MacIntyre Leicester

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection rating inspection, we rated this key question Good. At this inspection the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 81 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The service demonstrated a robust and embedded learning culture that actively supported continuous improvement in practice. Staff reported feeling confident to reflect on their work and identify areas for development, and managers reinforced this through regular supervision, reflective discussions, and access to ongoing learning opportunities. There was clear evidence that incidents were thoroughly reviewed, with learning identified and practice adapted or changed to ensure people remained safe and their needs continued to be met. Information and learning was routinely shared with the team through email updates, handovers, and structured staff meetings, ensuring staff remained informed, aligned, and able to apply learning consistently across the service.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service had clear and well‑established systems, pathways and transition processes that supported people to remain safe and experience continuity of care. Transitions into the service were well‑coordinated, with relevant information gathered, shared and acted upon to reduce risks and promote positive outcomes. A collaborative approach with families was embedded, ensuring they were involved in planning and decision‑making so that transitions were seamless and fully reflective of the person’s preferences and needs.

One representative reflected on their relative’s transition into the service, “The provider was so good, it was a natural progression to here, [person] started gradually and worked up. It’s been a benefit to us all as well as [person]. It made sense and was in [persons] best interest in the long term for transitions. It was a logistical plan, and it worked well. The provider played an amazing part in it all and [person] has flourished every step of way.”

The provider also developed small, person‑centred staff teams, using staff‑matching approaches to ensure people were supported by individuals whose skills, values and communication styles aligned with their needs. This promoted consistency, reduced anxiety and helped people build trusting relationships with staff. These combined systems ensured people experienced safe, smooth transitions and support that remained responsive and personalised.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The service had effective safeguarding systems and a strong safeguarding culture that ensured people were protected from the risk of abuse and avoidable harm. Staff demonstrated a clear understanding of their safeguarding responsibilities, received regular safeguarding training and updates, and were confident in recognising and reporting concerns promptly.

Managers ensured all concerns were taken seriously and referred incidents to the provider’s internal compliance team, where they were formally screened, reviewed and, where appropriate, escalated and reported to external agencies. This additional layer of oversight strengthened accountability and ensured that all incidents were responded to consistently and transparently.

Where appropriate, the provider ensured Community DoLS authorisations were applied for and in place to lawfully support people’s care. Applications were made in a timely and well‑informed way, with staff clearly understanding the least restrictive principles and how to uphold people’s rights, choices and freedoms while keeping them safe.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

People were actively involved in identifying, understanding and managing risks relating to their health, wellbeing and daily lives. Staff worked closely with people, relatives and professionals to ensure risk assessments were meaningful, personalised and reflective of people’s strengths as well as their support needs. Health‑related risks, such as epilepsy, diabetes and mental health needs, were clearly documented with guidance for staff on recognising early signs of deterioration and responding promptly. Social care risks, including community access, travel, relationships and daily living skills, were explored with people in a way that promoted confidence and independence rather than limiting opportunities.

The provider promoted positive risk‑taking, recognising that people with learning disabilities and autistic people should be supported to live full, active and self‑directed lives. Staff understood that risk management was not about restricting people but enabling them to try new things safely, learn skills and make informed choices. We saw examples of staff working with people to gradually increase independence, such as accessing new community activities, managing money or medicines, with clear plans in place to monitor progress and adjust support as needed.

For example, one person was supported to complete a challenging charity walk in Snowdonia, an activity that reflected their personal interests and sense of purpose. Another person was supported to take part in paddle‑boating experiences, which were carefully planned with known risks assessed. Staff ensured the person’s swimming ability was assessed and strong enough to safely participate, and additional safety measures were put in place to enable them to enjoy the activity with confidence. These examples demonstrated a strong embedded commitment to enabling people to take meaningful, enriching risks that enhanced their wellbeing and upheld their rights.

This approach aligned strongly with the principles of Right Support, Right Care, Right Culture, ensuring people were empowered, respected and supported to take age‑appropriate risks in ways that upheld their autonomy. Relatives told us they felt fully involved in discussions about risk and appreciated the balanced, thoughtful approach staff took. Staff demonstrated a good understanding of each person’s communication style and used this to ensure people could express their views, preferences and concerns. As a result, risk management was collaborative, dynamic and centred on what mattered most to each individual, helping people stay safe while leading meaningful and fulfilling lives.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service provided safe, well‑maintained environments that supported people to live comfortably and securely. Staff carried out regular health and safety checks, and any identified risks were promptly addressed to prevent harm. Property maintenance concerns were reported on behalf of people, ensuring repairs were completed quickly and did not compromise safety or quality of life. People’s homes were also decorated and styled to reflect their personal preferences, interests and personalities, helping create spaces that felt genuinely their own and promoted a sense of comfort and belonging.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs. Staffing levels were regularly reviewed to ensure they continued to reflect the individual needs of people with learning disabilities and autistic people, in line with the principles of Right Support, Right Care, Right Culture. Rotas demonstrated that shifts were consistently covered by small, regular staff teams, which promoted continuity, reduced anxiety and helped people feel safe through familiarity.

