The inspection took place on 19 October 2017 and was unannounced. The Hawthorns is a care home that provides personal care and accommodation for up to 22 older people. There were 20 people living at the home at the time of our inspection visit. There was a registered manager in place, who was present throughout the visit. 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.

At our last inspection in June 2016, we rated this service ‘Requires Improvement’ overall. We had also identified a breach of the regulations because systems had not always been effective to drive the quality and safety of the service. Following the last inspection, the provider told us how they would improve the service. At this inspection, we found improvements had been made to meet all legal requirements and support a rating of ‘Good’ overall.

People were safe using the service. Staff were aware of how to identify and report any safeguarding concerns and how to help manage people’s risks. People were supported by sufficient levels of staff who had been suitably recruited.

People received safe and appropriate support with their medicines. Systems were in place to promote consistently safe medicine management practices.

People were supported by staff who understood their needs. Staff received training and support for their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were supported to have enough food and drink of their choice and preference. People had access to healthcare support as needed to promote their health and wellbeing.

All people and relatives told us staff were kind and caring. People were treated with respect. We observed good, caring interactions from staff and saw people and staff spent time together. People were supported to express their views and make decisions about their care.

People received care that met their needs and wishes. People were encouraged to engage in activities of interest to them. People and relatives felt able to express their views and complain if necessary, although no formal complaints had been raised.

There was a registered manager in place who understood their responsibilities to the Commission. Systems were in place to involve people and relatives in their care and in monitoring the quality of the service. People and relatives consistently expressed satisfaction with their care and staff told us they felt supported in their roles.

The inspection took place on 19 October 2017 and was unannounced. The Hawthorns is a care home that provides personal care and accommodation for up to 22 older people. There were 20 people living at the home at the time of our inspection visit. There was a registered manager in place, who was present throughout the visit. 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.

At our last inspection in June 2016, we rated this service ‘Requires Improvement’ overall. We had also identified a breach of the regulations because systems had not always been effective to drive the quality and safety of the service. Following the last inspection, the provider told us how they would improve the service. At this inspection, we found improvements had been made to meet all legal requirements and support a rating of ‘Good’ overall.

People were safe using the service. Staff were aware of how to identify and report any safeguarding concerns and how to help manage people’s risks. People were supported by sufficient levels of staff who had been suitably recruited.

People received safe and appropriate support with their medicines. Systems were in place to promote consistently safe medicine management practices.

People were supported by staff who understood their needs. Staff received training and support for their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were supported to have enough food and drink of their choice and preference. People had access to healthcare support as needed to promote their health and wellbeing.

All people and relatives told us staff were kind and caring. People were treated with respect. We observed good, caring interactions from staff and saw people and staff spent time together. People were supported to express their views and make decisions about their care.

People received care that met their needs and wishes. People were encouraged to engage in activities of interest to them. People and relatives felt able to express their views and complain if necessary, although no formal complaints had been raised.

There was a registered manager in place who understood their responsibilities to the Commission. Systems were in place to involve people and relatives in their care and in monitoring the quality of the service. People and relatives consistently expressed satisfaction with their care and staff told us they felt supported in their roles.

We visited this service and talked with people to gain a balanced overview of what people experienced, what they thought and how they were cared for and supported. There were eighteen people living in the home at the time of our visit.

We spoke with three members of staff, the manager and administrator, five of the people who lived in the home, one visitor to the home, and five relatives. We observed how people were cared for and how staff interacted with them to get a view of the care they experienced.

We considered all of the evidence we had gathered under the outcomes that we inspected. We used that information to answer five key 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. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We observed the interactions between the people who lived in the home and staff. People looked at ease in their surroundings. Staff spoke with them in a calm and friendly manner. There were enough staff on duty to meet the needs of the people who lived at the home.

We saw there were systems in place to ensure people received their medicines safely and as prescribed.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes and hospitals. No applications had been made. The manager understood how this legislation applied to people and protected their rights.

We found that equipment was serviced at regular intervals to ensure it was safe to use.

Is the service effective?

People’s health and care needs were assessed with them, and they were involved in writing their care plans. Specialist pressure relieving, mobility and equipment needs had been identified in care plans where required.

It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and knew them well. We saw people's care plans and risk assessments were reviewed on a regular basis to ensure their changing needs were planned for.

Visitors and the relatives of people living in the home confirmed that they were able to see people in private and that visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers were available at all times, showed patience and gave encouragement when supporting people. One person told us, “I’m very satisfied, when I ring the buzzer staff come to help.” A relative told us, “It’s a good place to be looked after, staff are very courteous and caring.” Another relative said, “It’s an excellent home, the staff are brilliant.”

People using the service, their relatives, friends and other people involved with the service completed an annual satisfaction survey. The suggestions and ideas voiced by people were followed up.

People’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People’s needs had been assessed before they moved into the home and care plans reflected people’s assessed needs. We saw people's care plans and risk assessments were reviewed on a regular basis to ensure their changing needs were planned for.

Records confirmed people’s preferences, interests, and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People had access to some activities and were able to maintain relationships with their friends and relatives.

Records showed that staff responded quickly to changes in people's health. We saw people had access to a variety of health care providers to ensure their needs could be met.

Is the service well led?

The registered manager had been in post since the home had opened. The manager was experienced and caring and provided good leadership based on how best to meet the needs of people in an individualised way.

There were systems in place so people who lived in the home could share their views about how the home was run. The manager was able to give us examples of actions taken and changes that had been made as a result of listening to the people living in the home.

There were systems in place to ensure the quality of the service was regularly assessed and monitored.

On the day of our inspection we saw there were 20 people living at The Hawthorns. We spoke with five members of staff, three people who used the service and four relatives. We looked at policies and processes, three care records and three staff records, to gain an insight into the care provided.

We saw that people were involved in decisions about their care. Care plans and risk assessments were in place and were updated regularly to ensure people received the care they needed.

We saw that staff co-operated effectively with external health providers to ensure people who lived at The Hawthorns received co-ordinated care.

We saw that the equipment used was maintained regularly. This was to ensure people who lived at The Hawthorns were safe.

There were adequate numbers of staff on duty and staff received appropriate support and training to enable them to care for the people who lived at the service. Staff told us they really liked working there and that the provider was very supportive. One person told us, “The staff are lovely and help me if I need it.”

People experienced good quality care and effective systems for monitoring were in place. There was evidence that people and their families knew how to complain if things were not right. There were a variety of activities designed to meet people's needs and maintain their independence. People told us they liked living at The Hawthorns. One person told us, “They (the staff) always ask me what I want.”

We spoke to four people, four relatives and or visitors and four staff. We also looked at three people’s care documents and four staff personnel files. As well as associated provider documents.

At this inspection we saw that the provider had a culture which encouraged people to be voice their opinions about the service and their needs. People felt confident to make complaints, knowing there would be no negative repercussions.

Staff were skilled and supported in their roles, they received training to recognise and report abuse, this formed part of their mandatory training.

Staff were able to meet the care and welfare needs of the people using the service. The associated documentation was detailed but the information required to deliver care was well presented, making it easy for staff to find information about people. The provider worked with external healthcare professionals when needed to meet people’s needs. One relative when asked about the service said, “Absolutely brilliant”.

You can see our judgements on the front page of this report.