Archived: Hawthorns

Updated 15 February 2017

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

This inspection took place on 12 December 2016 and 19 December 2016 and was unannounced. The inspection was carried out by one inspector.

Before the inspection we looked at previous inspection reports and notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern.

We spoke with three people, three relatives, six care staff, the manager and the deputy manager. We reviewed four people's care files, six staff records and records relating to the management of the home. Prior to the inspections we spoke to commissioners of the home to get their views how on the service is run.

Updated 15 February 2017

This inspection took place on 12 and 19 December 2015. It was an unannounced inspection. We carried out this inspection following concerns raised with us in relation to leadership and the overall maintenance of the service. When we last inspected this service in October 2015 we found the service was meeting its legal requirements.

The Hawthorns is registered to provide accommodation for people who require nursing or personal care. The home provides accommodation and support for up to six adults who have learning disabilities. It is situated in Minster Lovell near Oxford. On the day of our inspection six people were living at the service.

The service did not have a registered manager. 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.

Risks to people were not always managed safely. People were not always protected against the risk associated with the services environment and untoward incidents.

People were not protected against the risk of the spread of infection. Hand washing facilities within two areas of the home did not have hot water available to assist people and staff with maintaining their hygiene.

Medicine administration records were not always accurate. Staff did not receive regular competency checks to ensure they had the correct skills for administering medicines. Medicines were not always stored in line with the manufacturer’s guidance.

Staff had completed training in relation to MCA. However, not all staff understood the principles of the Act and how to support people in line with the principles.

Records relating to the recruitment of new staff showed relevant checks were not always completed before staff worked unsupervised at the home. Staff training was not always up to date.

Care records did not always include guidance on how to support people who may demonstrate behaviour that could be seen as challenging to themselves or others.

The provider had not always notified CQC of reportable events. Audits were not conducted to monitor the quality of service.

Equipment relating to the day to day running and management of the service was not always working.

There were sufficient staff to meet people's needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. People had access to activities which included range of activities of their choosing.

People had sufficient to eat and drink. Staff who clearly understood the likes and dislikes of the people they were caring for.

The overall rating for this service is 'Inadequate' and the service is in special measures. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel their provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. One breach of the Health and Social Care Act 2008 (Registration) Regulations (2014).You can see what action we told the provider to take at the back of the full version of this report.