CQC report explained · a nursing home
What the CQC found at The Hawthorns
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staff assessed risks, recruited safely, managed medicines safely and had enough staff to support people.
- Effective?
- Good
- People's care needs were assessed and staff had appropriate training and support. Staff worked with health professionals, supported nutrition and followed the principles of the Mental Capacity Act.
- Caring?
- Outstanding
- Inspectors found an exceptionally strong person-centred culture. Staff treated people with kindness, respect and compassion, while supporting independence, relationships, equality and personal goals.
- Responsive?
- Outstanding
- Care was tailored to people's preferences, needs and aspirations. People had a wide range of personalised therapeutic and social activities, including opportunities to take part in the local community.
- Well-led?
- Good
- The management team was visible and supportive, with effective audits and quality checks. Staff, families and professionals described good communication and strong partnership working.
What inspectors found, February 2023
Rated Outstanding; inspectors found exceptionally caring and personalised support, with safe, effective and well-led care.
This was an unannounced inspection on 27 and 30 September 2022. Two inspectors spoke with people, relatives, staff and professionals. They reviewed care records, medicines records, recruitment files, training records, complaints and other documents.
The home was rated Outstanding overall. Caring and Responsive were Outstanding. Safe, Effective and Well-led were Good. Inspectors found highly personalised care, kind staff, strong activities, good links with health professionals and safe medicines management.
The previous rating was Requires Improvement, published in May 2020, and there had been breaches of regulations. Inspectors found that improvements had been made and the home was no longer in breach of regulations.
Kind and respectful care
Staff were described as compassionate, approachable and deeply committed to people's quality of life. Inspectors saw positive interactions and a welcoming atmosphere.
“The genuinely welcoming and inclusive conduct of staff meant people felt relaxed and respected.” from the report
Personalised support
Care plans recorded people's routines, choices, health needs and goals. Staff helped people make decisions and supported them to become more independent.
“Staff provided an exceptionally personalised service for individual people that met their specific preferences and wishes.” from the report
Activities and community links
People had many activities matched to their interests and goals. The home also supported people to take part in charitable and community projects.
“The Hawthorns has extremely strong links with the local community, due to their passion and dedication they have built-up long-standing relationships with members of the public” from the report
Safe medicines and staffing
Medicines were checked and stored safely, and staff had medicine training and regular competency checks. Inspectors also found there were enough staff and recruitment checks were effective.
“People received their medicines safely and on time and their health was well managed.” from the report
Improved management
The home had improved since the previous inspection. Its audits, care records and systems for monitoring quality were found to be effective.
“Enough improvement had been made since the last inspection, so the provider is no longer in breach of regulation 17.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you meet my relative's particular nursing, rehabilitation or dementia-related needs?
- 02How are medicines checked and how are staff's medicine skills assessed?
- 03What activities and community opportunities could my relative take part in based on their interests and goals?
- 04How would you support my relative to make their own choices and remain as independent as possible?
- 05How would you keep our family involved in care planning and respond if we raised a concern?
This unannounced inspection looked at all five key questions and included infection prevention and control measures; it found that improvements had been made since the previous Requires Improvement inspection. This explanation was written from the published report of 2 February 2023 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, May 2020
Rated Requires Improvement; inspectors found kind, responsive care but gaps in safety records, staff competency checks and management oversight.
This was an unannounced planned re-inspection on 27 January, 29 January and 6 February 2020. Inspectors spoke with people, relatives and staff, and checked care records, medicines records and other management records.
People generally said they felt safe and were happy with the home. Staff were described as kind and respectful. The home provided activities, supported independence and helped people access health care and the community.
Inspectors found important shortfalls, mainly on one of the five units. Equipment checks, emergency evacuation plans, care plans, oral care records and training competency records were not always complete or properly monitored. The overall rating was Requires Improvement, with Caring and Responsive rated Good.
The home breached Regulation 17 on good governance. A warning notice was issued. The registered manager took immediate action on some issues, including rewriting evacuation plans and checking vital equipment, but CQC said it would continue monitoring the home.
Kind and respectful staff
People and relatives described staff as kind, respectful and supportive. Staff knew people well and encouraged independence.
“People and relatives told us staff were very kind and always spoke to them in a respectful way.” from the report
Activities and community links
People had varied activities for their emotional, physical and social needs. The home also supported people to access the community and worked with local organisations.
“People had a range of activities to support their emotional, physical and social needs.” from the report
People involved in their care
People and relatives were involved in care discussions. Staff supported people to express their views and used advocacy services when needed.
“People and relatives were involved in discussions about people's care and support needs.” from the report
Medicines and staffing
Inspectors found systems for medicine storage and administration, and said enough staff were deployed to meet people's needs.
“Enough staff were deployed to meet the needs of people.” from the report
Incomplete safety records
seriousOn one unit, daily and weekly checks of vital equipment and other essential support were not regularly recorded. One person's equipment checks had not been recorded for eight days.
“Records relating to the daily and weekly monitoring of vital equipment had not been regularly completed.” from the report
Weak management oversight
seriousThe home's audits and governance systems did not identify important gaps in records, care plans and emergency evacuation plans. This led to a breach of Regulation 17.
“Governance systems were not always effective. The issues we identified on the unit had not been recognised.” from the report
Training competency gaps
seriousThe home could not always show which staff had completed specialist competency checks. Some staff supporting people with PEG feeding did not have the appropriate training.
“Competency reviews of specialist training was not effectively monitored.” from the report
Gaps in oral care records
needs fixingOral care plans lacked detail, some records had gaps and inspectors could not establish that required mouth care had taken place.
“Some people needed to receive mouth care twice a day, records had gaps and we could not establish that this care had taken place.” from the report
Care plans varied
needs fixingSome care plans lacked clear instructions about staying safe during bathing and moving and handling, and what staff should do when a person's condition changed.
“Care plans on one unit lacked detail on how to assist people to remain safe during bathing and moving and handling.” from the report
- 01What checks are now in place to make sure vital equipment is inspected and recorded every day and week?
- 02How do you confirm that all staff supporting people with PEG feeding have the correct training and competency sign-off?
- 03How have personal emergency evacuation plans been rewritten for people who use specialist equipment?
- 04How do you now check that mouth care is provided as planned and recorded correctly?
- 05What is being done to make care plans on every unit consistent and clear about changes in people's needs?
This was an unannounced planned re-inspection that assessed all five CQC questions; the report says the main issues found were on one of the home's five units. This explanation was written from the published report of 15 May 2020 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 The Hawthorns
3 rated inspections over 7 years: the service has improved, from Good to Outstanding.
- February 2023Outstandingcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good
- May 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
47 live-in carers within about an hour of County Durham
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.