Cintre is a residential care home for up to seven people with mental health needs. Some people may also have learning difficulties. There were five people living in the home at the time of our inspection.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The individual domain Effective was rated Good at our last inspection but at this inspection it was rated Requires Improvement. This is because we found that although staff and the registered manager understood the principles of the Mental Capacity Act 2005 (MCA), some improvement was required in the recording of decision making and gaining consent. We have recommended that the service reviews its practices to ensure they are fully complying with the requirements of the Act.

The service was safe. People told us they felt safe and that there was always staff available if they needed them. People received safe support with their medicines, these procedures had recently been reviewed following some administration errors identified by the registered manager.

People were supported by staff who were kind and caring. It was evident that positive relationships had been built between people and staff. Staff treated people with dignity and respect

The service was responsive to people’s needs. Staff understood people well and knew the signs to look for that people’s mental health might be deteriorating. People were able to follow their own hobbies and interests.

The service was well led. There was a registered manager in place supported by a deputy. Staff told us senior staff within the organisation were approachable and they felt able to raise concerns and voice their opinions.

This inspection took place on 12 February 2016 and was unannounced. When the service was last inspected in August 2013 there were no breaches of the legal requirements identified.

Cintre House is registered to provide accommodation and personal care for up to seven people. At the time of our inspection there were six people living at the service. Cintre support people with a diagnosis of mental health and learning difficulties.

A registered manager was in post at the time of 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.

Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. Staff we spoke with felt the staffing level was manageable to meets people’s needs safely. Safe recruitment procedures ensured all pre-employment requirements were completed before new staff were appointed and commenced their employment.

Staff were supported to undertake training to enable them to fulfil the requirements of the role. Staff had not been supported by a regular supervision programme. The deputy manager has recently re-introduced a regular programme of supervision and they have been booked with staff members.

People were supported with their medicines by staff and they had their medicines when they needed them.

People’s rights were being upheld in line with the Mental Capacity Act (MCA) 2005. This is a legal framework to protect people who are unable to make certain decisions themselves.

People had their physical and mental health needs monitored. All care records that we viewed showed people had access to healthcare professionals according to their specific needs.

Where appropriate people were encouraged to maintain contact with their family and were therefore not isolated from those people closest to them.

People received effective care from the staff that supported them. Staff were caring towards people and there was a good relationship between people and staff. People and their representatives were involved in the planning of their care and support. Staff demonstrated an in-depth understanding of the needs and preferences of the people they cared for.

People’s needs were met by a small staff team who worked together to offer the best care they could. People received good care that was personal to them and staff assisted them with the things they made the choices to do.

There were effective systems in place to assess, monitor and improve the quality and safety of the service.

People told us that they talked to staff about the support they wanted. Individual plans had been written which showed the support that had been agreed and helped to ensure that staff provided this in a consistent way. One person described the support they received from staff as “brilliant”. We found that staff helped people to make choices in their daily lives and respected the decisions that they made.

People said that staff helped them with things that could be difficult for them, such as dealing with money and managing relationships. People were given the opportunity to develop their lifeskills and staff supported people to access the community. We found that the arrangements in place for medication and personal care promoted people’s independence and rights.

The staff we met with were knowledgeable about people’s needs. Procedures were in place to ensure that suitable staff were employed to support the people who used the service. The relationships we observed between staff and the people who used the service were friendly and respectful. We found that systems were in place for monitoring standards in the home and the quality of service that people received.

There were four people at the home on the day of our visit. We spoke with them about what daily life was like for them at Cintre House.

People had positive views about what life was like at Cintre House. Examples of comments people shared with us included, “it’s brilliant here”, “the staff are not too bad from what I’ve seen”, “my keyworker is nice ”.

People told us they felt safe at Cintre House. People knew how to raise concerns if they had them.

People were effectively supported by enough suitably trained staff to live a fulfilling life at Cintre House and in the community.

When people made complaints these were taken seriously by the provider and were properly investigated.

People who spoke with us were able to discuss their life at the home and what they

enjoyed about living there.

People said that they appreciate having their own rooms, and being able to choose how

they are decorated. One person told us "I chose to have my own television in my room so I can watch what I want".

People told us that the food was "brilliant” and that there was plenty to eat at times that suited them. A staff member told us “we changed our morning routines. People used to eat breakfast together, but it didn't suit everyone, as people like to get up at different times. We changed it so people get up and have breakfast when they like. It tends to be before ten in the morning. It works well now for every-one".

We were told by staff "if we need more staff, for any reason, then we can have them. People have worked here for a long time. Even the most recent staff have been here about three years".

People told us that there was assistance for them to maintain their personal hygiene if

required and that their privacy and dignity was respected.