This was a targeted inspection to check whether the provider had met the requirements of the warning notice in relation to Regulation 12 Safe care and treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This consisted of one inspector and one pharmacy inspector.

Service and service type

Hawthorn Green Residential and Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided.

The service had a manager registered with the Care Quality Commission. A registered manager is a person who is legally responsible for how the service is run and for the quality and safety of the care provided. Although the registered manager was not present during the site visit, they were present for both follow up calls following the inspection.

Notice of inspection

This inspection was announced with short notice of less than 24 hours. We notified the provider the day before to ascertain if it was safe for us to proceed with an inspection site visit, in accordance with COVID-19 safety protocols.

Inspection activity started on 18 January 2021 and finished on 11 February 2021. We requested a range of documents related to people’s care, the management of the service and policies and procedures that were sent to us by the provider between 18 January 2021 and 11 February 2021. We visited the home on 19 January 2021 to carry out observations, talk with the management team and to review further records related to the service. We made calls to people and their relatives between 4 and 11 February 2021 and calls to care staff between 1 and 5 February 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included any significant incidents that occurred at the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed the previous inspection report and actions plans submitted after the last inspection. We contacted the local authority commissioning team and reviewed their recent safeguarding enquiry investigation report and infection prevention and control (IPC) follow up meeting report, both from November 2020. We used all of this information to plan our inspection.

During the inspection

We reviewed a range of records. This included 12 people’s care and medicines records and records related to the management of the service, which included quality assurance checks and updates and memos sent out to the whole staff team.

We spoke with 13 staff members. This included the registered manager, the clinical consultant, the head of operations, the head of quality, an administrator, two nurses and six care assistants.

We carried out observations throughout the day in relation to infection prevention and control procedures, staff awareness of best practice and care and support provided to people who were in communal areas. We also checked the procedures in place for the management of people’s medicines.

We spoke with four people via a video call and made contact with three relatives, but only managed to speak with one of them.

After the inspection

We continued to seek clarification from the provider to validate evidence found related to the management of people’s medicines, qual