The Hawthorns

Updated 9 April 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

The Hawthorns is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. A provider well-led inspection was carried out on 10 June 2019 and we used this information to plan the inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and eight relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, two operational managers from within the provider’s organisation and three support workers.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff recruitment files and training records. A variety of records relating to the management of the service, were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures and health and safety records. We spoke with two professionals who were involved with the service.

Updated 9 April 2020

The Hawthorns is a residential care home providing personal care for up to nine people who have a learning disability or autistic spectrum disorder. At the time of our inspection there were nine people living in the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Nine people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

The service was exceptionally well-led by a team who were committed to providing an exceptionally high standard of person-centred care. This was confirmed by relatives, healthcare and social care professionals and staff. The provider and management team promoted an open and honest ethos and learned from mistakes. Staff were very dedicated and motivated, they were well trained and there were effective systems to ensure staff remained competent in their role. Staff ensured people were at the heart of the service. The staff and management team were creative, committed and determined to support people to live independent lives and challenge the barriers around supporting people with learning disabilities and autism. People's views about the service were valued and there were effective procedures in place to continually monitor and improve the quality of service people received.

People received a service which was exceptionally responsive to their needs and preferences. The registered manager and staff were highly responsive and skilled at helping people achieve positive outcomes, building confidence, independence and helping develop life skills. Staff went above and beyond to ensure people's needs and lifestyle choices were respected. Technology developed by the provider was embedded in service delivery and supported staff to provide people with genuinely person-centred care. The running of the service centred around the experience of people as individuals and recognised the value of their expertise in how their own care should be delivered and they were fully involved in planning and reviewing the care and support they received. People's communication needs were assessed and understood by staff. People were provided with information in a format which met their needs. Relatives felt confident that any concerns would be taken seriously, and action would be taken to address them

The provider had systems in place to safeguard people from abuse. Staff were aware of each person's safety and how to minimise risks for them. Medicines were managed safely. Accidents and incidents were monitored to identify and address any patterns or trends to reduce the risk of reoccurrence. Systems were in place to recruit staff safely. People were supported with good nutrition and could access appropriate healthcare services.

People had personalised rooms. They 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 supported by staff who were kind, caring and treated them with dignity and respect. They were relaxed and happy in the company of staff and the registered manager. There was a system in place to respond to any concerns.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 4 January 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.