Tanglewood

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this newly registered service. This key question has been rated outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 had a very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The registered manager and wider organisation promoted a positive and inclusive culture which put people at the centre of their care. A relative commented, “There is an ethos that runs down from the top.” This meant people thrived in an environment where they were supported by staff with a positive ‘can do’ approach to care and support.
Tanglewood had been open for just over a year at the time of this assessment. Staff told us they had gelled together as a team and had a common aim; to ensure people were able to live fulfilling and rich lives. One commented, “The team here is very supportive of one another, we work together. Everyone genuinely gets on. It helps to create a happy home.” Throughout the assessment staff spoke about the need to listen to people and adjust their approach accordingly.
Relatives told us Green Light had invested time and resources into understanding people’s needs and any likely challenges. Before people had moved into the service behaviour analysts had worked with families and people to develop positive behaviour plans which would enable staff to form an understanding of people. A relative commented, “The behaviour analyst was spot on with their observation of [Name].”
 

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

Staff and relatives were positive about the leadership, both of Tanglewood and Green Light. Staff told us senior leaders, including the nominated individual, took an interest in services, people and staff. A member of staff told us, “They (leaders) know their individual staff, you are a person to them.” A relative described how they had been supported by the nominated individual when the organisation had been working with them to develop a service for their family member. They commented, “[Name] walked beside me from the minute I made the referral.”

Staff and relatives were also complimentary about the registered manager and deputy manager. They described their approach as ‘relaxed, but you know where the boundaries are.’ This was reflected in the atmosphere in the service. People and staff were observed to be at ease with each other. There was a sense of purpose with plans being actioned and staff occupied and pro-active but calm and cheerful. One member of staff told us, “[Registered manager] and [Deputy manager] are regularly on shift. Both very hands on.” This meant they were able to continually monitor the service and model organisational values.
The strong leadership had a positive impact on people’s experiences. Staff morale was high and people benefitted from consistent and confident support from staff who felt valued and were able to ask questions and voice any concerns.
 

The provider was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard.

Senior leaders and the registered manager promoted a culture where speaking up was encouraged and any concerns were immediately acted on. Suggestions made by staff about the delivery of support were explored and, where appropriate, trialled and put into practice. One member of staff told us, “'I raised a concern and it was acted on. [Registered manager] sent out a team message to all staff."

Relatives also told us they felt valued and listened to. One told us, “[Registered manager] stayed and spoke to me for an hour. There is a genuine interest in my perspective.”
The culture of openness and a willingness to take all views into account helped ensure any ideas for improvement were encouraged, listened to and acted upon. People benefitted from a service that was designed around them, flexible and adapted to changes in needs.
 

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us they were always treated fairly and the organisation was flexible when they had responsibilities outside of work. One member of staff told us, “I have had support to learn and develop, I can say if I can't do it. Everyone is ready to support me.” When staff had any specific circumstances which restricted who they could work with or the type of work they could do, individual risk assessments were completed.
Green Light subscribed to a health plan app which employees, and their dependents, could use for support with health care costs.
 

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There were excellent systems for monitoring and collecting data relating to risks and outcomes. Data was analysed regularly and behaviour analysts, the positive support team, the registered manager and staff at Tanglewood were able to respond quickly to any emerging patterns and trends. There was a strong emphasis on using data and experiences to drive improvements and improve outcomes for people. One member of staff told us, “It’s a very professional organisation.”

There were clear roles and responsibilities throughout the organisation. A Positive Behaviour Support (PBS) team included behaviour analysts who were able to accept referrals from services. In addition, Green Light had a physical intervention team who worked with services providing bespoke training and monitoring any restrictive practices. Staff told us this training had been relevant to their role and well delivered. Although they had rarely needed to implement it the training had given them confidence. This investment in expertise meant people received care that was focused on their individual needs putting them at the centre of their care.
 

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The service worked with other agencies in order to provide joined up care across services. Information was shared appropriately and in people’s best interest. An external professional commented, “I’ve found [Registered manager] to always be welcoming, approachable and willing to chat and facilitate my visits.”
 

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

When things did not go to plan the registered manager worked with staff to understand what could be done differently in the future. When describing occasions when things had not worked well, staff never spoke in negative terms but demonstrated a curiosity and a willingness to learn from the event.

Staff had opportunities to reflect on their practice in debrief meetings, supervisions and regular staff meetings. One member of staff commented, “[After an incident] we will have a debrief with managers, they will make sure we are OK, we can feedback about what happened and talk through it. It is very supportive.”

Key workers had monthly reviews with people which were used as an opportunity to reflect on the previous month, what had worked well for people and how this could be built on.
The organisation was committed to investing in their workforce. For example, there was a strong emphasis on the importance of training. Skilled practitioners had developed bespoke training for supporting an individual with specific physical needs, when they were distressed or anxious. Behaviour analysts worked with individuals and staff to try and understand what people were communicating and how staff could respond to them to improve outcomes.