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Hawthorn House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 28 January 2020

About the service

Hawthorn House is a care home that was providing personal care to nine people with a learning disability or mental health needs at the time of the inspection. The service accommodates up to nine people.

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 registered for the support of up to nine people, which 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.

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

Overall we found improvements had been made since our last inspection; people had access to more structured activities and there was better staff consistency. Care plans also contained clearer information about how staff should support people safely when they were distressed. However, we continued to find some inconsistency in the reporting of safeguarding concerns to the local authority and notifying the Care Quality Commission (CQC) of certain incidents as required. Therefore, the service continues to require improvement.

People were satisfied with the service and told us they were happy living at Hawthorn House. Staff were aware of risks to people’s safety and wellbeing. Systems were in place to ensure people received their medicines as prescribed, but there were minor recording issues with certain types of medicines. The provider agreed to address this.

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. People were supported with their nutritional and health needs. They had access to a range of health professionals, an annual health check and regular medication reviews.

People and visitors spoke positively about staff. Staff were respectful and responsive to people’s needs. People were encouraged to be as independent as possible and were involved in some aspects of running the home, such as cooking.

Staff morale had improved since our last inspection and staff felt supported. Systems were in place to check the quality and safety of the service. Audits were completed more consistently than at our last inspection, however the quality assurance systems had not been effective in addressing the inconsistent practice in relation to safeguarding referrals and CQC notifications, which had reoccurred since our last inspection. Issues in the provider's training department had resulted in delays with the completion of staff induction processes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection the service was rated requires improvement overall (published 7 August 2018). This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a scheduled inspection based on the service’s previous rating.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas

Safe

Requires improvement

Updated 28 January 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 28 January 2020

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 28 January 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 28 January 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 28 January 2020

The service was not always well-led.

Details are in our well-led findings below.