The Care Quality Commission
  • Care Home
  • Care home

Archived: The Hawthorns Care Centre

Overall: Good read more about inspection ratings

76 St Anne's Road, Woolston, Southampton, Hampshire, SO19 9FF (023) 8044 3061

Provided and run by:
Life Style Care plc

Important: The provider of this service changed. See new profile

All Inspections

12 September 2017

During a routine inspection

The Hawthorns Care Centre is a nursing home which provides accommodation for 73 people. At the time of our inspection they were providing care for 58 people. There were three floors to the home; two floors were dedicated to people with nursing needs, whilst the other floor offered residential accommodation for people who did not require nursing care.

At the last inspection on 9 and 11 July 2015, the service was rated Good overall and Requires Improvement in the ‘caring’ domain.

At this inspection we found the service remained Good overall and had made improvements in the ‘caring’ domain, which is now rated good.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager and senior staff carried out a series of audits and checks to help ensure the quality and safety of the service. People told us the registered manager was responsive to feedback and acted quickly to resolve complaints and issues.

The provider had made adaptation to the building to make it suitable for people’s needs. This involved making the garden accessible and providing signs to help people find their way around their home.

Staff were caring and understood people’s needs. There were sufficient staff available to provide unhurried and personalised care which incorporated a wide range of activities. People’s preferences and routines were identified in their care plans. Risks to people’s safety, health or wellbeing were assessed and monitored. Staff knew people well and followed these guidelines to meet people’s needs.

Staff were aware of safeguarding procedures and the steps required in recognising and reporting abuse. Staff respected people’s dignity and privacy and were conscious of respecting people’s preferences around their end of life care. Staff understood the importance of respecting people’s choice and freedoms and worked within legal guidelines to protect these.

Staff were subject to appropriate recruitment checks and completed training which covered the key aspects of their job. The registered manager provided ongoing support and supervision to help them remain effective in their role.

People had access to healthcare services when required and the service had established a working relationship with a local GP surgery, which meant people maintained regular contact with their doctor. People followed a diet which was appropriate to their preferences and needs and were supported to take their medicines safely. The service had arrangements in place for safe storage, administration and disposal of medicines.

09 June 2015

During an inspection looking at part of the service

This Inspection took place on 09 and 11 June 2015 and was an unannounced inspection. At our last inspection on 17 and 24 July 2014 we identified breaches of regulations relating to: Not having sufficient numbers of suitably qualified, skilled and experienced staff to meet the needs of people and care planning was not always personalised. We set compliance actions and the provider sent us an action plan telling us they would meet the requirements of the regulations by 28 January 2015.

At this inspection, on 09 and 11 June 2015, we found action had been taken. Improvements had been made to include a more personalised approach to care planning. There were more regular consistent staff on duty.

The Hawthorns Care Centre is a nursing home which provides accommodation for 73 older persons. At the time of our inspection they were providing care for 52 people. There were three distinct storeys to the home. One for people who required medical and physical support. The second for people with mental health needs and those people living with dementia. The third area was in the process of changing to accommodate people who required residential care and not nursing services.

There is a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Sometimes people were not always treated with respect or dignity. One person’s door was open as they received personal care. We also saw some good examples of staff asking people for consent before offering support.

People felt safe living at the Hawthorns Care Centre. Staff knew their responsibilities to maintain people’s safety. They had received appropriate training and knew how to report any concerns to management and external agencies. Robust recruitment processes ensured staff were suitable to work with older people and had the right skills, knowledge and experience. There were sufficient staff to provide the care people required.

People were supported to take their medicines safely. Records of administration were consistent and complete. Medicines were stored in securely in appropriate locations in the home. Nurses were assessed to be competent to administer medicines and received regular training on medicines. Appropriate actions were taken in the event of errors of administration.

People’s needs were assessed prior to them moving into the home. Where risks were identified as part of the care planning process, these were assessed and plans put in place to minimise those risks to people.

People received care that was personal to their needs. They and their relatives were involved in providing information on their likes, dislikes and their preference for their care. Staff knew about people’s histories and events and people that were important to them. Staff made time to engage people in conversations as they assisted them with care and activities.

People enjoyed the food and were able to make choices of meals on the menu. For people who required it special diets were available and staff monitored food and fluid intakes and people’s weights. Health support from GPs and other health professional was available in the home and people were supported to attend appointments out of the home.

Relatives told us communication was good with staff and the registered manager. The atmosphere in the home was more relaxed and staff did not appear to be hurried when supporting people. People and their relatives were involved in decisions about the care received.

