CQC report explained · a residential care home
What the CQC found at Hawthorn House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, safe medicines management and systems for managing risks, accidents and infections. They recommended that the provider develop and implement a legionella risk assessment.
- Effective?
- Good
- Staff had relevant training, supervision and appraisals. People's food, drink and health needs were supported, and the rating improved from Requires Improvement at the last inspection.
- Caring?
- Good
- People and relatives described staff as kind and respectful. Staff supported privacy, dignity, independence and people's choices.
- Responsive?
- Good
- Care was personalised and plans recorded people's preferences and communication needs. People took part in activities and outings, and complaints were handled according to the provider's policy.
- Well-led?
- Good
- Inspectors found approachable leadership, regular checks and audits, and opportunities for people and staff to give feedback. The team leader managed the home day to day, supported by the registered manager.
What inspectors found, October 2019
Hawthorn House was rated Good; inspectors found safe, kind and personalised care, with improvements still needed to some risk records and legionella checks.
This was an unannounced inspection on 18 September 2019. Inspectors reviewed care records, medicines records, staff recruitment and training records, and how the home was managed. They spoke with people living there, relatives, staff and health professionals, and observed care.
The home provided personal care for five older people with mental health needs. Inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe, staff were kind, and their choices, health needs, food and activities were supported.
The report identified some areas to improve. The provider was advised to develop a legionella risk assessment. One epilepsy risk assessment needed updating, although this was corrected during the inspection. The overall rating stayed Good.
Protection from abuse
Staff knew how to identify and report abuse, including when to contact outside authorities. People told inspectors they felt safe.
“People were protected from the risk of abuse because staff had completed training and knew what action to take.” from the report
Kind and respectful care
People and relatives said staff were caring and kind. Staff respected privacy, dignity, independence and people's individual backgrounds.
“People and relatives told us staff were caring and kind.” from the report
Choice and nutrition
People were offered choices of food and drink, with snacks and drinks available during the day. Staff monitored people who were at risk of choking.
“People were supported to meet their nutritional and hydration needs. People told us they were happy about food and drinks provided and were given choice.” from the report
Personalised support
Care plans recorded people's preferences, likes, dislikes and communication needs. Staff knew people's histories and used this information to support them.
“People received personalised care and care plans were in the main person-centred.” from the report
Learning from incidents
The home monitored accidents and incidents, discussed outcomes at team meetings and used audits to identify learning and improvements.
“Accidents and incidents were monitored for trends and learning points.” from the report
Legionella risk assessment
needs fixingThe home carried out water checks, but inspectors recommended a formal risk assessment and advice from a reputable source.
“We recommend the provider seeks guidance and advice from a reputable source in relation to developing and implementing a legionella risk assessment.” from the report
Epilepsy information
needs fixingAn epilepsy risk assessment did not include the signs staff should look for. The team leader updated it and added a care plan during the inspection.
“Risks related to one person who had epilepsy were identified, however, the risk assessment required updating to include signs to look for.” from the report
Documenting preferred forms of address
minorOne person's preferred way of being addressed was not recorded in their care plan. Inspectors observed that the person responded positively to it.
“one person who was addressed by staff by their country of origin did not have this documented in their care plan.” from the report
- 01What legionella risk assessment is now in place, and how often is it reviewed?
- 02How do you make sure epilepsy care plans include the signs to look for and the correct action during a seizure?
- 03How are each person's preferred form of address, privacy and cultural needs recorded in their care plan?
- 04What activities and outings are currently available, and how are people involved in choosing them?
- 05How are relatives told about changes in a person's care needs?
This was a planned, unannounced inspection covering all five key questions; the report says both the premises and the care provided were looked at. This explanation was written from the published report of 23 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2017
Rated Good overall; inspectors found safe, kind care, but the service required improvement in effectiveness, including choking advice and staff training.
Inspectors visited unannounced on 5 December 2016. They spoke with four people and three staff, reviewed care records and other documents, and observed care in the home.
Overall, people were kept safe and treated with kindness and respect. Medicines were managed safely, staff understood safeguarding, and people were supported to attend healthcare appointments and maintain relationships.
The main shortfalls were under the Effective question. The home had not always sought specialist advice for people at risk of choking, and some staff training records were not up to date. Inspectors also recommended improving meaningful activities.
People felt safe
People told inspectors they felt safe and staff knew how to recognise and report possible abuse. Risk assessments covered issues including choking, falls and road safety.
“People were safe from harm because staff were aware of their responsibilities and able to report any concerns.” from the report
Safe medicines
Medicines were securely stored, records were maintained and people received medicines as prescribed. The records checked had no gaps.
“Medicines were well managed and people received their medicines as prescribed.” from the report
Approachable management
People and staff could approach the registered manager with concerns. The manager was described as hands-on and knowledgeable about people's needs.
“The registered manager demonstrated good leadership and management.” from the report
Choking advice
seriousThe home did not always seek advice from a speech and language therapist for people identified as being at risk of choking. This contributed to the Requires Improvement rating for Effective.
“The service did not seek healthcare professional advice from the speech and language therapist (SALT) in relation to people identified by them as being at risk of choking.” from the report
Out-of-date training records
needs fixingAlthough staff said they had completed eating and drinking and mental health training, records showed this had last been completed in 2013 and 2014. Inspectors said staff might not have been up to date with current guidance.
“Therefore staff may not be up to date with the latest guidance and practices in these areas to ensure that people received care from staff who were adequately trained.” from the report
Limited activities
needs fixingSome people said there was not enough to do and wanted activities such as gardening, visiting gardens or attending church. Inspectors recommended seeking guidance on meaningful activities.
“Therefore people's individual needs in relation to some activities may not have been met.” from the report
Staffing at busy times
minorThe staffing level on the inspection day met people's needs, but some staff said an extra staff member would sometimes allow more one-to-one time.
“However, staff felt that at times the service needed an additional staff member.” from the report
Food choice
minorSome people described the food as average, repetitive or often frozen, and said there were not enough choices. Records showed people were involved in weekly menu planning, but inspectors still identified food choice as an area needing improvement.
“Feedback and observations on the day of our inspection showed that people were not always happy with the food choices.” from the report
- 01What specialist advice has the home obtained for each person identified as being at risk of choking?
- 02When were staff last trained in eating and drinking support and mental health awareness?
- 03How are people's preferred activities, such as gardening or attending church, recorded and followed up?
- 04How many staff are normally on duty at different times, and how is extra one-to-one support provided when needed?
- 05How are residents involved in choosing meals, and what has changed about the range and freshness of food?
This was an unannounced inspection covering all five CQC questions, with observations, discussions and checks of care and management records. This explanation was written from the published report of 1 April 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Hawthorn House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 1 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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