We carried out a review of the data available to us about Hawthorn House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hawthorn House, you can give feedback on this service.
Hawthorn House is a residential care home providing accommodation with personal care to five people with mental health needs aged 60 and over in one adapted building. At the time of the inspection there were five people using the service.
People’s experience of using this service and what we found
Safety checks were carried out to ensure the building was safe and suitable for people who used the service. We have made a recommendation related to legionella testing.
People were protected from the risk of abuse because staff knew how to identify and report any concerns. Risks to people were assessed and managed to reduce the risk of avoidable harm. People were supported to take their medicines safely. There were enough staff available to meet people’s needs. Care staff were recruited safely. Records showed pre-employment checks had been carried out to make sure new care staff were of good character to care for people.
Processes were in place to report, monitor and learn from accidents and incidents. Guidelines were in place for care staff on reporting incidents and accidents and staff were clear about their role in reporting these.
People were protected from the risk of infections because staff followed good infection control practices; policies and procedures supported this.
Medicines were being managed safely at the home. Care staff had received medicines training, so they were competent to administer medicines.
People were supported by staff who received regular training and support to effectively carry out their role.
People’s nutritional and hydration needs were met. They told us they were given food and drink of their choice.
People’s health needs were met because the service worked closely with other health care professionals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were looked after by staff who respected their privacy and dignity. We noted that confidential information about people were kept securely in a locked cupboard accessed by staff.
People were supported by staff who understood their needs and how they wanted to be supported.
People knew how to make a complaint. People and relatives were aware of the complaints procedure. Quality assurance process were in place to develop/improve the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 29 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Prior to this inspection this service was inspected on 18 June 2014 where all standards inspected were met.
Hawthorn House is registered to provide accommodation with personal care to six people. The client group consist of people with mental health needs and learning disabilities. At the time of our inspection there were five people using the service. The home is located in a residential area of Tottenham.
There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staffing levels were allocated based on people’s level of need and planned activities. People’s needs were assessed and care plans created for each person using the service. We observed good interactions between staff and people using the service and people were treated with respect.
Staff understood their role and responsibilities in keeping people safe from harm and knew how to raise any concerns. Assessments were undertaken to assess any risks to the people using the service and the staff supporting them. Risks were assessed and plans put in place to keep people safe.
The service followed safe recruitment practices and carried out appropriate checks before staff started supporting people.
Care staff received supervision and a yearly appraisal. These processes gave staff an opportunity to discuss their performance and identify any further training they required. Care staff placed a high value on their supervision and support.
People received a service that was caring. They were cared for and supported by staff who knew them well. Staff understood the importance of treating people with dignity and respect. Although some people told us that staff did not always knock before entering their rooms. People were supported to maintain relationships with family and friends.
Staff supported people to take their medicines when required and attend healthcare appointments and liaised with their GP and other healthcare professionals. Although staff we spoke with told us that they had received training in assisting people with eating and drinking and knew how to assist people at risk of choking. 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.
The service had a complaints policy. This included timeframes for dealing with complaints and provided external contact details. People told us that they knew how to make a complaint and felt comfortable approaching the registered manager with any concerns.
We have made a recommendation about engaging people in meaningful activities.
As part of this inspection we spoke with two people who use the service, a relative, the registered manager, a director, two care staff. We also reviewed records relating to the management of the home which included, three care plans and risk assessments.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People were protected from the risk of unsafe premises because the provider had maintained the building. One person we spoke with told us they felt safe living at the home.
Is the service effective?
People told us they were happy with the care they received and felt their needs had been met. Staff we spoke with understood people's needs. A relative told us that they were involved in their relatives care.
Is the service caring?
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One person told us that staff were, 'very kind.' A relative told us that some staff were caring and others focused on the task.'
Is the service responsive?
We saw that the service had a complaint procedure and staff were aware of this should people wish to make a complaint. One person we spoke with told us that they were able to approach staff if they had any concerns.
Is the service well-led?
Staff we spoke with showed that they understood the needs of individual people they cared for. People were cared for by staff who understood their needs.
There were systems in place for monitoring the quality of the service and people were asked their views of the service and we saw that this was acted on.
We spoke to all five people who used the service and they all said positive things about the home. All said the staff were kind to them and three singled out three different members of staff for praise. People told us they liked the activities on offer and one person told us they were 'never bored.'
A visiting care co-ordinator said they had no concerns about the home and when asked about the quality of the food they said, 'they [the provider] supply vegetables and salad. There are three square meals [a day] and they give a choice.'
Records were up-to-date and comprehensive and there were handovers between each shift.
Relatives of the people who live at Hawthorn House said that they felt involved by staff when it was appropriate.
We found that premises were clean and the environment was looking homely.
Medication was given by people who were trained and aware of the standard medication administration procedures. People were consulted on whether they needed staff's support with taking medication and this was recorded.
Staff were supported and able to meet peoples' needs. Two people told us that they liked staff. Relatives told us that they found staff supportive. One relative told us 'they do as much as possible to support independence' another said that they 'smile and look happy'.
We did however find that that the home has not had a registered manager for over 18 months which could potentially affect the operation of the home and the care and support received by people living in the service.
You can see our judgements on the front page of this report.
This person also said that she had a care plan but did not want a copy of it.
Two people said staff were kind to them and treated them well. One said, "Staff are good here. They treat me right, they help me with everything and I like it." One person said she didn't like the food. Another said, "I love it, I eat everything."