We carried out an unannounced inspection of the service on 17 October 2017. Mac Mae provides care and support for up to 6 people with a learning disability. On the day of our inspection 6 people were using the service and there was a registered manager in place.

At the last inspection, in November 2015, the service was rated Good. At this inspection we found that the service remained Good. However, the rating for the Caring domain has changed from Good to Outstanding.

People continued to feel safe and staff ensured that risks to their health and safety were reduced. There were sufficient staff to meet people’s needs in a timely manner and systems were in place to support people to take their medicines.

Staff received relevant training and felt well supported. People were asked for their consent and appropriate steps were taken to support people who lacked capacity to make particular decisions. People were supported to eat and drink enough to maintain good health.

Positive and caring relationships had been developed between people and the staff who cared for them. Staff went the extra mile to ensure people were empowered to live their life as independently and fully as possible. Staff promoted people’s right to make their own decisions and respected the choices they made. People were treated with dignity and respect by staff who understood the importance of this.

People received person-centred and responsive care from staff who had a clear understanding of their current support needs. Care plans were in place which provided clear information about the care people required. People knew how to make a complaint and there was a clear complaints procedure in place.

There was an open and transparent culture which enabled people and staff to speak up if they wished to. The management team provided strong leadership and a clear direction to staff. There were robust quality monitoring procedures in place.

Further information is in the detailed findings below.

We inspected the service on 17 November 2015. The inspection was unannounced. Mac Mae provides care and support for up to 6 people with a learning disability. On the day of our inspection 6 people were using the service.

The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were supported by staff who knew how to recognise and respond to abuse and systems were in place to ensure people were protected from harm. Risks were assessed and managed and people were supported by enough staff to ensure they received care and support when they needed it. Medicines were managed safely and people received their medicines as prescribed.

People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support. People were supported to make decisions and where there was a lack of capacity to make certain decisions; people were protected under the Mental Capacity Act 2005.

People were supported to maintain their nutrition and staff were monitoring and responding to people’s health conditions.

People were supported by staff to live their life the way they wished to and people felt staff were kind and caring. Staff knew people’s individual preferences and tailored their support to meet their needs. Staff respected people’s privacy and dignity. .

People were involved in planning their care and support. They were supported to have a social life and to go out into the community and go on holidays. People felt confident to speak up if they had any concerns and staff knew how to respond to issues raised.

People were involved in giving their views on how the service was run and there were systems in place to monitor and improve the quality of the service provided.

During our inspection we spoke with five people who used the service, two members of staff, the registered manager and the operations manager. People told us they were happy with their care. One person said, "I like living here because I know the people well". Another person said, "I like the staff, they are all nice".

We saw that people were involved in making decisions about their care and support, and staff respected people’s choices.

People were treated with care and compassion, by staff who understood and were responsive to people’s needs.

People told us they felt safe at Mac Mae. We saw that there were effective systems in place to protect people from harm, and staff were aware of what to do if they felt people were at risk of harm. All staff were checked to make sure they were suitable and safe to work with vulnerable people.

The service was well led because there were effective systems in place to regularly assess, monitor and improve the service.

We spoke with two people who used the service. They told us their choices and independence were respected and that they had agreed to the support that was provided. One person told us they had plenty of opportunities to do activities and said staff had supported them to find a voluntary job which they really enjoyed. Another person said they were able to speak with staff if they had a problem or concern and we observed this happening on the day of our visit.

We looked at the care plans and records of two people who used the service. We found people’s needs were assessed and care was planned and delivered in line with their individual plan.

We found medication to be handled appropriately and to be safely stored and administered.

Staff received appropriate professional development and staff we spoke with demonstrated a good understanding of the needs of people who used the service.

Records were accurate and fit for purpose.

We saw one person who lived at Mac Mae. They told us that: “I like living here and the staff are nice”.

We spoke with one person who lives at Mac Mae. Everyone else had either left for their day time activities or were leaving as we arrived. We asked if the person felt safe living at Mac Mae, and they said that they did. We also asked if the staff were kind, and again we were told that the staff were: “Very nice, I like the staff.”

We asked if there were enough staff, and we were told: “Yes there are.”