Archived: Hawthorns

The Hawthorns is registered to provide accommodation for people who require nursing or personal care. The home provides accommodation and support for up to six adults who have learning disabilities. It is situated in Minster Lovell near Oxford. On the day of our inspection six people were living at the service.

The service did not have 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.

Risks to people were not always managed safely. People were not always protected against the risk associated with the services environment and untoward incidents.

People were not protected against the risk of the spread of infection. Hand washing facilities within two areas of the home did not have hot water available to assist people and staff with maintaining their hygiene.

Medicine administration records were not always accurate. Staff did not receive regular competency checks to ensure they had the correct skills for administering medicines. Medicines were not always stored in line with the manufacturer’s guidance.

Staff had completed training in relation to MCA. However, not all staff understood the principles of the Act and how to support people in line with the principles.

Records relating to the recruitment of new staff showed relevant checks were not always completed before staff worked unsupervised at the home. Staff training was not always up to date.

Care records did not always include guidance on how to support people who may demonstrate behaviour that could be seen as challenging to themselves or others.

The provider had not always notified CQC of reportable events. Audits were not conducted to monitor the quality of service.

Equipment relating to the day to day running and management of the service was not always working.

There were sufficient staff to meet people's needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. People had access to activities which included range of activities of their choosing.

People had sufficient to eat and drink. Staff who clearly understood the likes and dislikes of the people they were caring for.

The overall rating for this service is 'Inadequate' and the service is in special measures. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel their provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration. For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. One breach of the Health and Social Care Act 2008 (Registration) Regulations (2014).You can see what action we told the provider to take at the back of the full version of this report.

We found improvement in ensuring the dignity, privacy and independence of service users was respected. Each person had monthly meeting with their key worker meeting. One person told us 'I have meetings with my key worker, I talk about what I want and what I want to do in the future".

We found people using the service were supported by staff to make personal choices. We saw a care plan in place supporting one person to play football with a local community football team.

We found that care was delivered safely and people told us they felt safe in the home. They told us they could talk to the staff if they had any worries. One person told us 'I am safe here and I can talk to my key workers'. A relative told us 'I feel she is most safe and I have no concerns'.

We found people were supported by sufficiently skilled and experienced staff. A relative told us "there are always plenty of staff about". One care worker informed us 'staffing levels here are fine, there are always enough staff on duty, if we are short they (the managers) always find cover'.

We found care workers were trained and supported to deliver good care. One member of staff told us 'the training here is very good, it's up to date and modern and there is plenty of it'. One relative we spoke with told us 'I cannot praise the staff team highly enough, they have turned my daughters life around'.

We were shown around by staff and people that use the service and saw bedrooms, communal areas, bathrooms and toilets were clean and free from unpleasant odours. People told us that their bedrooms were personalised to their wishes.

People told us that they were involved in menu planning and "could have what they wanted to eat" as they "know what I do not like".