Tanglewood

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Pre-admission assessments were completed before people moved into Tanglewood. Relatives told us these had been thorough and completed over a period of time. This gave the person time to get to know the service and staff, so everyone involved could be assured Tanglewood would be suitable for them and provide them with a good life. One relative had written a blog about their experience. In it they stated, ‘[Name’s] transition was very carefully planned and took place slowly over many months, always at [pronoun’s] pace. To begin with, a small number of [pronoun’s] support team came to work with us in our own home. This gentle approach allowed [Name], and all of us as a family, to get to know [pronoun’s] carers in the comfort and safety of familiar surroundings. Trust and relationships were able to grow naturally, and there was a real sense of continuity and consistency in how [Name] was being supported.’
Due to circumstances, another person had needed to move into Tanglewood with less preparation. This meant they were at risk of staff not knowing them well and not being able to fully meet their needs. To ensure this did not happen, the provider arranged for staff from their previous home to work alongside staff at Tanglewood for a period of time. This meant the person was supported well by staff who knew them and Tanglewood staff could develop their knowledge and skills to effectively support them. Since the move the person’s confidence had grown and they were living a more enriched life with a wider range of opportunities.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Green Light was committed to delivering care in line with good practice. A Positive Behaviour Support team and behaviour analyst was available for additional support if needed.
Staff at Tanglewood worked consistently in line with the principles of Right support, right care, right culture. People were able to take part in activities they were interested in and were encouraged to try new experiences. Choice and control underpinned the staff approach to providing care and support in line with people’s preferences.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us they worked together well and had a shared approach and values. One member of staff told us, “We all want to make sure everyone gets to go out. We start the day focusing on getting the tasks done so we can get on with the day.”
The service worked with other agencies to help ensure people got consistent care.
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were encouraged to eat a healthy and varied diet. Their preferences and habits relating to food and drink were known and respected.
Everyone took part in regular exercise. An external professional commented, “The team there seem proactive in supporting them to get out and about, try new things and do activities that are meaningful to them.” One person had specialised equipment which staff supported them to use regularly. This helped them to them improve their posture which positively impacted on their health generally.
 

The provider always monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

One person had previously been living somewhere where the environment had not met their needs leading to them becoming isolated and anxious. Tanglewood had been identified as a more suitable home for them. Following the move the person had become more confident and was able to go out, visiting family and regularly exploring the local area. Their life had been transformed by the move. Although there were still some things that caused them anxiety, the registered manager and staff were working with the person to overcome these. A member of staff commented. “It has been a whole new lease of life for [pronoun]. There are still some things they struggle with, but we are getting there, at [Name’s] pace.”

Incident forms and ABC records were used to capture when people might be demonstrating they were unsettled or unhappy. These were analysed to help staff understand what might be going wrong and how they could better support people. One person’s records showed they had become unsettled when other people had moved into Tanglewood. Staff had worked with the person encouraging them to develop social skills and interact more positively with their housemates. Subsequently there had been a decrease in their distress and incidents. Staff told us the person would now greet people unprompted and had even offered to make them drinks.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People had control over their day to day lives, making choices about how they spent their time, what they ate and when, and their environment. For example, on our second visit to Tanglewood, staff told us one person had been ‘out of sorts’ and had chosen not to go out during the day. They had since agreed to go for a drive in the evening and take a flask of tea to a local beach. Staff had prepared a meal which could be reheated so the person could decide if they wanted to eat before their drive or later. We observed staff asking the person what they wanted to do and checking they were still happy with the arrangements. This was done gently without putting the person under any pressure.
Staff used agreed communication techniques to help people express their wishes. These were highly personalised and we saw staff switch between communication styles according to who they were talking with.