I have lots of hoops & a lovely pair of quilt frame ends and poles for them that are all going unused because I've learned I can only hand quilt with ease & accuracy using nothing but thimble, short, sharp needles, thread, the quilt (pin basted) and me. I can stitch toward me, but prefer going from right to left, which I can easily do when not using a frame or hoop. I think I've probably maxed out on my "stitches per inch" at 7 (on the top) if I want to get through all 3 layers (w/Warm & Natural batting). The stitching lines are straight, the stitches of consistent size and the quilts are for home use, so it's all good. I have no further aspirations in the hand-quilting category.
I've never mastered the method of just moving the quilt while keeping the needle stationary, either. I confess that I move both quilt and needle.