Archived: Tanglewood

Tanglewood is a small residential service which provides accommodation and personal care for up to three people who have learning disabilities, some complex health care needs and some behaviours that can challenge. At the time of our inspection there were three people living there, who were also registered blind.

Accommodation is provided in a detached house. There are public transport links to local amenities and shops in the nearby town of Folkestone. Accommodation is arranged over the ground floor, with each person having their own bedroom. The service has large enclosed

gardens.

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. At the time of this inspection the service had a registered manager.

Staff followed correct and appropriate procedures in the storage and dispensing of medicines. People were supported in a safe environment and risks identified for people were managed in a way that enabled people to live as independent a life as possible. People were supported to maintain good health and attended appointments and check-ups. Health needs were kept under review and appropriate referrals were made when required.

A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were sufficient numbers of staff on duty to make sure people were safe and received the care and support that they needed.

Staff had completed induction training when they first started to work at the service. Staff were supported during their induction, monitored and assessed to check that they had the right skills and knowledge to be able to care for, support and meet people’s needs. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The registered manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the registered manager had applied for DoLS authorisations for people who were at risk of having their liberty restricted to help keep them safe.

The care and support needs of each person were complex, and each person’s care plan was personal to them. People had detailed care plans, risk assessments and guidance in place to help staff to support them in an individual way.

Staff encouraged people to be involved and feel included in their environment. People were offered activities and participated in social activities when they chose to do so. Staff knew people and their support needs well.

Staff were caring, kind and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff.

People were encouraged to eat and drink enough and were offered choices around their meals and hydration needs. Staff understood people’s likes and dislikes and dietary requirements and promoted people to eat a healthy diet.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. Action was taken to meet any improvements identified.

Staff told us that the service was well led and that they felt supported by the registered manager and provider. The registered manager had good management oversight and was able to assist us in all aspects of our inspection.

We found that Tanglewood was a family run service, and the owner and manager lived on the premises.

We spoke with one person who used the service, and they told us that they liked living in the home and told us about some of the activities they enjoyed doing there. We saw that staff supported and interacted effectively with people, providing reassurance, and in accordance with their individual communication needs.

We looked at three people's care plans and saw that they were individualised and contained people's choices and preferences about how they liked to be supported. Risk assessments were in place to identify and minimise risks as far as possible to people who used the service.

We found that people were safe, that the provider had taken steps to help protect people from the risks of abuse, and that staff had received appropriate training to recognise when people might be at risk.

We found that there were sufficient staff on duty, who were suitably trained and skilled and were able to support people according to their individual needs. One member of staff told us 'the owners are very good; they step in and support us when needed'.

We found that the service kept accurate records and stored them safely and appropriately, to ensure people's details and information was protected.

We saw that this was a family run service from the owner's and manager's own home.

We spoke with one person living at the home. They told us about their favourite activities and that they liked living at the home. People appeared happy and content and we saw staff interacting with people, talking and reassuring people who were partially sighted and had complex communication needs.

We found that there were care plans, and health details in place for all people that used the service. We saw that complex needs and health issues were addressed appropriately.

Records showed that there were sufficient staff to ensure people's needs were met and that they had been properly recruited and trained. We found that the service monitored quality of care in an ongoing way.