes. We advise on whether the proposed model is deliverable and safe, and will say if we think a different ratio or pattern would work better. If we do not think we can deliver something safely, we say so rather than accept it.
How is a 2:1 package priced?
Individually. Ratio is one driver among hours, practitioner requirements, risk, location, travel, overnight cover, management and reporting. We do not publish a generic hourly figure for complex packages because it would not tell you anything reliable about yours.
How quickly can a 1:1 or 2:1 package start?
We will confirm feasibility and mobilisation requirements following referral review. Mobilisation depends on the ratio, the practitioner skills required and availability in that specific area, so we do not quote a standard timescale before reading the referral.