We carried out a review of the data available to us about Hawthorn Manor Residential Home 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 Manor Residential Home, you can give feedback on this service.
Hawthorn Manor Residential Home is a residential care home providing personal care to up to 37 people. The service provides support to older people, some of whom were living with dementia and frailty. At the time of our inspection there were 33 people using the service. The service accommodated people on two floors of a large building, built around an enclosed garden and an attractive inner courtyard. People had their own room with en suite facilities and call bells if required.
People’s experience of using this service and what we found
People told us they felt safe living at Hawthorn Manor Residential Home, and that staff knew how to support them. A relative of a person living with dementia told us, “(Person) is happy and content at the moment. They like being looked after and thought this was a hotel.”
People told us there were enough staff to keep them safe and they did not have to wait long for help from staff when they called on their call bells.
People received their prescribed medicines when they needed them and staff offered people any ‘as required’ medicines when administering medicines. The service was clean, well presented and during our inspection and people and their relatives confirmed this was usual for the service.
Staff were trained to do their jobs and received regular supervision and appraisal. People had enough food and drink to maintain good health and people told us a new cook had recently improved the food. People were supported to attend health appointments and maintain good health and staff were responsive to people’s changing needs.
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 encouraged to decisions for themselves.
Staff were kind and caring and people and their relatives spoke warmly about their staff. People were supported to be as independent as they were able to be, and staff protected people’s dignity. There were activities for people to do, either in groups or one on one with an activities co-ordinator. People were supported to maintain friendships and relatives were welcomed to visit without prior appointment.
The management team consisted of a new manager, a deputy manager and a regional manager, who worked together to ensure the service delivered good care and support. The provider was known to people and regularly visited the service to audit people’s experiences and support the manager.
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 11 October 2018)
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, which will help inform when we next inspect.
We found the following examples of good practice.
¿ Staff supported people to spend time with their friends, while remaining safe. Staff supported people to social distance, to reduce the risk of people feeling isolated.
¿ There was a plentiful supply of personal protective equipment (PPE). Staff used PPE appropriately and safely.
¿ The service was working with people to plan how they wanted to celebrate the lives of those who had died.
Hawthorne Manor is a care home. It provides accommodation and personal care support for up to 37 people aged 65 and over. At the time of inspection there were 36 people living there.
People’s experience of using this service and what we found
People’s relatives told us their family members were happy and well cared for. Relatives told us they were kept well informed about their relatives well being. There was a lovely atmosphere in the service. Relatives felt assured by the behaviour of staff. Feedback from those receiving support was that people were cared for in a safe and kindly manner.
There was a new manager at the service who was working in conjunction with the new care and quality compliance manager to identify areas for improvement. For example, the content of some care documentation was not always accurate or clear. However, the impact on people was reduced by staff’s knowledge and understanding of people’s care needs. We did find that medicine storage temperatures had exceeded recommended levels on numerous occasions, during the excessively hot weather. The Provider and manager were acting to address this issue and install ventilation to these areas. We have made a recommendation around this.
Relatives commented on how clean and odour free the service was. Additional cleaning had been implemented in response to the pandemic to keep people and staff safe, but this was not always recorded and is an area for improvement. Staff had been given information about guidance for managing infection control in relation to COVID 19.
The new manager had completed a full audit of the service and had identified the shortfalls found at this inspection.
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 27 November 2018).
Why we inspected
We undertook this targeted inspection to check on specific concerns we had about management of risks, infection control and good governance. The overall rating for the service has not changed following this targeted inspection and remains Good.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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.
Hawthorn Manor Residential Home is a ‘care home'. People in care home services receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The accommodation was modern and spanned two floors. A stair lift was available for people to travel between floors. Staff provided residential care for up to 37 older people. There were 33 older people living at the service when we inspected.
At our last inspection on 10 February 2016, we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
Since our last inspection the registered manager and provider had been consistent in auditing the risks associated with providing care and the quality of people’s experiences.
The outcomes promoted in the provider's policies and procedures were monitored by the registered manager to make sure they were in line with current legislation and practice. The policies included equality and human rights. There were multiple audits being undertaken to support learning and improve quality.
Staff consistently demonstrated they shared the provider's vision and values when delivering care. People were supported to maintain friendships and contacts with those they chose. Activities were planned to assist people to their purpose and pleasure in life.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People’s needs continued to be assessed and their needs were recorded. People’s right to lead a fulfilling life and to a dignified death was understood and respected at all levels. People, their relatives and health care professionals had the opportunity to share their views about the service either face-to-face, by using feedback forums or by responding to formal bi-annual provider quality surveys.
We observed that staff were friendly and caring. Staff understood the risks to people’s individual health and wellbeing and risks were clearly recorded in their care plans. Incidents and accidents were reported and appropriately investigated.
Risks to people from poor nutrition and hydration were minimised because people were offered meals that were suitable for their individual dietary needs and met their preferences. People were supported to eat and drink according to their needs, staff supported people to maintain a balanced diet.
There continued to be enough staff on duty to meet people’s physical and social needs. The registered manager checked staffs' suitability to deliver personal care during the recruitment process.
Staff received training and supervision and continued to be that matched to people’s needs effectively.
The premises and equipment were regularly maintained and checked to minimise risks. People’s medicines were managed, stored and administered safely. The service was clean and odour free. Staff followed the provider's infection control policy. Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise concerns by the registered manager. Emergency response contingency plans were in place.
