Tanglewood Mews

Updated 8 April 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Tanglewood Mews is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 did not have a manager registered with the Care Quality Commission. A new manager started in the service during the inspection and applied to be registered. The provider is legally responsible for how the service is run and for the quality and safety of the care provided. Once a manager is registered, they have legal responsibility alongside the provider.

This inspection was unannounced.

We visited the home on 26 January 2021 and continued to collect evidence towards the inspection until 11 March 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service. Some people who used the service were not able to verbally communicate with us in detail, but we observed how they interacted with staff. We spoke with three members of staff including the manager and deputy manager. We looked at multiple medicine’s records and records around people’s daily care. We also looked at records in relation to infection prevention and control.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke via telephone with a professional who regularly visits the service and four relatives about their experience of the care provided. We also spoke with three care staff, the new manager and area manager. We looked at training data and quality assurance records. This included two people’s care records. We looked at two staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.

Updated 8 April 2021

About the service

Tanglewood Mews is a care home providing accommodation and personal care for up to seven people with physical and/or learning disabilities. Care is provided in a purpose-built house over two floors. At the time of inspection there were five people living at the home. The service also provides personal care to people living in supported living. There were 14 people receiving personal care at the time of our inspection.

People’s experience of using this service and what we found

There were some omissions and inconsistencies that the provider’s auditing system had not identified. We found that some records required a review to ensure they reflected people’s current needs and guidance.

We have made a recommendation about the provider improving auditing processes.

When we visited the service, the registered manager was no longer in post and the home was being managed by an interim manager. During the inspection a permanent manager was appointed and applied to be registered with the Care Quality Commission.

People who used the service, relatives, staff and professionals told us they felt management were approachable and knowledgeable about the service. Most staff told us there had been recent improvements in the service. Some staff told us, however, that they did not always feel involved in the running of the service and were not asked for their views on how it could develop.

We observed staff following infection prevention and control guidance including wearing appropriate personal protective equipment. The environment was clean, and the management made checks of safety and cleanliness. The service was maintained to a good standard and people’s rooms/apartments were personalised. Where people had complex needs the service was working to make the environment as safe and suitable as possible.

There were arrangements in place to ensure people received their medicines safely and when required. Staff undertook training in the safe management of medicines and regularly had their competencies assessed to ensure they were following the correct practices.

There were enough staff to meet people’s care needs. The service followed safe recruitment practices.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

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 (published 27 September 2019).

Why we inspected

The inspection was prompted in part due to concerns received about management support, infection prevention and control and staffing levels. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

The overall rating for the service has remained at Good at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Well-Led section of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Tanglewood Mews.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.