20 November 2023
During an inspection looking at part of the service
Hawthorne House is a residential care home providing personal and nursing care to up to 102 adults across seven separate units. People living at Hawthorne House have various needs which include dementia, physical disabilities, mental health needs and rehabilitation for acquired brain injuries. Each of the units are adapted to meet the needs of the people living there. At the time of our inspection there were 99 people living at the service.
People’s experience of using this service and what we found
Governance systems, management, and provider oversight had not been fully effective, and standards had declined in the home since our last inspection. A new manager had been in post for approximately 2 months when we completed this inspection. They acknowledged improvements were required across the service and had been, and were continuing, to work with the provider to introduce new systems to help improve the service. The service was being supported by the local Integrated Care Board (an NHS organisation) to make the necessary improvements. There was a friendly atmosphere within the service. People and relatives were generally positive in their comments about the staff team.
People told us they felt safe at the home but risks to people's health and well-being had not been consistently identified and assessed. Some of these risks were associated with unclear records, medicine management and staffing arrangements. Staff received training relevant to their roles but staff on some units felt pressured and not able to support people how they would like. People’s medicines had not been managed safely consistently to ensure people received their medicines as prescribed. People had individualised care plans that supported staff to deliver their care. However, some people did not experience person centred care that always met their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff were recruited safely in line with the providers policy. People told us staff treated them with respect. People had access to healthcare professionals to support their needs when necessary to ensure they remained well.
The prevention and control of infection was managed safely. Good infection prevention and control processes were followed.
We received concerns in relation to the management of risks related to people’s care needs. As a result, we undertook a focused inspection to review the key questions of safe and well led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hawthorne House on our website at www.cqc.org.uk.
Rating at last inspection
The last overall rating for this service was Good (published 1 May 2021)
Why we inspected
The inspection was prompted in part due to concerns received about management of risks associated with people’s care including medicine management. A decision was made for us to inspect and examine those risks.
Enforcement
We have identified breaches in relation to safe care and treatment, staffing and the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.