Hawthorn Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. ​ At our last inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.​

This service scored 66 (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 had a proactive and positive culture of safety, based on openness and honesty. Management listened to concerns about safety and investigated and reported safety events. A staff member told us, “All incidents are reported and reviewed. Staff are very good at reporting.” Lessons were learnt to continually identify and embed good practice. People received safe care because staff learned from safety alerts and incidents. Any incidents about people's safety were discussed with staff in a timely way, with action taken to mitigate further risks.

Staff worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when people moved between different services. Information was collected before people started to use the service, and a detailed hospital passport was prepared to ensure their needs could be met, if they moved elsewhere.

Staff at the service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The manager shared concerns quickly and appropriately.A staff member told us, “We are always encouraged to report any concerns, for example any unexplained bruising.” People and relatives told us they felt safe, they would speak with staff if they were worried, and they always felt listened to. Their comments included, “We trust the staff”, “I have settled in, I am safe. Staff keep an eye on you, they are on hand all the time” and “I get the support, they are there for anything that is needed.”

Staff worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.However, we discussed where improvements to some records were needed, to ensure all risks were identified with corresponding care plans in place with triggers and de-escalation techniques where people experienced agitation or distress. The manager took action to address this during the inspection. Staff supported people safely and appropriate equipment was available if people needed assistance. Peoples’ comments included, “Staff watch you when you are walking about” and “I had the hoist at first, I do not need it now.”

Staff at the service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. A relative told us, “[Name] has the hoist to get to the bathroom, it is always available.” Equipment was regularly serviced to maintain safety.

The manager made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.There were sufficient staff to support people safely. However, we received mixed feedback about staffing levels and staff deployment. People told us they felt safe with staff support, but not all people and relatives thought there were sufficient staff. Relatives and people’s comments included, “The staff are pretty good. They are always busy”, “More staff would be an improvement, sometimes it is a long time before anyone comes” and “[Name] is not kept waiting, it is very good there are enough staff.” Staff feedback and staffing records showed staff received training, supervision, observations and checks of competency and appraisal to carry out their role safely and effectively. Staff members’ comments included, “There is plenty of training”, “Loads of training, most training is online, some face to face” and “you can ask for additional training.” Staff were safely recruited.

3. Staff at the service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.Staff told us personal protective equipment (PPE) and all cleaning materials needed were available. They confirmed they had received infection control training. Improvements had been made to infection prevention and control since the last inspection. Peoples’ comments included, “The cleanliness is all fine in my room” and “The place is very nice. The cleanliness is very good. Staff come in everyday and clean the room, sometimes twice.”

Medicines optimisation

Improvements were needed to medicine management to ensure staff made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were involved in planning, including when changes happened to their medicines. Medicines, including controlled drugs were stored securely and safely. However, records were not in place for all creams applied by care staff as part of personal care. Patch application records were not always available to demonstrate rotation in line with manufacturers guidance to prevent side effects.

Guidance for prescribed medicines to be taken on a ‘when required’ basis or with a variable dose was not always person-centred and some was missing. Some medicines care plans were not sufficiently detailed or contained conflicting information.Medicines for some people were out of stock and could not be given, action was taken to address this during our inspection.

Some medicine codes on the electronic monitoring system were unclear when medicines were out of stock, and did not always clearly show who had administered them for creams and insulin administered by visiting professionals. After our site visit, we received evidence to show the improvements being made, including a daily monitoring check by the manager of the electronic system.