The Hawthorns (Evesham)

Updated 19 March 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of one adult social care inspector, one specialist professional (nurse) advisor (SPA) and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

The Hawthorns (Evesham) is a care home. People in care homes receive accommodation and nursing or personal care 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection took place on 5 February 2019 and was unannounced. This meant the provider and staff did not know we would be visiting.

What we did:

Before inspection: We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The information provided by the provider was used to plan our inspection and was taken into account when we made judgements in this report.

During the inspection: We spoke with 16 people who used the service and ten relatives. We also spoke to the registered manager, the quality manager, the activity coordinator, the cook, the administrator, a member of laundry staff, three nurses and three support workers.

We looked at five care files, three staff files to review recruitment, training and supervision records. We looked at records of accidents, incidents, complaints and compliments and reviewed audits, quality assurance reports and surveys.

Updated 19 March 2019

About the service: The Hawthorns (Evesham) is a care home that provides accommodation and support for up to 47 people who require either nursing or personal care. Personal and nursing care is provided to people living with dementia or an acquired brain injury. At the time of the inspection 46 people were using the service. Six people with an acquired brain injury were living on the top floor and 40 people living with dementia were on the first and ground floor. The first and ground floor had been separated into four areas so only ten people living with dementia were together with their own lounges and kitchens.

People’s experience of using this service: People using the service benefitted from an extremely well led and caring service. People and their relatives were placed at the heart of the service and involved at every level. Assessments to support staff to mitigate risks were in place and people were activity encouraged to take positive risks. Staffing levels were high. Medicines were administered safely, and the service was piloting an electronic Medicine Administration System (eMAR) that had been developed by Shaw Healthcare Ltd. The registered manager had worked hard to reduce or discontinue when required (PRN) anti-psychotic medicines, using techniques to identify any triggers and put distraction technique's into place rather than administer medicines.

Staff had received a high level of training. Staff were fully supported to gain extra qualifications. If English was not the staff members first language another staff member would support them. The support staff received, generated a highly motivated staff team. People were very happy with the food provided and the cook had thought of innovative ways to support people to eat who preferred food on the move.

Staff demonstrated an exceptionally high level of kind and supportive care. Staff continuously smiled as they went about their work. Staff collaborated with people and their relatives to make sure they knew about the person’s interests and needs so they could have a positive impact on the person’s life. Where people had equality and diversity needs these were managed sensitively.

There was a truly holistic approach to planning, and delivering care and support. Each person’s care plan was linked to how they wanted to be cared for, their preferences and their needs. People were at the heart of a service that was organised to suit their individual needs. Every person had their own activity timetable that covered all their needs such as intellectual, social, sensory, spiritual and emotional needs. Although they had an activity coordinator, who was extremely dedicated and cheerful, all staff provided continuous short snappy activities throughout the day.

The atmosphere within the service was exceedingly friendly, comfortable, inviting and open. Positive and innovative ways to support people had been and were continuously being developed. The registered manager had recently won the Hennell Aware for Innovation and Excellence in Dementia Care. This award is to celebrate the achievements of someone who have shown their ability to implement positive change for people with dementia.

Rating at last inspection: The rating at the last inspection was good, (published in March 2016.)

Why we inspected: The inspection was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.