Hawthorn Lodge Care 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.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant people’s needs were not always met.

The service remained in breach of legal regulation in relation to person-centred care.

This service scored 61 (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.

We received mixed feedback from people and their relatives about the person-centred approach of staff. One person said, “The agency staff leave a bit to be desired with care. They don’t know me or my needs.” Another person said, “Staff don’t always acknowledge us. Last evening there were 2 night staff talking outside my room and I had to ask them to keep their voices down. No apology, they just glared at me.” Whilst a relative told us, “Since my family member has been here, she’s lost the use of her legs and needs assessing to get her walking again on a frame, which she wants. They just use the rotunda and wheelchair all the time. I asked the manager several weeks ago to get her assessed by a physiotherapist but have heard no feedback yet.”

Another person was more positive and said, “A lot of them give more than 100% and I’m generally happy with the staff.”

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.

Prior to our assessment, the CQC had received multiple concerns from an external health partner, regarding alleged poor transfers to hospital and the lack of information provided at the time of each event. We raised this with the management team, who explained there had been a breakdown in relationships, which they were working hard to address. The management team understood the importance of ensuring safe transfer for people going into hospital. They had produced an updated hospital transfer form for each person, using their electronic planning system. Senior staff had undertaken significant training, under the National Early Warning Score 2 (NEWS2) approach, to ensure the service had a robust approach to managing unplanned admissions to hospital in future. The NEWS2 is a standardised clinical scoring system, to enable prompt assessment and monitoring, of a person who is presenting as unwell or deteriorating.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The management team followed the five steps to meet the Accessible Information Standard, (AIS). Care plans detailed people’s individual communication needs, such as language, and aids such as glasses or hearing aids. Where people had a preference not to use their hearing aid or wear their glasses, their care plans included guidance on how staff should support and encourage people to understand any risks to their personal safety.

The management team used additional resources, for example, talking buttons. These were available throughout the building and gave useful information for people who may have difficulty reading print. The talking buttons were also used to play music, with pictorial guides to the artist and song on each button. A picture guide describing the different colour of staff uniforms was displayed in the main corridor, so people and their visitors could identify staff easily.

People had use of pictorial menu guides, which were available in the dining area, however, we saw these were not always used as an effective tool to support menu choices. The service had produced literature for people in different font sizes, to assist in sharing information for people.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Support plans and records were not captured in ways that met people’s requirements for meaningful communication and decision-making. Therefore, people were not always enabled to be active participants in their care.

Residents’ meetings had previously been held infrequently, so people were not actively involved in shaping the service. The new management team had a planner in place for more regular meetings to take place in future, to ensure people and relatives were involved in shaping the service. One person said, “We’ve had some meetings but they’re fairly wide apart. They ask if there’s anything we want to bring up or ideas for activities, and they may have news to tell us. One thing we said was how long mealtimes take and we’ve seen how they sped it up a bit.” A relative told us, “I’ve never heard of a meeting for families and don’t hear anything. There’s no newsletter or anything. My family member goes to the residents’ meeting and joins in.”

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

People gave positive feedback about support provided for them to access appointments in the community, one person said, “A carer came with me and took me for a hospital appointment.”

Relatives and visitors were encouraged and made welcome by the service. One person said, “My family member visits any time, she’s coming soon to take me to a hospital appointment.” A relative told us, “We can come anytime, but since last week, we’re asked to avoid mealtimes.”

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People were not always supported to access community facilities, understand voting and lead a full, enriched life at Hawthorn Lodge. We found a lack of planned activities which were individually tailored for people. The service currently had no dedicated activity co-ordinator, although a member of care staff was fulfilling this role in the interim, with recruitment underway.

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.

The management team worked with external health professionals who supported with people’s palliative care needs. The management team ensured care plans were reflective of when a person was receiving end of life care. We found people’s advance decisions and what mattered to people were clearly recorded in their plans of care and hospital admission documents.

Staff had all completed training in death, dying and bereavement, to ensure people were effectively supported at the end of their lives.