Mansfield Supported living

On this page

• 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

Effective – 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.

This is the first assessment for this newly registered service. This key question has been rated 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 96 (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 ensured people’s care and treatment were effective by carrying out thorough, person-centred assessments and regularly reviewing individuals’ health, care, wellbeing and communication needs. Assessments were comprehensive, accurate and reflected each person’s unique circumstances, strengths, preferences and desired outcomes.

The management team completed detailed assessments that involved the person, their family members and, where appropriate, external health and social care professionals. This collaborative approach enabled staff to develop a complete understanding of the person’s needs, wishes, life history and preferred methods of communication. Where people felt overwhelmed, anxious or fearful about the assessment process, the team adapted their approach and completed assessments over several shorter visits. This ensured people were given the time and support needed to express their views and that their needs were accurately captured without causing unnecessary distress.

Staff demonstrated a strong commitment to understanding the individual behind the assessment rather than relying solely on historical information. They told us some people had previously been misunderstood in other services because staff had not recognised or correctly interpreted their communication methods. As a result, some people had been subject to inaccurate assessments and restrictive care plans that did not reflect their actual abilities or wishes. The registered manager carefully reviewed existing information, sought further evidence and spent time getting to know people to ensure assessments were based on a true understanding of their needs. This approach helped identify where previous assumptions or restrictions were unnecessary and enabled people to receive care and support that promoted independence, choice and positive outcomes.

As a result, people’s care plans were highly individualised, reflective of their current needs and provided staff with clear guidance to support people safely and effectively. Regular reviews ensured changes in people’s health, wellbeing and communication needs were identified promptly and care was adapted accordingly.

The provider consistently planned and delivered care and treatment in partnership with people, which ensured support was centred around what was important to them and what mattered most in their daily lives. Care was delivered in line with current legislation, best practice guidance and evidence-based approaches, while remaining flexible and responsive to each person’s individual needs, preferences and goals. The service demonstrated a strong commitment to continually develop practice and seek innovative ways to improve outcomes for people.

Staff recognised that effective communication was fundamental to deliver safe, personalised care. For example, one person used British Sign Language (BSL) as their primary method of communication. Rather than relying solely on established communication techniques, staff worked closely with the person to further develop their communication methods and incorporated Makaton and supported them to create their own personalised signs when existing signs did not fully capture their wishes or experiences. This ensured the person could express themselves as fully and independently as possible. The person’s individual communication methods were clearly documented within a dedicated communication book, which enabled new staff to quickly learn and understand the person's unique language and maintain consistent, effective communication from the outset.

The provider actively sought specialist advice and expertise to ensure care reflected current evidence-based practice for people living with complex and progressive health conditions. For example, specialist professionals were involved and supported people living with Huntington’s Disease. Staff worked collaboratively with healthcare professionals to understand the progression of conditions, anticipate future needs and adapt support accordingly. This proactive approach helped people maintain their independence, dignity and quality of life for as long as possible.

The provider demonstrated commitment to partnership working across staff teams, healthcare professionals and external organisations to achieve the best possible outcomes for people. Collaborative working was embedded throughout the service, which ensured people experienced coordinated, seamless care that reflected their individual needs, preferences and aspirations.

The provider worked effectively with a wide range of professionals and agencies and ensured comprehensive information was shared whenever people moved between services. Detailed assessments, care plans and communication profiles accompanied people during transitions, which enabled receiving services and professionals to gain a clear understanding of their needs. This meant people did not have to repeatedly tell their story or relive previous experiences, reducing anxiety and which ensured continuity of care from the outset.

Detailed handovers took place between staff at every shift change, which ensured important information about people's wellbeing, communication, health needs, achievements and any concerns was shared accurately. These handovers were thorough and person-centred, which enabled staff to provide consistent support and respond effectively to any changes in people's needs.

The provider demonstrated an exceptional commitment to support people to live healthier lives and achieve outcomes that had a significant and lasting impact on their wellbeing, independence and quality of life. Care was highly personalised, with staff working alongside people to understand their individual health goals and develop tailored approaches that reflected their needs, preferences and aspirations.

Staff showed exceptional skill, patience and creativity in helping individuals overcome long-standing barriers to good health, particularly where these were linked to autism, sensory needs or past experiences. They understood that traditional health promotion approaches were not always effective and adapted support in ways that people could understand and engage with. This included the use of visual aids, personalised routines, positive reinforcement and gradual goal setting to help people make sustainable lifestyle changes.

