Trezela House is a small care home that can accommodate up to eight people who have mental health needs. The service is situated close to the centre of Wadebridge within walking distance of shops and amenities. At the time of our inspection there were eight people living at the service.

We carried out this unannounced inspection on 28 February 2017. At the last inspection, in January 2015, the service was rated Good. At this inspection we found the service remained Good.

People told us they felt safe living at Trezela House and with the staff who supported them. People told us, “I am happy here” and “I like it here, this is my home.” Relatives said, “[Persons’ name] is very happy living at Trezela House”, “Brilliant it’s like a home from home” and “It’s an incredible place.”

Care and support was provided by a consistent staff team, who knew people well and understood their needs. People were supported to access the local community and take part in a range of activities of their choice. Staff arranged regular holidays and day trips for either the whole group or a smaller group depending on the type of holidays and outings people wanted to go on.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People were supported to eat and drink enough and maintain a balanced diet and were involved in meal planning. Menu planning was done in a way which combined healthy eating with the choices people made about their food.

People were supported to maintain good health, have access to healthcare services and receive on-going healthcare support. Staff supported people to arrange and attend appointments to see their GP and other necessary healthcare appointments.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. People who received care, or their advocates, were involved in decisions about their support and consented to the care provided. Risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

Where people did not have the capacity to make certain decisions staff acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People and their families were given information about how to complain. The registered manager and owner were visible in the service, regularly working alongside staff to provide care and support for people. There was a positive culture within the staff team and staff said they were supported by the registered manager and owner.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. People and their families were involved in the running of the service and were regularly asked for their views through on-going conversations with staff and surveys.

The home was registered to provide personal care and accommodation for up to eight people who had mental health needs. On the day of the inspection we spoke privately, and on a one to one basis, with seven of the people who lived at Trezela House.

People we spoke with were happy with the home’s standards. The comments we received included “they look after us pretty well,” and “I am very happy, the staff are lovely.”

Everybody was happy with the staff support they received. People said the staff always had time to talk with them if they had a problem, staff had positive attitudes and were always friendly and kind. A couple of people expressed a wish to move on although this was due to personal reasons rather than to specific concerns about the home. Nobody who we spoke with had any concerns or complaints about the service provided by the staff at the home.

The accommodation was furnished, decorated and maintained to a satisfactory standard. The home was very clean and there were no offensive odours. Health and safety standards were well maintained.

The medication system was well organised and operated effectively. There were satisfactory numbers of staff on duty. Staff training provision was to a satisfactory standard. The service had a suitable quality assurance system to ascertain the views of people and ensure good standards of care were maintained.

We spoke with four people who used the service about their view of living at Trezela. Most comments were positive and we were told “I like living here the staff are kind and helpful”, “I am safe and looked after here. I can talk to the staff and they listen to me” and “the staff are okay, some better than others, but they are all kind and I can talk to them”.

One person told us they did not want to live at Trezela as they would have preferred to live in their own home, but added they liked their room, which was personalised, warm and comfortable and that they felt safe at Trezela.

People who used the service were seen to make choices about what they did during the day. For example, we saw people chose to access community based activities, people chose whether to stay in their rooms or use the communal areas or whether to get up or stay in bed. We saw staff were polite and respectful during conversations with people. People who used the service freely approached staff during our inspection to request support or to spend time with them chatting.

People were safeguarded against abuse by the home’s policies, procedures and training for staff.

The home was clean and tidy on the day of our inspection and communal areas were decorated and furnished in a homely and comfortable style.

The home had a robust recruitment procedure that was consistently followed to ensure that people received care and support by staff who were suitable to work at the home.

We inspected Trezela House 14 and 15 January 2015, the inspection was announced the day before the visit, this was to ensure people would be present at the service on the day of inspection.

At the last inspection in November 2013 we did not identify any concerns.

Trezela House provides accommodation and personal care for up to eight people who have mental health needs. The home is privately owned. The home has a registered manager in place. 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 happy and relaxed on the day of the inspection. We saw people moving around the home as they wished, interacting with staff and relaxed and engaged in their daily activities. Staff were attentive and available and people had free access to all areas of the service.but did not restrain people or prevent them from going where they wished. We saw staff encouraged people to engage in meaningful activity and spoke with them in a friendly and respectful manner.

Care records were detailed and contained specific information to guide staff who were supporting people. Care profiles were developed in a format which was more meaningful for people. This meant staff were able to use them as communication tools. Risk assessments were in place for day to day events such as using a vehicle and one off activities. Where activities were done regularly risk assessments were included in people’s care documentation.

Relatives told us Trezela House was a caring environment and staff had a good understanding of people’s needs and preferences. We found staff were knowledgeable about the people they supported and spoke of them with affection.

The service adhered to the requirements of the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards which aimed to protect people’s rights to make decisions for themselves and to be respected to leave the service if they requested to do so and were not legally prevented from doing so.

People had access to a range of activities. These were arranged according to people’s individual interests and preferences. Staff recognised when people became bored with activities and helped them identify new interests.

Staff were well supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively. The staff team were supportive of each other and worked together to support people.

People knew how to raise concerns and make complaints. People told us concerns raised in the past had been dealt with promptly and satisfactorily.

Incidents and accidents were recorded. These records were reviewed regularly by all significant parties in order that trends were recognised. This helped staff to keep people safe at the service.

There was an open and supportive culture at Trezela House. Staff and relatives said the registered manager was approachable and available if they needed to discuss any concerns. All staff felt they were fully appreciated by the management and had an understanding of the day to day demands on them.