3 April 2020
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.
One inspector carried out this inspection.
Service and service type
Hawthorn House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last 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
People on the day we visited were unable to communicate their views to us. We spoke with seven relatives about their experience of the care provided. We spoke with six members of staff including the locality manager, the registered manager, support workers and the chef.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at the file for the one staff member recruited since our last inspections in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
The provider sent us further information which we used when making our judgements for the service. We also contacted relatives for their views about the service.
3 April 2020
Hawthorn House provides a short break service to up to ten people at a time. There four people at the service when we visited, however, this fluctuated regularly.
The service has not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The property was larger than recommended having been built to accommodate up to ten people. Although this is larger than current best practice guidance, this was mitigated as the building was integrated into a housing estate. The registered manager and staff team ensured there were enough staff to ensure people received highly personalised care and could access the local community when they wanted. The registered manager had also engaged with the local community to ensure excellent links were in place.
People’s experience of using this service and what we found
People received a highly personalised service from exceptionally caring staff. The registered manager and staff were extremely passionate and motivated to provide high-quality, person-centred care. Relatives valued the service and praised staff for their commitment to people. One relative commented, “I think it is an excellent service … In my opinion they should be outstanding.”
The registered manager demonstrated especially strong leadership and had been proactive in driving forward service improvement for the benefit of people staying at Hawthorn House. Quality assurance was fully embedded into service delivery to ensure standards remained consistently high.
The service went above and beyond to ensure people’s needs were met and they achieved their goals. Staff endeavoured to provide people with an enjoyable stay that was focused around their hobbies and interests. Staff were dedicated to caring for people living at the service. This ensured people received a unique service which met their needs. Staff excelled in working in partnership with professionals to ensure people’s health and wellbeing were prioritised.
People were safe at Hawthorn House. Relatives confirmed the service was a safe place. Staff knew how to report safeguarding and whistle blowing concerns. The provider had enough staff on duty to meet people’s individual needs. New staff were recruited safely. The registered manager investigated incidents and accidents logged. People received their medicines safely. Staff completed various risk assessments and health and safety check to enhance people’s safety.
Staff were very well supported and received the training they needed. Staff supported people to have enough to eat and drink. 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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.