Tanglewood Care Home

Updated 18 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered persons were meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

Before the inspection, the registered persons completed a Provider Information Return (PIR). This is a form that asks them to give some key information about the service, what the service does well and improvements they plan to make. We also examined other information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about. We also invited feedback from the local authority who contributed to the cost of some of the people who lived in the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

We visited the service on 27 and 28 July 2017. The first day of the inspection was unannounced. The second day was announced so that we could complete all of the checks remaining from the first day. The inspection team consisted of an inspector, special professional advisor and an expert by experience. The special professional advisor was a registered nurse. An expert by experience is a person who has personal experience of using this type of service.

During the inspection visit we spoke with 18 people who lived in the service and with six relatives. We also spoke with two nurses, four care workers, the floor manager, two senior care workers, the laundry manager and two housekeepers. In addition, we spoke with both of the activities coordinators, the training manager, one of the directors of the company, the operations director and the registered manager. We also observed nursing and personal care that was provided in communal areas and looked at the nursing and personal care records for 10 people who lived in the service. In addition, we looked at records that related to how the service was managed including staffing, training and quality assurance.

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who were not able to speak with us.

After our inspection visits we spoke by telephone with another two relatives.

Updated 18 April 2018

We carried out this inspection on 27 and 28 July 2017. The first day of the inspection was unannounced. The second day was announced so that we could complete all of the checks remaining from the first day.

Tanglewood Care Home with Nursing can provide accommodation, nursing and personal care for 55 older people and younger adults. It can also provide care for people who live with dementia and/or who have a physical disability. There were 49 people living in the service at the time of our inspection nearly all of whom were older people. The accommodation was a modern two storey building. In the grounds of the main building there were four self-contained bungalows each of which could be occupied by one person.

The service was run by a company who was the registered provider. There was a registered manager in post. 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. In this report when we speak both about the company and the registered manager we refer to them as being, ‘the registered persons’.

Nurses and care staff knew how to respond to any concerns that might arise so that people were kept safe from abuse. People were helped to avoid preventable accidents and medicines were managed safely. There were enough care staff on duty. Most of the necessary background checks on new care staff had been completed in the right way.

Nurses and care staff had received training and guidance and they knew how to care for people in the right way. People enjoyed their meals and they were helped to eat and drink enough. Nurses and care staff had ensured that people received all of the healthcare they needed.

People were helped to make decisions for themselves. When people lacked mental capacity the registered persons had ensured that decisions were taken in people’s best interests. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had ensured that people only received lawful care.

Nurses and care staff were kind and people were treated with compassion and respect. People’s right to privacy was promoted and there were arrangements to help them to access independent lay advocacy services if necessary. Confidential information was kept private.

Although one part of a person’s nursing care had not been planned and recorded properly, in practice they had received all the nursing care they needed. Other people who lived in the service had also been provided with all of the assistance they needed and had agreed to receive. Nurses and care staff promoted positive outcomes for people who lived with dementia and people were supported to pursue their hobbies and interests. There were arrangements to quickly resolve complaints.