Hawthorne Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service under the current provider. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective.

Assessments were carried out for people prior to admission to the home. However, assessments and care plans were not always consistent, detailed or accurate. For example, there was contradictory repositioning guidance within the same person’s care records. Some care plans did not give staff clear guidance on how conditions affected the person or what to monitor. For example, 1 person had a flexible feeding tube inserted however, the persons care plan lacked details around the signs and symptoms of a wound infection around the insertion site. This potentially placed the person at risk of harm through a delay in intervention.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The provider generally made sure people’s care and treatment was effective by assessing, planning and delivering care in line with current guidance. People received care based on recognised tools including a tool for predicting people’s pressure sore risk and a tool to identify people who are at risk of malnutrition. Where risks were identified, appropriate equipment such as pressure-relieving mattresses were used. People told us care met their needs and provided an example of when staff responded appropriately when health concerns arose.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People had access to a range of health professionals including GPs, nurses, opticians and chiropodists. Referrals were made when people’s needs changed. Staff shared information through care records and daily handover meetings and inspectors saw evidence of multi-disciplinary involvement in care planning. Feedback from families and professionals supported that partnership working was in place and generally effective, however some stated improvements around communication could be made. For example, one professional stated they found the service lacked communication and the service responsiveness was hit and miss.

People had hospital passports should they need to transition between healthcare services. These included information around their immediate needs, medicines and next of kin details.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to maintain their health and wellbeing and to access healthcare services where needed. Staff understood how to identify and escalate changes in people’s health needs. However documentation needed to be clearer in regard to managing potential sources of infection.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Where appropriate monitoring tools were being used to improve people’s outcomes. For example, people’s weights, food and fluid intakes and repositioning were being recorded.

Actions were taken to improve people’s outcomes. For example, a staff member was aware that a person was at the risk of weight loss and would often not eat their food. The staff member decided to try and encourage the person to eat more by eating their own dinner sat with them. This person gained weight.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Inspectors observed some staff asking for consent before providing care. One person told us ‘They’ll always ask before turning me or doing anything for me.’

Mental capacity assessments and DoLS applications were in place where required and improvements had been made around this. However, inspectors observed some occasions where staff gave instructions rather than seeking consent or there was a lack of communication, particularly around moving hand handling, which did not fully reflect best practice. For example, we observed staff perform a moving and handling technique with no communication or attempt to ascertain consent.