Several people had been supported to make significant improvements to their physical health through healthier eating, increased physical activity and ongoing encouragement from staff. In some cases, people had lost substantial amounts of weight, which enabled them to be considered for specialist health treatments and procedures that had previously not been available to them due to health risks associated with their weight. Staff worked closely with healthcare professionals to ensure people achieved their goals safely and in a way that promoted long-term success. These achievements had not only improved people's physical health but also enhanced their confidence, self-esteem and future opportunities.

People spoke passionately about the positive impact this support had on their lives. One person described how improvements in their health had transformed their mobility, independence and ability to participate in activities they enjoyed. One person said, “I walk miles now and go to lots of places.” The person explained they had previously relied on a wheelchair for mobility but, through ongoing support, encouragement and lifestyle changes, had become far more active and independent. Other people also reported increased mobility, greater stamina and improved confidence, which allowed them to access their community more frequently and enjoy a wider range of experiences.

The provider demonstrated an outstanding commitment to monitoring, reviewing and improving outcomes for people. Systems were highly personalised and focused on which ensured care and treatment continually evolved to meet people's changing needs, preferences and aspirations. The provider did not measure success solely against clinical expectations; they actively sought to understand what a positive outcome looked like for each individual and ensured their views remained central to decision-making.

People were actively involved to review their care and support and were given genuine opportunities to influence how services were delivered. For example, people were able to choose whether they wished to have a dedicated key worker. Staff recognised this approach was important to some people who valued a consistent point of contact, while others preferred to work with a wider range of staff to promote choice, independence and flexibility. The provider responded to these preferences and adapted support arrangements accordingly, which demonstrated a highly individualised approach to achieve positive outcomes.

The provider had developed effective systems to monitor people who were at risk of abuse and used information gathered through reviews, observations, safeguarding concerns and multi-agency working to improve outcomes. For example, one person was being financially exploited by a family member which placed them at significant risk of financial hardship and emotional distress. Staff worked closely with the person, local safeguarding teams and relevant agencies to ensure appropriate protective measures were implemented. The person's finances became stable, their anxiety reduced and they reported feeling safer and more in control of their daily life.

The provider was particularly effective in supporting people who experienced self-neglect. Staff recognised that achieving positive outcomes often required patience, trust and a person-centred approach. One person had previously struggled to maintain their personal hygiene, nutrition and home environment, which had negatively impacted their physical health and wellbeing. Through regular engagement, motivational support and collaborative goal setting, staff encouraged the person to take small but meaningful steps towards independence.

The provider demonstrated an exceptional commitment to which ensured people’s rights around consent were understood, promoted and consistently respected. Consent was embedded within the culture of the service and staff viewed it as an ongoing process rather than a one-off event. People were supported to make decisions about their care, treatment and daily lives in ways that maximised their independence, choice and control.

Staff took time to carefully explain people's rights around consent and used communication methods tailored to individual needs. Information was provided in accessible formats and at a pace people could understand, which enabled them to make informed decisions about matters affecting their lives. Staff routinely checked people's understanding and adapted their approach where required to ensure people were fully involved in decision-making.

Where people lacked capacity to make specific decisions, the management team ensured robust and decision-specific mental capacity assessments were in place. Assessments clearly identified the areas where support was required while also recognised and promoted the decisions people remained able to make independently. For example, even where people required support with more complex decisions, staff ensured they retained choice and control over aspects of their everyday lives, such as selecting their clothing, choosing activities, deciding how to spend their time and expressing preferences about their care and routines. This demonstrated a strong commitment to the principles of the Mental Capacity Act and ensured restrictions on people's rights were minimised.

The provider also showed a willingness to question and challenge historic decisions where they did not believe these accurately reflected a person's abilities. Where appropriate, people were supported to challenge previous capacity assessments that may have underestimated their decision-making abilities. The management team gathered clear evidence of people's understanding, decision-making skills and ability to retain and weigh up information. They worked with relevant professionals to ensure assessments were accurate, fair and reflective of the individual's current abilities.

This rights-based approach ensured people were not unfairly deprived of opportunities to make decisions about their own lives and future. Staff understood that capacity could vary between decisions and could change over time, and they continually sought ways to maximise people's involvement in choices that mattered to them.