The registered manager had sent statutory notifications to CQC when required. The CQC rating from our last inspection had been displayed.
Hawthorne Manor is a care home providing accommodation and support for up to 37 older people who require assistance with personal care. The accommodation was provided over two floors and there is chair lift available to access the first floor.
There was 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 provider, 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.
People were given individual and group support to take part in their preferred activities and interests. There were no planned trips out of the home, currently as people did not like going out in the cold weather. However the staff were looking into facilities of different locations locally where people may like to visit once the weather improves.
Medicines were stored, administered and disposed of safely. Only trained staff administered medicine. Staff had received training and their competency to administer medicine this had been checked. Audits of medicines made sure people received the medicines they had been prescribed.
The environment was suitable for the people who lived there and looked well maintained.
People spoken with all said that they were very pleased with the care and support that they received at the home.
There were systems in place to obtain people’s views about the service. These included formal and informal meetings with people using the service and their families and annual surveys.
There was a complaints procedure on the homes notice board. The registered manager explained that all people and their families had been given a copy of the complaints procedure. People told us that they would know how to complain but that they had no need to. They were confident that any complaint would be taken seriously by the registered manager.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. As the people living in this home have mental capacity and there was no deprivation of liberty there had been no reason to make an application. The registered manager and staff understood why and when an application should be made. The service was meeting the requirements of the Deprivation of Liberty Safeguards.
Staff had received safeguarding training and knew how to protect people. They knew the action to take in the event of any suspicion of abuse towards people. Staff also understood the whistle blowing policy. Staff said they were confident raising any concerns with the registered manager or outside agencies if this was needed.
People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. The registered manager and staff contacted other health professionals for support and advice when necessary.
People were provided with diet that met their needs and wishes. Menus offered variety and choice. People said they liked the meals offered and that at residence meetings they were asked for suggestion for the menu. Staff made sure that people had plenty of drinks offered through the day. We observed lunch being served and people were happy with their choices.
Staff were recruited using procedures designed to protect people from being cared for by unsuitable staff. Staff were trained to meet people’s needs and their performance was discussed during one to one supervision and their annual appraisal. Staff were supported to carry out their roles.
There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how any risks could be minimised. There were systems in place to review accidents and incidents and make any relevant changes to reduce further harm.
There were quality assurance processes were in place to make sure people received a service, which maintained their health and wellbeing. People and their family’s views were sought through surveys and meetings to monitor and improve the service being offered.
The staff were fully aware and used in practice the home’s ethos for putting people at ease so that they feel happy and comfortable, whilst maintaining people’s independence, respect and dignity.
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and the staff told us.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
People received a consistent and safe level of support.
Procedures for dealing with emergencies were in place and staff were able to describe these to us.
All of the people who were able to converse with us said that they felt safe in the home; and indicated that if they had any concerns they were confident these would be quickly addressed by their key-worker in the first instance, or by the manager.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager told us that they had not found it necessary to apply for a Deprivation of Liberty safeguard for anyone to date. Where some people in the home had been assessed as lacking mental capacity unable to make decisions about their care and treatment, they either had an advocate, a next of kin or representative to speak on their behalf or meetings were held with people's representatives, Social Services and health professionals to make decisions on people's behalf and in their best interests where this was needed.
Is the service effective?
People had an individual care plan which set out their care needs. People who used the service and family told us they had been fully involved in the assessment of their health and care needs. One relative said, 'They keep me informed at all times and I feel involved'. Assessments included needs for any equipment, mobility aids and specialist dietary requirements.
People had access to a range of health care professionals some of which visited the home. This meant that people were sure that their individual care needs and wishes were known and planned for and that they had the equipment they needed to meet their individual needs.
Is the service caring?
Relatives told us that they felt their people who lived in the home are safe. One Person said, 'X is very much safe here. They are so much better living here'.
People's care needs were discussed with them; and care plans demonstrated people's individual needs and how to support them appropriately. Staff were knowledgeable about the people in their care, and were suitably trained to deliver care correctly.
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, 'I am comfortable here, staff are very good and I think they are meeting my needs. I like it here'. A relative said, 'I am able to approach the staff or manager at any time. Staff talk to all of us at all times. We are very involved' and 'They keep me informed at all times and I feel involved. I would recommend the home to anyone'.
Is the service responsive?
People's care plans were regularly reviewed, and were promptly amended if there were any changes in their health care needs. People were fully involved in their care planning. The staff ensured that referrals were made to other health and social care professionals as needed, to support people with meeting their different needs. People were enabled to take part in activities of their choice and to go out into the community.
People knew how to make a complaint if they were unhappy. One relative said, 'If I need to complain, I will go to the manager. She is very approachable'.
All areas were well maintained and the manager said that maintenance requests were dealt with promptly. We looked at the maintenance log and saw that regular maintenance request was carried out.
Is the service well-led?
The home had a system to assure the quality service they provided. The way the service was run had been regularly reviewed. Prompt action had been taken to improve the service or put right any shortfalls they had found.
Information from the analysis of accidents and incidents had been used to identify changes and improvements to minimise the risk of them happening again.
People's personal care records, and other records kept in the home, were kept up to date.
People who used the service, their relatives, friends and other professionals involved with the service were recently sent an annual satisfaction survey by the manager to be completed.