The provider’s complaints policy outlined timeframes for responses to complaints. Where complaints had been made, these were managed and resolved to the satisfaction of the person making the complaint. People were able to express their views on the care they received and felt they had been listened to by staff and the registered manager.

The culture of the organisation was to provide a high standard of nursing care to suit the individual needs in a modern purpose built home with a calm and tranquil atmosphere. Staff and relatives agreed this was being achieved at the Hawthorns. The provider ensured quality was maintained by using a number of audit systems to monitor standards and suggest improvements to the service regularly.

7 and 24 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection undertaken on the 17 and 24 July 2014. We last inspected this service on 27 February 2014 which was a follow up inspection to check that improvements identified at the previous inspection had been completed. At this last inspection the concerns had been addressed.

The Hawthorns Care Centre is a nursing home providing accommodation for persons who require nursing or personal care. They provide long term care for people who may live with dementia, have physical or health impairments or who may require end of life care. They provide accommodation for 73 people but at the time of our inspection they were providing services to 49 people. The home was divided into three separate floors providing differing levels of care and support based on the needs of individuals. There is currently no registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.’

Some people said they were happy to live at The Hawthorns and were satisfied with the support they received. However, other people and some relatives shared concerns they had about the level of care they received. Whilst all people had individualised care plans and assessments, some people’s assessed needs were not included in their care plans. Where some people had to wait for support they tried to walk without staff support and placed themselves at risk of falling. People were not supported appropriately by staff and according to their care plans. For example one person said “I know when I want help I will have to wait some time for it.”

People told us the staff were polite and caring, however they said there were never enough staff to support them on occasions. This was a view shared by relatives who told us of occasions when they noticed staff shortages. One relative said, “The carers are amazing and attentive. Sometimes there does not seem to be enough of them.” Staff told us they did not feel supported by managers and lacked clear leadership. One member of staff said, “How can we give good care if we don’t have the right staffing levels. Staff received supervisions; however these had not occurred on a regular, scheduled basis.

The provider told us how they were looking to recruit a manager who could provide the leadership required. Professionals shared their concerns about staff shortages but had noticed an improvement in staffing levels. Staff training was occurring and most staff had attended necessary training in the last year.

Staff were knowledgeable about the care needs of the people they supported. They spoke warmly about the relationships they had with people who used the service. We saw people responding well to the care and compassion shown by staff. Staff offered people choices in ways they understood and assisted them to make decisions about elements of their care.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to nursing homes. One person living in the service was subject to DoLS. This information was displayed on the person’s care records and staff were aware restrictions were in place. A mental capacity act assessment had occurred and a best interests meeting had been held requiring what was necessary to ensure the safety of this person. The temporary manager understood when an application needed to be made and how to submit these if required.

People’s health care needs were assessed and people were able to access support from visiting health professionals and visits to specialists when required. Healthcare professionals told us they could leave instruction for the nurses to follow and were confident these were carried out.

People told us the standard of cooking was excellent. There were choices at each meal time and where people did not want the main meal choices on the menu they were offered choices of foods they liked. The food was nutritious and provided healthy options for people. People had good access to drinks throughout the day and the chef planned the menu to suit the time of year. On the day of our inspection it was very hot and the chef and staff gave people cold drinks and ice creams throughout the day.

People’s privacy and dignity was respected and staff showed care and compassion when speaking to people. We observed people were happy when they were engaged in conversations with staff. However one person told us, “the staff are so busy they don’t have time to talk to us sometimes.” When staff entered people’s rooms they knocked and waited for an answer before entering.

Some people and relatives told us they were involved in some aspects of planning their care. One relative said they had been able to make changes to their mum’s care plan, However we were also told by another relative, “I do not feel involved in care plans.”

Staff told us they did not receive regular supervisions. Staff records confirmed this and that some staff had not received supervision for six months. The temporary manager was aware of this and had begun to schedule supervision sessions for all staff.

Thorough recruitment checks were carried out prior to staff working in the service. This ensured staff were suitable to work with people.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

27 February 2014

During an inspection looking at part of the service

At our last visit in on 3 October 2013 we found staffing levels were not adequate to ensure people's care needs were met in a timely way. On this occasion we found improvements had been made. More staff had been recruited along with a bank of staff to cover sickness and annual leave. This meant there were enough staff to ensure people's needs were met.

We spoke with three people who used the service. They were complimentary about the staff, and all said there were sufficient staff to care for them. We also spoke with three members of staff. They told us staffing 'had improved' and they were better able to assist people without rushing around.

