Hawthorne Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this service under the current provider.

This key question has been rated good.

This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff showed an understanding of the importance of person-centred care and we observed examples of people being supported with day to day choices such as clothing, food and routines. Care plans contained a basic level of information however did not always clearly capture people’s preferences, histories, protected characteristics or what mattered most to them. One care plan contained detail around the persons behaviour and the desired goal however, it failed to identify what steps should be taken or information to deescalate the behaviour.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Staff understood people’s complex health and care needs and worked with external professionals to respond to changes and support continuity of care. Relatives told inspectors staff communicated with them and responded to concerns when these were raised. However, external professionals reported some inconsistencies in communication, escalation and follow‑ups. This could put people at the risk of delays in receiving external input.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider did not consistently provide information in a format that could be easily understood by people. For example, staff did not consistently provide information to people at meal times. There were no visual cues on what food was being provided and staff did not consistently explain to people the food that was on offer.

It was also observed that during lunch there were 12 people in the dining room however, only 1 person had their meal explained to them, the other people had their lunch placed down in front of them. However, the provider did tell us that people’s care plans could be provided in an alternative format if needed, for example in a large print. People’s communication needs were documented in care plans.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People told us that they had been involved in the admissions process and had an awareness of their relatives care plan but had not been actively involved in any care plan reviews or further conversations. There was no awareness of any newsletter or sharing of information other than the home’s social media page or a phone call. One relative told us that the management team were receptive to feedback, they felt listened to and the concerns they had were resolved. There were systems in place that demonstrated the service listened and responded to concerns. For example, records showed complaints were investigated, outcomes recorded and lessons learned. Whilst resident and relative meetings had taken place historically, these were not recent or regular. There was limited evidence of how feedback from meetings was being used to shape improvements.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The service worked with various external professionals day to day and when people’s needs changed. For example, the service described a time when a referral had been made to an independent advocacy service to support an individual to express their needs. This maintained the person’s individual rights. These actions support equitable outcomes by reducing the risk of people being disadvantaged due to complexity, disability or social circumstances.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff demonstrated an understanding of the importance of treating people fairly and ensuring care was tailored to individual needs, preferences and protected characteristics. Leaders and staff described how they worked to remove barriers to care, including making reasonable adjustments to communication, routines and activities to promote inclusion and wellbeing. For example, staff described communication adjustments that can be put in place such as providing information in larger fonts for people with visual impairment.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were supported to plan for and to make informed decisions about their future, including at the end of their life. Care records contained information to support people with important life decisions. For example, end of life care plans were in place for people, with important information on how people wished to be cared for at the end of their life however, some of these were functional and not person centred. For people that did not wish to consider this, it was documented and staff stated that they would reapproach the person and/or relatives at a later time. Leaders demonstrated an understanding of the importance of planning ahead to meet people’s changing needs, including supporting independence for as long as possible.