Trafford Waters Care Home Also known as Tanglewood Shared Services Limited

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to person centred care.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We received mostly positive feedback from people and their families about staff conduct. People told us staff were kind and caring, ‘Yes, they are, they check [relative] is all right and if [relative] needs anything, [relative] feels valued and looked after” and “[Relative] said after a week in hospital it felt like coming home to people who care for [relative].”

We received mostly positive feedback from visiting professionals about their experience of the staff team. They told us, “When I’ve visited the care home, there has been a warm and welcoming atmosphere. Staff are friendly and make time to engage with residents as well as professionals. The individual I support has told me they feel well supported by staff and have built positive relationships with most of them, which is important.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

Information was captured about individual characteristics during the preadmission assessment. This included information about people’s religion or culture for example.

However, more work was required in this area to improve staff knowledge of individual residents. An ‘About Me’ document was completed on admission and provided basic information, but we could not see if these had been reviewed. The information recorded was mainly about people’s specific care needs and did not capture enough information about their wider lives including their likes and dislikes.

Inconsistent staffing and high staff turnover also impacted on the quality of the relationships between people and staff. Families told us, “There is a high turnover, they [staff] are nice...there are issues with training and lack of experience” and “They could spend more time getting to know [relative] and what they like…the primary cause is too much staff turnover.”

The provider used, ‘Life Library’, to support and promote a fuller picture of each person’s lives. Life Library is an interactive, collaborative life story app that saves stories, memories and interests and can help to improve communication between people, families and staff in a care home setting. Staff and families were not all aware of the app when we spoke to them.

The provider did not always promote people’s independence. Activities provision was inconsistent and there was a lack of choice available to people.

The environment was adapted to meet people’s needs and there was a range of appropriate equipment to support and maximise people’s independence. This included walk-in showers, handrails and ramps, for example. However, we did receive some concerns from families about the availability of sensor mats used to help prevent falls.

It was not clear if people had enough choice, structure and routine to have a fulfilled life. We observed very few activities for the residents during our 4 onsite visits. People often looked bored and staffengagement was very task focused. One activities coordinator was absent during the assessment and a second was currently being recruited. We requested evidence of additional hours being provided to support other staff to provide activities in their absence, but none were provided. People were not engaged in meaningful hobbies and interests in a personalised way during the assessment. The registered manager showed us a folder with photos of residents being taken on day trips on a minibus. No other evidence of activities was provided.

Staff told us, “The residents get bored very easily. The activities are colouring in, hair, nails. There needs to be a better range. Those with capacity are bored by the activities. One resident watched Mamma Mia four times on the TV today. There are no iPads for one-to-one activity for example. It is a lovely place in terms of space and the environment. Some residents want to go out but there is no staff to supervise. These people have capacity and want to go out. There is not enough staff. Why not ask them in advance and book the staff? People who have capacity feel restricted” and “There are regular activities usually, there is no activities person currently.” We were also told the activities coordinators went through a period where they were working as carers as there was not enough staff in the home.

Families told us, “Activities started off okay at Christmas, there was lots going on. [Relative] was getting involved. It has tailed off. It is now colouring at the dining table for example. Sometimes there are films. There have been two trips since our [relative] has been here. They went to a café last week, but it was shut so they went to sale water park instead” and “When we joined there was a life library, but it had gone now…they know she likes the garden and flowers, I am hoping they will get her into the garden.”

Staff did not always respond to people’s needs in the moment or act quickly enough to minimise any discomfort, concern or distress.

A high number of families and staff expressed concerns about staffing levels and the impact this had on the ability of staff to respond appropriately to people’s needs. They told us, “I was always told there would be staff in the common room, but I have been there on numerous occasions when there is no staff in the common rooms for minutes at a time. People are a falls risk” and “It is a common experience for us to witness the lounge unstaffed. Sometimes we feel we need to intervene when there are no staff. Family pass the frames to people for example.”

Inspectors observed periods where communal areas were not supervised and staff were not available to respond to people’s needs. A high proportion of staff we spoke with told us there were not enough staff. They told us, “I've been left on my own with 12 residents. I would expect another carer at least. Management told me they were short staffed. We're constantly getting calls/text messages asking for cover. The receptionist does this. The last time they did this was yesterday, I was already on shift. These are group messages sent to everybody.”

Staff did not always know people well enough to respond in the most appropriate way to respect their wishes, needs and preferences. For one person, we found their care plan contained inaccurate information and required updating. This took several weeks to address and may have had a negative impact, as the person was receiving inappropriate responses from staff. During the assessment, we observed the person becoming irritated, which indicated their needs were not being consistently met.

Call bell response times were reviewed on a weekly basis, and the available data did not highlight any concerns. The response times were mostly within the parameters set by the provider.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Many of the staff we spoke with were unhappy and did not feel valued. They felt unsupported and this was impacting on their wellbeing. There had been some recent improvements noted by staff although they felt further improvement was still needed. They told us, “It is poor, it is draining on the staff, I know 3 staff who are looking to leave, we do not feel supported” and “This was stressful. We weren’t asked if we were okay, we didn’t get breaks. We are being asked now, and we are getting our breaks. The seniors do a 12-hour shift, but they are too busy to support you.”

We were told both staff turnover and sickness levels were high. Staff also told us there were no consequences if staff repeatedly called in sick.

The provider had some initiatives in place such as employee of the month and ‘attend to spend’ but some staff said this was not consistent and the overall culture was poor.