Tanglewood

Updated 5 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by a single inspector.

Service and service type

Tanglewood is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We contacted the local authority commissioning and safeguarding teams for their views about the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

People at the service were not able to communicate their views about the care they received. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with two care workers, the registered manager, the deputy manager, the maintenance person and a representative of the provider.

We looked at two people’s care records, three staff records and records related to the running of the service such as fire safety records, audits and meeting minutes.

After the inspection

We contacted six relatives of people using the service to ask for their views. We also contacted two health care professionals for feedback about the service. We continued to seek clarification from the provider to validate evidence found.

Updated 5 February 2020

About the service

Service type

Tanglewood is a residential care home providing accommodation and personal care, registered to support up to six people with learning disabilities and or autism. People using the service also had complex health needs and physical disabilities. There were six people using the service at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service

The service applied the principles and values of Registering the Right Support and other best practice guidance. For example, in the way it assessed people's needs and worked with people to identify individual goals that increased their confidence and independence.

People received highly personalised care that responded to changing needs, focused on their strengths, empowered them and gave them choices. This enhanced their quality of life. Staff were innovative and creative in the way they provided opportunities for stimulation and interaction. People had detailed personalised care plans in place which reflected their individual needs and preferences. Staff were creative in the way they communicated with people to understand their wishes.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Relatives told us they thought people were safe at the home and we observed people we relaxed in the presence of staff and each other. They were protected from the risk of abuse because staff understood the provider’s safeguarding and whistle blowing procedures, should they need to do use them.

There were enough staff working on each shift to meet people’s needs. Recruitment checks were completed before staff started to work. Staff received training and support to meet the needs of people at the home.

Staff knew how to report and record the details of any accidents or incidents which occurred at the home. The registered manager reviewed accident and incidents for learning and to reduce the risk of repeat occurrence.

Possible risks to people were identified and risk management plans detailed guidance for staff to follow to minimise possible risks. Medicines were safely stored, administered and administration was accurately recorded. Staff were aware of the action to take to reduce the risk of infection.

People were supported to maintain a balanced diet. Staff worked closely with a range of health professionals and ensure people had access to a range of healthcare services when needed. The home had been adapted to meet people’s needs.

Staff treated people with kindness and compassion. People were involved in making decisions about the support they received. Staff treated people with dignity and respected their privacy.

There was a system to monitor the quality and safety of the service and any learning identified was shared with staff. The registered manager sought people’s views on the service through regular meetings and an annual survey. They sought to make improvements based on feedback. The provider had a complaints procedure in place and people told us they knew how to complain. The expressed confidence that any issues they raised would be addressed to their satisfaction.

There was an open and inclusive culture at the home. Staff and the registered manager shared the aim of providing good quality person centred care. Staff spoke positively about the culture and management of the service. The home worked in partnership with health professionals, voluntary groups and the local authority.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (5 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.