MacIntyre Leicester

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last rated inspection, we rated this key question Good. At this inspection the rating has changed to Outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (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 made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The service demonstrated an exceptionally thorough and person‑centred approach to assessing and reviewing people’s needs, resulting in consistently high‑quality, tailored support. Regular, face to face person‑centred reviews were completed with people and those who knew them well, ensuring assessments remained accurate, meaningful and reflective of each person’s preferences, strengths and aspirations.

A highly collaborative approach was embedded, with family members, health professionals and staff teams actively involved in shaping and updating support plans. This ensured changes in people’s needs were identified early and the right support, interventions and adjustments were implemented without delay. Relative’s comments included, “I am involved in decision making about support. We work together to improve approaches that are meaningful for [person]” and “They suggest systems that include [person] and help [person] to be independent while managing risk and safety.”

Staff demonstrated an in-depth understanding of each person, and assessments were continually refined to promote independence, wellbeing and positive outcomes. This proactive, partnership driven approach meant people consistently received support that was not only safe and effective, but truly personalised and responsive.

Staff consistently demonstrated a strong learning culture, routinely sharing insights and successful approaches with each other when introducing new activities or supporting people to develop daily living skills. This collaborative practice ensured that learning was embedded across the whole team rather than remaining with individual staff members.

When a new approach proved effective, staff worked proactively to formalise it. Clear guidance was developed, and care plans were promptly updated to reflect the improved methods of support. This ensured consistency, reduced variation in practice, and enabled all staff to deliver care in a way that maximised each person’s independence.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The provider delivered highly effective, evidence‑based care and treatment, demonstrating a deeply embedded commitment to best practice and national guidance. People’s health needs were assessed and monitored in line with NICE guidance, with staff using this information to shape proactive, personalised health plans. Comprehensive baseline assessments were completed for each person, covering general health, primary health needs and areas where people with learning disabilities may be at increased risk of deterioration.

This included bowel management, pain, eating and drinking, and annual health checks. Assessments also ensured people had access to essential primary healthcare such as eye care, hearing checks, dental treatment and foot care. The provider also ensured access to the national screening programme for people who met the eligibility criteria, supporting early identification of potential health concerns. Staff monitored people closely and consistently, recognising subtle changes in presentation and acting swiftly to secure the right care, support or health pathway before needs escalated.

In addition, the provider’s internal Positive Behaviour Support (PBS) team played a central role in delivering evidence‑based behavioural support. They worked collaboratively with staff, people and families to complete functional assessments, observations and detailed analyses that informed meaningful PBS plans. These plans focused on proactive, preventative strategies that reduced the risk of distress and promoted emotional wellbeing.

For example, one person became distressed when waiting for relatives to arrive, particularly when they were unsure about the timing. Staff worked collaboratively with the person and their family to develop a clear, personalised communication plan. Together, they identified that using the phrase “after lunch” provided a consistent and reassuring timeframe that the person understood and felt comfortable with.

Staff implemented this approach reliably, which significantly reduced the person’s anxiety and the frequency of distress‑related incidents. This demonstrated staff’s ability to adapt communication in a way that was meaningful to the individual, promoted emotional wellbeing and upheld the principles of person‑centred care.

Records showed timely referrals to the PBS team were made whenever people experienced changes in their health, behaviour or emotional state, ensuring early intervention and coordinated, specialist input. This integrated, anticipatory approach demonstrated a strong culture of using evidence‑based frameworks to guide practice, prevent deterioration and ensure people consistently received the highest standard of care.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff teams and services worked well together to ensure people received coordinated and consistent support. We observed staff communicating clearly during handovers, sharing up‑to‑date information about people’s needs, preferences and any changes in their presentation. This meant staff coming on shift were well prepared and able to respond appropriately from the outset.

Staff described positive working relationships with colleagues across the service and with external professionals, such as community nurses, general practitioners (GPs) and internal Positive Behaviour Support (PBS) teams. Records showed timely referrals, joint planning and collaborative problem‑solving when people required additional input, helping to prevent delays in care. This joined‑up approach supported continuity, reduced the risk of errors and ensured people experienced smooth, well‑coordinated care.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service took an exceptionally proactive and personalised approach to supporting people to live healthier lives, resulting in consistently positive and meaningful outcomes. Staff had an in‑depth understanding of each person’s health needs, preferences and goals, and worked collaboratively with families and health partners to promote wellbeing, independence and informed choice. For example, one person had recently experienced a decline in motivation and was refusing to take part in physical activities they previously enjoyed.

Staff teams, together with the person’s family, adopted a person‑centred, positive risk‑taking approach to explore new opportunities that might re‑engage them. Through this collaborative planning, staff identified the person could safely ride a bike, and they were supported to attend inclusive cycling sessions at a local ‘bikes for all’ community group. This significantly improved their physical health, confidence and social participation.

Additionally, another person was supported to develop their own food and dietary plan using a Picture Exchange Communication System (PECs). Picture Exchange Communication System is an Alternative Communication approach that supports people with autism or communication difficulties to express their needs by exchanging pictures for desired items. It helps build functional communication skills and can reduce frustration by giving people a clear, structured way to communicate. This enabled them to plan meals that aligned with their budget, health needs and personal preferences. As a result, they gained greater independence, made healthier food choices and developed a clearer understanding of how to manage their diet in a way that worked for them.

This highly personalised, strengths‑based and collaborative approach meant people were consistently empowered to make informed lifestyle choices and achieve outstanding health‑related outcomes that were meaningful and sustainable.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The provider had robust and proactive systems in place to monitor people’s progress and continually improve outcomes. Support was firmly aligned with the principles of Right Support, Right Care, Right Culture, ensuring care was safe, person‑led and promoted meaningful choice and control. Staff gathered detailed information about people’s health, communication, sensory needs and daily experiences, and used this insight to identify patterns, anticipate needs and adapt support promptly. Leaders demonstrated a commitment to evidence‑based practice, regularly reviewing data, feedback and incident trends to drive improvements that enhanced people’s independence, wellbeing and quality of life.

Relatives told us they could clearly see the positive impact of this approach, describing noticeable gains in confidence, emotional regulation and engagement in activities that mattered to them. Staff worked collaboratively with external professionals to ensure assessments, goals and interventions were consistent with best practice for people with learning disabilities, and they continually evaluated whether support strategies were achieving the intended outcomes.

As a result, people experienced outcomes that exceeded expectations, including managing their own finances, elements of their medicines and personally upholding their responsibilities within their tenancy agreements. Improvements were sustained through continuous learning and an embedded focus on delivering the right support, in the right way, within a culture that upheld people’s rights, dignity and individuality.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff demonstrated a clear understanding of their responsibilities under the Mental Capacity Act (MCA) and consistently sought informed consent before delivering care or treatment. We observed that people were provided with information in formats that met their individual communication needs, enabling them to make informed decisions about their care.

One person used personalised picture cards to choose from a range of walks they enjoyed, including several they had named themselves. These cards enabled the person to clearly communicate which walk they wanted to do on specific days, supporting meaningful choice, independence and engagement in activities that were important to them.

Records showed that consent was obtained appropriately and reviewed regularly. Where individuals lacked capacity, staff followed best‑interest processes. We found systems to assess people’s capacity did not always contain the relevant information required to ensure the MCA was consistently followed in line with legal requirements. The registered manager told us they had identified this issue and were in the process of developing a new tool to reassess people’s capacity in line with current legislation and best practice.

People told us they felt listened to and that staff respected their choices and preferences when planning and delivering care. One relative told us, “They ask for consent and tell [person] what they are doing all the time, they constantly narrate what is happening now and next to maintain predictability”