Tanglewood Care Home Service Carlisle Road Abington Biggar ML12 6SD Telephone: 01864 502152 Type of inspection: Unannounced Inspection completed on: 7 April 2017 Service provided by: Partners In Care Ltd Service provider number: SP2007008923 Care service number: CS2007144754
About the service This service has been registered since 2007. Tanglewood (operated by 'Partners in Care') offers a care home service for up to three children and young people. There were two service users at the time of this inspection and we met with both of them. In their 'Statement of Purpose' the service states: "The young people referred to Tanglewood usually display a number of anti social behaviours and/or emotional difficulties. The home can offer planned and emergency placements which can be considered dependent upon the needs of the young person referred and the compatibility and needs of the resident group." Placements can be short, medium or long-term. What people told us Both of the young people were very positive about the care they received at Tanglewood. Self assessment Self Assessment was up to date in 2016. No self assessment required in this inspection year. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good not assessed not assessed What the service does well The service has cared for four young people in the last 12 months and we heard of good outcomes for all of them. Those young people who have moved on in this time have kept in contact with the service. Where young people were previously reported as being vulnerable or at risk the service has been able to achieve good outcomes around their safety and emotional well being. The young people have reported that they have all felt well cared for in Tanglewood. We found that all young people experience nurturing care at Tanglewood and we also heard of; positive achievements in relation to education; becoming more active; and young people being properly included in their care. page 2 of 7
We identified the following key strengths which contributed to these positive outcomes: The relationships between staff and young people - we observed a genuine warmth between young people and the consistent carers we saw during the inspection. We also heard from all young people that these relationships were key to their care and wellbeing. The 1:1 ratio of staff enables strong bonds to be created and this in turn ensures that young people experience nurturing care. The care planning processes - The service has well-developed processes for planning care in partnership with the young people, their families and others. This ensures that work with young people is purposeful and in the context of an agreed plan of care. Systems and processes are child focussed and this ensures that young people are very involved both in their own individual care plans but also in day to day functioning of the house. The on-going commitment of core staff - Issues in relation to the retention of staff have meant that the role of a small number of staff is key to the continuing positive outcomes for young people. The staff who have been ever present in the service are skilled in their work and are genuinely committed to the service. Their motivation and commitment is admirable but we have a concern about how sustainable this position is - see 'what the service could do better' below. In this inspection we also noted the efforts of the service to address issues raised at the last inspection e.g. debriefing following incidents, induction processes for staff, appraisals for staff. What the service could do better We found the following significant area for improvement which gave us some cause for concern during this inspection as regards the ability of the service to sustain the positive outcomes they achieve for young people. The retention of staff - At the last inspection this was discussed and there was a recognition of the challenges to recruiting and retaining staff. The service outlined its plans to improve in this area. It is clear that this plan has not effectively reversed the trend. We heard from young people and staff that the increasing strain on key staff was a concern for both and it was clear that the sustainability of current staffing arrangements was questionable. We would particularly highlight the views of young people and their perceptions that: staff were working 'too hard'; that they had developed good relationships with staff who had subsequently left; and they were concerned that existing staff would go the same way. This lack of stability within the staff group is likely to effect the quality of care and will inevitably have an impact on the outcomes we have identified above. It will also have an impact on the integrity of the 'trauma pathways' approach of the service. Retention of staff has been a recurring problem for this service and we would urge the provider to make further steps to address this issue. This must include a clear effort to gather the views of all staff and to develop a coherent story for the failure to retain staff and a strategy to target the issues identified. Recommendation 1 page 3 of 7
In addition to this finding we would also highlight another issue which needs to be addressed by the service: Registration of staff - during the inspection we found that one member of staff had been employed in the service after their registration with the SSSC had lapsed. We have asked the service to ensure its auditing processes are adequately implemented to avoid a repeat of this in the future. With the difficulties in recruitment and retention of staff the service has not been able to progress on a recommendation made at the last inspection around involving staff in service development. We have continued this recommendation. Recommendation 2 Requirements Number of requirements: 0 Recommendations Number of recommendations: 2 1. To ensure that young people continue to experience stable, consistent nurturing care the service must ensure that the retention of staff is prioritised; evaluating what it does now and developing a clear and coherent strategy for making any necessary improvements. National Care Standards - Management and - Standard 7(9) 2. The provider should ensure that staff have the opportunity to contribute as appropriate to the evaluation of the service. National Care Standards, Management and - Standard 7.9 Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. page 4 of 7
Inspection and grading history Date Type Gradings 21 Apr 2016 Unannounced Care and support Management and leadership 6 May 2015 Unannounced Care and support Management and leadership 11 Jun 2014 Unannounced Care and support Management and leadership 26 Jun 2013 Unannounced Care and support Management and leadership 4 Mar 2013 Unannounced Care and support Management and leadership 25 Nov 2010 Unannounced Care and support Not assessed Not assessed Management and leadership Not assessed 31 May 2010 Announced Care and support Management and leadership 3 - Adequate page 5 of 7
Date Type Gradings 2 Feb 2010 Unannounced Care and support Not assessed Management and leadership Not assessed 5 Oct 2009 Announced Care and support Management and leadership 10 Feb 2009 Unannounced Care and support Management and leadership 3 Nov 2008 Announced Care and support 3 - Adequate Management and leadership 3 - Adequate page 6 of 7
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 7 of 7