Small staff teams were developed through robust, person‑centred staff matching, ensuring people were supported by staff whose interests, skills and personalities aligned with their own. This approach strengthened relationships, enhanced communication and enabled people to engage more meaningfully in activities that mattered to them.

For example, one person who enjoyed regular long walks was supported by a staff team who shared this interest. This meant staff could confidently plan and complete long walks with the person, identify new places to explore and encourage the person to broaden their experiences in a way that felt natural, enjoyable and empowering. This demonstrated a clear commitment to delivering support that was genuinely tailored to the individual and promoted choice, independence and wellbeing.

Relatives told us they felt reassured by the stability and competence of the team. One relative said, “One thing I know is they do lots of training. They have a schedule and I know it’s all up to date.” Another relative commented on staffing reliability, saying, “Staff are brilliant. Occasionally they are short if people are sick, but in the last 7 or 8 years this has rarely happened. Probably 80% of staff stay and they will always step in if there’s a need.” These views reflected a consistent picture of a well‑established, committed team who understood people well and ensured their needs were met safely.

New staff received a thorough induction that included shadowing experienced colleagues, competency checks and training specific to learning disability and autism practice. Staff demonstrated a strong understanding of people’s communication styles, sensory needs and preferred routines before working independently.

Training compliance was high, and staff were confident in safeguarding, risk management and personalised support. Staff had completed additional, bespoke communication training to ensure they could effectively support people’s individual and often unique communication needs. This included developing skills in a range of personalised communication methods, enabling staff to understand people’s preferences, recognise non‑verbal cues and respond in ways that promoted choice, control and reduced distress.

The provider had established a clearly defined role for a person with lived experience, referred to as an Expert by Experience to support the delivery of the mandatory training on learning disability and autism (Tier 2). This strengthened staff understanding of how to provide safe, compassionate and person-centred care to autistic people and people with a learning disability. Staff told us this training helped them better understand people’s lived experiences, adapt their communication styles and create environments where people felt heard, respected and included.

Leaders monitored staffing performance, skill mix and training needs effectively, ensuring the team had the right experience and capacity to deliver safe, person‑centred care that promoted people’s independence, dignity and rights.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had effective infection prevention and control (IPC) measures in place that promoted people’s safety and wellbeing. Staff followed clear procedures for hand hygiene, cleaning routines and the safe use of personal protective equipment (PPE) demonstrating a strong understanding of how to reduce infection risks within a supported living environment. Where required, people had an appropriate stock of PPE stored in their homes, ensuring staff could access it easily and use it correctly during support. Regular environmental checks ensured communal areas and individual homes remained clean, hygienic and well maintained. Staff received up‑to‑date IPC training and applied this consistently in their daily practice.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff we spoke with knew people’s medicine support extremely well and ensured key information was communicated clearly within the team. Managers maintained oversight of medicines‑related tasks, and audits were used to identify gaps and drive improvements. These actions meant people continued to receive safe, consistent support with their medicines while systems were being strengthened.

The provider had clear policies in place aligned with STOMP (Stopping Over‑Medication of People with a Learning Disability, Autism or Both), and leaders and staff understood their responsibilities to reduce unnecessary medicines. Staff were confident in recognising individual signs of discomfort, distress or changes in presentation that might indicate a need for PRN medicines, and they worked closely with health professionals to ensure medicines were reviewed regularly and used appropriately.

People received their medicines safely and in line with best practice guidance. Staff were trained in medicines administration and demonstrated a good understanding of their responsibilities, including how to support people who may communicate their needs in different ways. Some systems and processes required further development to strengthen safe practice. The registered manager told us, “We have pain and distress tools in place to aid the staff in presentation of pain for people. We also have body maps on the electronic care planning system, however, as we transfer over to the system, we will complete a full review of paper copy medicine records and ensure these documents are updated and in place”