This inspection took place on 26 September 2017 and was unannounced. The provider is registered to provide accommodation for up to 22 older people some of whom may be living with dementia.

The service is located in Hedon, a market town in the East Riding of Yorkshire. Accommodation is provided across two floors. There are gardens which are accessible to people and car parking is available at the front of the property. At the time of our inspection there were 20 people living at Hawthorn House.

At the last inspection in August 2016 the provider was rated as required improvement. The service was in breach of one regulation under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breach was in Regulation 19, Fit and proper persons employed. We asked the provider to submit an action plan regarding the breach and during this inspection we saw these actions were met. The service was no longer in breach of this regulation.

There was a manager who had been registered with CQC on the 8 November 2016. 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.

Staff knew how to keep people safe and understood their duty to protect people from the risk of abuse. Risks were managed so that people were protected, as far as reasonably practicable, from avoidable harm.

Sufficient staff were on duty to meet people's needs. Safe recruitment procedures were followed and appropriate pre-employment checks had been made including satisfactory written references. Appropriate background checks were also undertaken to ensure new staff were safe to work within the care sector.

Medicines were managed safely and people received them as prescribed. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People received care and support from staff who had the skills and knowledge to understand their role. Staff received documented supervision to ensure they were supported in their role and development.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to eat and drink sufficiently. Any specific dietary needs were recorded in their care plan and staff confirmed they requested support from other health professionals where it was required.

We saw people were supported with kindness, patience and consideration. Peoples privacy and dignity was respected.

People's needs were assessed and their care plans provided staff with guidance about how they wanted their individual needs to be met. Care plans were person centred and contained appropriate risk assessments. They were reviewed and amended as necessary to ensure they reflected people's changing support needs.

There was a complaints procedure for people to follow when they raised their concerns.

The service was clean, well maintained and accessible. There were systems of audit in place to check, monitor and improve the quality of the service. Associated actions were recorded with timely outcomes and these were reviewed for their effectiveness.

The registered manager had an understanding of their role and responsibilities and requirements in regards to their registration with CQC.

This inspection took place on 17 August 2016 and was unannounced. We previously visited the service in April 2014, when we found that the registered provider met the regulations we assessed. This is the first inspection since the new registered provider took over the service in January 2016.

The home is registered to provide accommodation and care for up to 22 older people, including people who are living with dementia. On the day of the inspection there were 21 people living at the home. The home is situated in the centre of the town of Hedon, a market town in the East Riding of Yorkshire, and also close to the city of Hull. There are various communal areas where people can spend the day and an enclosed garden. The second floor of the home is accessed by either a stair lift or a passenger lift, and there are ramps to the premises to enable wheelchair access.

The registered provider is required to have a registered manager in post and on the day of the inspection there was no manager registered with the Care Quality Commission (CQC). 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. However, a manager had been appointed and was due to commence work in September 2016. They had previously been registered as a manager with the Care Quality Commission.

On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs. There were recruitment policies and procedures in place but there needed to be more evidence that these had always being followed when new staff were employed. The records for one new employee contained only one employment reference and the Disclosure and Barring Service (DBS) check had been received after they had commenced work. The records for another new employee did not include an up to date DBS check. This meant that there was a lack of evidence that the people were suitable to be employed at the home.

This was a breach of Regulation 19 (3) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People told us that they felt safe living at the home. People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Staff told us that they were well supported by the previous registered manager and the deputy manager, and felt that they were valued. They confirmed that they received induction training when they were new in post and told us that they were happy with the training provided for them and that they felt it equipped them to carry out their roles effectively. The training records needed to be more robust to evidence that staff had completed induction and on-going training. The deputy manager told us they were in the process of compiling a new and up to date training matrix.

There was evidence that the registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

We checked medication systems and saw that medicines were stored, recorded and administered safely. Staff who had responsibility for the administration of medication had received appropriate training.

People who lived at the home and relatives told us that staff were caring and that they respected people’s privacy and dignity. We saw that there were positive relationships between people who lived at the home, relatives and staff, and that staff had a good understanding of people’s indiv