We carried out a review of the data available to us about The Hawthorns 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 The Hawthorns, you can give feedback on this service.
The Hawthorns is a residential care home providing nursing and personal care to up to 105 people. The service provides support to people with a range of needs including neurological rehabilitation, general nursing and some living with a dementia. At the time of inspection 84 people were using the service.
People’s experience of using this service
People who lived at the service received extremely high-quality, personalised support from a well-led service. Feedback received from people, relatives, staff and professionals about the support provided to people was extremely positive.
People were fully integrated into the local community. People had access to an abundance of activities which enhanced their wellbeing and sense of purpose. The staff were extremely passionate and continuously looked for new activities or events for people to be part of to minimise social isolation.
Staff were fully committed to providing a truly person-centred service. Staff were very proud to work for the service and said they felt supported by the whole management team. People said staff were undoubtedly caring and knew their needs very well. People were treated with the utmost respect by compassionate and kind staff.
There was an exceptionally strong and visible person-centred culture. The genuinely welcoming and inclusive conduct of staff meant people felt relaxed and respected.
Staff demonstrated effective skills in communication. Recruitment checks were in place to ensure staff were suitable to work at the service. Staff had received training and support to enable them to carry out their role.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
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 as well as leading on numerous charitable initiatives.
Staff were committed to improving people’s quality of life and promoting their independence through rehabilitation.
Staff provided an abundance of therapeutic and social activities for people that were tailored to their own preferences and aspirational goals.
People received their medicines safely and on time and their health was well managed. Staff had positive links with health care professionals which promoted people's wellbeing.
The registered manager provided strong leadership and proactively considered how they could enhance the service. There was a positive staff culture and staff were empowered to achieve the best outcomes for people through adopting a supportive teamwork approach to their work. Complaints procedures were in place, but people told us they have never needed to raise a complaint.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 15 May 2020) and there were breaches of regulations.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.
The Hawthorns is a care home providing both nursing and personal care to people. The service accommodates up to 105 people with a range of needs including neurological rehabilitation, general nursing and some living with a dementia. At the time of inspection 83 people were living at the service.
People’s experience of using this service and what we found
The service had five units each with its own head of unit reporting to the registered manager. Out of the five units we only found issues on one unit. Records relating to the daily and weekly monitoring of vital equipment had not been regularly completed. Some important documentation did not form part of an audit and nursing staff responsible for the recording of the information had not alerted the management team of the lack of its completion.
Governance systems were not always effective. The issues we identified on the unit had not been recognised. Competencies of training had not been monitored effectively. The registered manager immediately addressed the issues we identified and ensured people were safe.
People told us they were happy at the service. Medicines were managed safely. Enough staff were deployed to meet people’s needs.
People and relatives told us staff were kind and caring and promoted independence. People received care from staff who knew them well.
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.
Care and support plans varied. The majority of care plans were personalised and had input from people and their relatives. Care plans to support people with a specific support need lacked information around situations where staff were needed to take immediate action.
People had a range of activities to support their emotional, physical and social needs.
People, relatives and staff were regularly asked for feedback, this information was used to make improvements.
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 21 June 2016). There was an inspection on 17-18 October 2018 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.
Why we inspected
This is a planned re-inspection because of the issue highlighted above.
Enforcement
We have identified a breach in relation to the failure to keep accurate and complete records and to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.
The Hawthorns was last inspected by CQC on 3 February 2014 and was compliant with the regulations in force at the time.
The Hawthorns is located in a residential setting in Peterlee in County Durham. It provides accommodation with personal care for up to 98 people within three different categories of care, neurological rehabilitation (34 beds), dementia care (Seaham House, 27 beds) and general nursing (37 beds). On the day of our inspection there were 94 people using the service.
We saw that entry to the premises was controlled by key-pad entry but was generally open during the day. All visitors were required to sign in. This meant the provider had appropriate security measures in place to ensure the safety of the people who used the service.
The home comprised of 98 bedrooms, the majority of which had en-suite bathrooms. Facilities included several lounges and dining rooms, communal bathrooms, shower rooms and toilets, a hairdressing room, sensory room, treatment room, a gym and several communal gardens. The general reception was large and spacious with a comfortable seated area which provided people who used the service and visitors with tea/coffee facilities and a computer with internet access.
People who used the service and their relatives were complimentary about the standard of care at The Hawthorns. We saw staff supporting and helping to maintain people’s independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.
The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty in order to meet the needs of people using the service.
Training records were up to date and staff received supervisions and appraisals, which meant that staff were properly supported to provide care to people who used the service.
The layout of the building provided adequate space for people with walking aids or wheelchairs to mobilise safely around the home and was suitably designed for people with dementia type conditions.
The service was working within the principles of the Mental Capacity Act 2005 and any conditions on authorisations to deprive a person of their liberty were being met.
All the care records we looked at contained evidence of consent.
People were protected against the risks associated with the unsafe use and management of medicines.
People had access to food and drink throughout the day and we saw staff supporting people at meal times when required.
People who used the service had access to a range of activities in the home.
All the care records we looked at showed people’s needs were assessed. Care plans and risk assessments were in place when required and daily records were up to date. Care plans were written in a person centred way and regularly reviewed.
We saw staff used a range of assessment tools and kept clear records about how care was to be delivered and people who used the service had access to healthcare services and received ongoing healthcare support.
The registered provider had a complaints policy and procedure in place and complaints were fully investigated.
The provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.
As some people who used the service had complex communication needs, they were not able to share with us their experiences. Therefore, during the inspection we observed the quality of interaction between staff and people on the unit where people with dementia were accommodated.
During our observation, we saw staff offered people eye contact and took time to communicate clearly. We saw staff were attentive and responsive to people's different needs. We saw they took time to help people eat, drink and with their care needs and asked people before intervening with care tasks. We observed staff used eye contact, touch and appropriate humour to provide care with compassion. Where necessary, staff offered re-assurance and diversion when people became unsettled or agitated.
Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The needs of people who used the service were assessed, where necessary care plans developed, and interventions and progress was monitored and reviewed.
We looked around the home and its environment. We saw that it was decorated to a good standard and was well maintained across all three units. There was no evidence of malodour and the environment, furniture and fittings appeared clean. The decorative finish was suitable for the needs of people using the service. People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.
The provider had carried out appropriate pre-employment checks to ensure the suitability of staff. People were cared for, or supported by, suitably qualified, skilled and experienced staff.
People were made aware of the complaints system. We found people had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint. Also people's complaints were fully investigated and resolved, where possible, to their satisfaction.
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We spent time talking with several people, and watched how staff gave them support and care. People were very happy with the care provided. Comments included 'Staff are marvellous' 'The staff talk to me'
People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service.