26 November 2013

During an inspection looking at part of the service

During our inspection in October 2013, we found care and treatment was not planned and delivered in a way that was intended to ensure people's safety and welfare. People's needs around continence and skin care were not met. We therefore issued a Warning Notice to the provider. At the time of our inspection the provider did not have a registered manager in post.

We found there had been improvements since our last visit, particularly with regard to continence support and wound care. Needs were assessed and reviewed regularly and care and treatment was delivered according to the care plans. We saw staff responding to individual health care needs in a timely and kind way.

There were 34 people living at The Hawthorns Care Centre on the day of our visit. We spoke with one person using the service who told us they liked the staff and enjoyed the food. We spoke with three visitors who were all positive about how their relatives' needs were met. One relative told us staff 'bent over backwards' to support people. They also said their relative looked 'lovely and clean, nicely presented' Their impression was that staff knew their job well and understood people's non-verbal communication. One said they had been 'impressed' by the way staff communicated any changes in their relative's health and had also seen an improvement in their relative's physical abilities. Another visitor said the staff were 'very nice and attentive, you can take anything to them and they take action'.

19 September and 3 October 2013

During an inspection looking at part of the service

The Hawthorns Care Centre is a care home with nursing. Our visit on 19 September 2013 was to see if improvements had been made with regard to medication procedures. Two people we spoke with told us staff brought them their prescribed medication and that they could ask for tablets if they had a headache. We spoke with a visitor who confirmed their relative was getting their medication as required.

We found people received their medication as prescribed, including those who were prescribed it as 'when required'. Records were clear and matched the stocks held in the home. Training about medication was provided to staff and their level of competency was assessed.

After this visit we received concerns about poor care and staffing levels. We therefore visited on 3 October 2013 with a specialist advisor. A specialist advisor is a source of specific knowledge relevant to service we are inspecting. We spoke with four visitors who were positive about the staff and told us the staff were 'lovely', 'fantastic, approachable and kind'. However, they said staff were 'rushing around' and that there was not always enough staff on duty.

Some people did not have their care needs fully met. We saw there was a lack of care planning and review regarding continence and skin integrity. Processes had not been followed which meant the effectiveness of treatment was not monitored. Staffing levels were not adequate to ensure people's care needs were met in a timely way.

6 June 2013

During a routine inspection

We spoke with one person using the service who told us the staff were "good, kind and helpful". One visitor told us the staff were "fabulous" and "worked so hard". Two other visitors told us they had heard good feedback from another relative who had visited previously.

We found people were receiving the care and support which met their assessed care needs. We saw staff interacting appropriately with people, both to meet their physical care needs and their need to talk and share memories. People were receiving their medication as prescribed although the provider may like to note that people did not have care plans for medication prescribed as 'when required'. This could mean that people were given medication inconsistently.

The provider had recruited new staff and records showed they started work only after all the necessary checks had been completed. The manager ensured that new staff were trained and initially worked 'shadowing' other staff. There was a quality assurance programme in place which ensured people's views were considered, trends were identified and improvements monitored.

31 January 2013

During an inspection looking at part of the service

We spoke with two visitors who were pleased with the care provided and one told us that the staff, 'really do care'. Staff told us there had been improvements in the care plans which meant they knew how to meet people's needs. We found that everyone had a new care plan in place which detailed their individual care and support needs. Staff told us how they met these needs and were consistent in how they supported people. Care was provided as detailed in the up to date care plans.

22 November 2012

During an inspection looking at part of the service

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

A visitor told us they were happy with all aspects of care. We heard people telling the chef that they had enjoyed their lunch and two visitors told us that pureed food was provided to the people they visited. We saw staff supporting people to eat their meal and saw them offer choice about what they were eating. People received the support they needed, for example, a pureed or soft meal. Staffing levels had been increased and new staff had been recruited.

We found that care plans were not complete or up to date. As a result of this we also found that some people were not receiving the care and support they needed to meet their needs. We found that accurate records were not maintained with regard to medication and that two people had run out of prescribed food supplements.

11 July 2012

During an inspection in response to concerns

People who used the service told us they were happy with the staff and the care they received. One person told us that the staff had helped them to, 'feel better' that day. Relatives and visitors we spoke with felt that people received good care and support, although we were also told that it was difficult to find staff. One visitor told us that staff were 'responsive to individual needs'. Relatives felt that people had enough food and that there were always fluids available. However we found that people did not always get the nutrition or hydration which met their needs and there were not always enough staff.