The inspection was carried out on the 11 October 2018. The inspection was unannounced.

Hawthorn Manor Residential Home is a ‘care home'. People in care home services receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The accommodation was modern and spanned two floors. A stair lift was available for people to travel between floors. Staff provided residential care for up to 37 older people. There were 33 older people living at the service when we inspected.

At our last inspection on 10 February 2016, we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Since our last inspection the registered manager and provider had been consistent in auditing the risks associated with providing care and the quality of people’s experiences.

The outcomes promoted in the provider's policies and procedures were monitored by the registered manager to make sure they were in line with current legislation and practice. The policies included equality and human rights. There were multiple audits being undertaken to support learning and improve quality.

Staff consistently demonstrated they shared the provider's vision and values when delivering care. People were supported to maintain friendships and contacts with those they chose. Activities were planned to assist people to their purpose and pleasure in life.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People’s needs continued to be assessed and their needs were recorded. People’s right to lead a fulfilling life and to a dignified death was understood and respected at all levels. People, their relatives and health care professionals had the opportunity to share their views about the service either face-to-face, by using feedback forums or by responding to formal bi-annual provider quality surveys.

We observed that staff were friendly and caring. Staff understood the risks to people’s individual health and wellbeing and risks were clearly recorded in their care plans. Incidents and accidents were reported and appropriately investigated.

Risks to people from poor nutrition and hydration were minimised because people were offered meals that were suitable for their individual dietary needs and met their preferences. People were supported to eat and drink according to their needs, staff supported people to maintain a balanced diet.

There continued to be enough staff on duty to meet people’s physical and social needs. The registered manager checked staffs' suitability to deliver personal care during the recruitment process.

Staff received training and supervision and continued to be that matched to people’s needs effectively.

The premises and equipment were regularly maintained and checked to minimise risks. People’s medicines were managed, stored and administered safely. The service was clean and odour free. Staff followed the provider's infection control policy. Staff understood their responsibilities to protect people from harm and were encouraged and supported to raise concerns by the registered manager. Emergency response contingency plans were in place.

The registered manager had sent statutory notifications to CQ

We carried out this inspection on the 10 and 11 February 2016. It was unannounced.

Hawthorne Manor is a care home providing accommodation and support for up to 37 older people who require assistance with personal care. The accommodation was provided over two floors and there is chair lift available to access the first floor.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider, 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.

People were given individual and group support to take part in their preferred activities and interests. There were no planned trips out of the home, currently as people did not like going out in the cold weather. However the staff were looking into facilities of different locations locally where people may like to visit once the weather improves.

Medicines were stored, administered and disposed of safely. Only trained staff administered medicine. Staff had received training and their competency to administer medicine this had been checked. Audits of medicines made sure people received the medicines they had been prescribed.

The environment was suitable for the people who lived there and looked well maintained.

People spoken with all said that they were very pleased with the care and support that they received at the home.

There were systems in place to obtain people’s views about the service. These included formal and informal meetings with people using the service and their families and annual surveys.

There was a complaints procedure on the homes notice board. The registered manager explained that all people and their families had been given a copy of the complaints procedure. People told us that they would know how to complain but that they had no need to. They were confident that any complaint would be taken seriously by the registered manager.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. As the people living in this home have mental capacity and there was no deprivation of liberty there had been no reason to make an application. The registered manager and staff understood why and when an application should be made. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

Staff had received safeguarding training and knew how to protect people. They knew the action to take in the event of any suspicion of abuse towards people. Staff also understood the whistle blowing policy. Staff said they were confident raising any concerns with the registered manager or outside agencies if this was needed.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. The registered manager and staff contacted other health professionals for support and advice when necessary.

People were provided with diet that met their needs and wishes. Menus offered variety and choice. People said they liked the meals offered and that at residence meetings they were asked for suggestion for the menu. Staff made sure that people had plenty of drinks offered through the day. We observed lunch being served and people were happy with their choices.

Staff were recruited using procedures designed to protect people from being cared for by unsuitable staff. Staff were trained to meet people’s needs and their performance was discussed during one to one supervision and their annual appraisal. Staff were supported to carry out their roles.

There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how any risks could be minimised. There were systems in place to r

One inspector visited the home, during this visit we were able to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People received a consistent and safe level of support.

Procedures for dealing with emergencies were in place and staff were able to describe these to us.

All of the people who were able to converse with us said that they felt safe in the home; and indicated that if they had any concerns they were confident these would be quickly addressed by their key-worker in the first instance, or by the manager.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager told us that they had not found it necessary to apply for a Deprivation of Liberty safeguard for anyone to date. Where some people in the home had been assessed as lacking mental capacity unable to make decisions about their care and treatment, they either had an advocate, a next of kin or representative to speak on their behalf or meetings were held with people’s representatives, Social Services and health professionals to make decisions on people’s behalf and in their best interests where this was needed.

Is the service effective?

People had an individual care plan which set out their care needs. People who used the service and family told us they had been fully involved in the assessment of their health and care needs. One relative said, “They keep me informed at all times and I feel involved”. Assessments included needs for any equipment, mobility aids and specialist dietary requirements.

People had access to a range of health care professionals some of which visited the home. This meant that people were sure that their individual care needs and wishes were known and planned for and that they had the equipment they needed to meet their individual needs.

Is the service caring?

Relatives told us that they felt their people who lived in the home are safe. One Person said, “X is very much safe here. They are so much better living here”.

People’s care needs were discussed with them; and care plans demonstrated people’s individual needs and how to support them appropriately. Staff were knowledgeable about the people in their care, and were suitably trained to deliver care correctly.

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, “I am comfortable here, staff are very good and I think they are meeting my needs. I like it here”. A relative said, “I am able to approach the staff or manager at any time. Staff talk to all of us at all times. We are very involved” and “They keep me informed at all times and I feel involved. I would recommend the home to anyone”.

Is the service responsive?

People’s care plans were regularly reviewed, and were promptly amended if there were any changes in their health care needs. People were fully involved in their care planning. The staff ensured that referrals were made to other health and social care professionals as needed, to support people with meeting their different needs. People were enabled to take part in activities of their choice and to go out into the community.

People knew how to make a complaint if they were unhappy. One relative said, “If I need to complain, I will go to the manager. She is very approachable”.

All areas were well maintained and the manager said that maintenance requests were dealt with promptly. We looked at the maintenance log and saw that regular maintenance request was carried out.

Is the service well-led?

The home had a system to assure the quality service they provided. The way the service was run had been regularly reviewed. Prompt action had been taken to improve the service or put right any shortfalls they had found.

Information from the analysis of accidents and incidents had been used to identify changes and improvements to minimise the risk of them happening again.

People’s personal care records, and other records kept in the home, were kept up to date.

People who used the service, their relatives, friends and other professionals involved with the service were recently sent an annual satisfaction survey by the manager to be completed.