Inspection on 11/04/07 for Hawthorne Care Home

This inspection was carried out on 11th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hawthorne Care Home 07/07/08

Hawthorne Care Home 14/04/08

Hawthorne Care Home 05/11/07

Hawthorne Care Home 12/04/06

Hawthorne Care Home 31/10/05

Hawthorne Care Home 24/01/05

Hawthorne Care Home 10/09/04

Hawthorne Care Home 01/10/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hawthorne Care Home School Walk Bestwood Village Nottingham NG6 8UU Lead Inspector Steve Keeling Key Unannounced Inspection 11th April 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hawthorne Care Home Address School Walk Bestwood Village Nottingham NG6 8UU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0115 9770331 0115 9770332 njh1963@yahoo.co.uk 1st Care Limited Doris Agatha Francis Care Home 36 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (34) of places Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Hawthorne Nursing Home is registered to provide accommodation and care to males and females whose primary care needs fall within the following categories :Old age (OP) 36 - the category old age refers to people aged 65 years and over Within the total number of beds at Hawthorne Nursing Home a maximum of 5 beds may be used for the category DE(E) One named person accommodated within Hawthorne Nursing Home may be under the age of 65 years (Reference Minor Application No. V1889 dated 07.03.05) The maximum number of people to be accommodated at Hawthorne Nursing Home is 36 12th April 2006 2. 3. 4. Date of last inspection Brief Description of the Service: Originally constructed as the village Rectory, Hawthorne Care Home has been extended and developed to provide accommodation and care for up to 34 people over the age of 65 years. A maximum of two beds may be used to accommodate people who are terminally ill and one bed is provided for a named individual under 65 years. Situated to the North of Nottingham City centre in Bestwood Village, Hawthorne Care Home has thirty single bedrooms and three double bedrooms. A passenger lift provides access to the first floor. The current fees charged at the home range from £277 to £450 per week and residents are required to pay additional costs for hairdressing, chiropody and newspapers. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mr S.A. Keeling and Mrs Mary O’ Loughlin conducted the unannounced inspection on the 11th April 2007 over a 6-hour period. The usual method of inspection is case tracking, this is a method of randomly selecting residents within the home and discussing with them their expectations and experiences within the home together with the care practices utilised within the home environment. The case tracking method examines the records of residents to determine if the residents identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two service users were case tracked. Also as part of the inspection process the manager, a member of staff and a resident’s relative were informally interviewed to further evidence the quality of care afforded to the residents. A range of additional information was used to determine the outcome of this inspection and the report, these included the previous judgments and findings, information received from a friends and relatives of residents in response to a carers and advocates questionnaires and pre-inspection information provided by the registered provider in April 2007. What the service does well: Significant time and effort is spent making admission to the home personal and well managed. The staff places a high value in ensuring individuals receive information, reassurance and support. Residents are afforded privacy and their dignity is maintained. Residents at the home are able to participate in stimulating social activities if they choose and are encouraged to maintain contact with their family and friends within the home and the broader community. Residents are encouraged to exercise choice and control over their lives and are provided with a wholesome, appealing and balanced diet. Residents feel confident that complaints will be listened to and taken seriously. Residents stated that they feel very safe within the homes environment. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 6 Residents benefit from a safe, well-maintained environment which is a very pleasant, comfortable and clean, although the residents dining areas would benefit from redecoration. An appropriate number and skill mix of staff are employed at the home to meets the residents needs. The recruitment process utilised at the home is effective in promoting the residents safety and staff receive appropriate training to be competent in meeting the needs of the service users. Residents live in a home, which is run and managed by a person who is fit to be in charge. Appropriate measures are in place to ensure that residents’ financial interests are safeguarded. The health, safety and welfare of service users is promoted and protected. What has improved since the last inspection? What they could do better: The recording and planning of health care needs to improve to ensure the health and welfare of the residents. The management of medicines does not safeguard the residents. Quality-monitoring systems would benefit from improvement. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Standard 3 was inspected on this occasion. This judgement has been made using available evidence including a visit to this service. Significant time and effort is spent making admissions to the home personal and well managed. The staff place a high value in ensuring individuals receive information, reassurance and support. EVIDENCE: The records of the most recently admitted resident were examined and show that the staff at the home continue to ensure appropriate assessments are undertaken on prospective residents before admission is arranged. The records also show that any external professional assessment is also obtained including hospital transfer information. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 10 A resident was being admitted to the home during this inspection and was able to confirm that they had received appropriate written information about the home to enable them to make a decision about coming to stay. They had also benefited from visiting the home previously and talking to staff before accepting a place there. On admission the resident had been welcomed and staff spent time introducing themselves and provided privacy and refreshments to the resident and their family. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Standards 7, 8, 9 and 10 were inspected on this occasion. This judgement has been made using available evidence including a visit to this service. The recording and planning of health care needs to improve to ensure the health and welfare of the residents. The management of medicines does not fully safeguard the residents. Residents are afforded privacy and their dignity is maintained. EVIDENCE: Each resident has a care plan but the practice of involving residents in the development and review of the care plans is variable. The records of two residents were examined, each contained appropriate risk assessments in all areas of health care. However there were shortfalls in the provision of care plans for all areas of risk that had been identified. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 12 Daily records and discussions with staff confirmed that the identified risks were being addressed appropriately and there was no risk to the residents. The staff were seen to communicate effectively with relatives and visitors to the home and relatives said they that they were fully informed of any changes in their relatives condition. One relative stated that the care was “fantastic” and “all the staff are wonderful” Residents spoken with were aware of their care plans but did not access them or get involved in the drawing up of these plans. Residents said they could talk to staff easily about any changes they felt they needed to be initiated in their care delivery. Medicines requiring cold storage were stored within a drug fridge, however the records of the fridge temperature show that staff do not act appropriately to ensure that appropriate temperature is maintained resulting in a potential risk to residents through the degradation of the medication. Omissions on Medication Administration Record (MAR) were not documented effectively. Staff administering Controlled Medicines did not always follow the home policies and procurers to reduce the risk of error. The medication policies stated that each controlled drug administration should have a signed witness. An examination of the homes controlled drug book evidenced that on several occasions the policy had not been adhered to. Medicine policies were not up to date and require review to include the revised management of the disposal of medicines and controlled drugs. Staff were observed to maintain the privacy of residents in their care and at all times were polite and helpful. Residents spoken with felt very safe at the home, said all the staff were good and helpful. A Resident’s relatives also confirmed that residents were always well cared for, staff always supervised the lounge areas and responded quickly to any requests from residents. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Standards 12, 13, 14 and 15 were inspected on this occasion. This judgement has been made using available evidence including a visit to this service. Residents at the home are able to participate in stimulating social activities if they choose, and are encouraged to maintain contact with their family and friends within the home and the broader community. Residents are encouraged to exercise choice and control over their lives and are provided with a wholesome, appealing and balanced diet. EVIDENCE: The manager stated that residents are provided with a wide range of social activities at the home and documentation evidenced that social activities are now facilitated by the social activities coordinator. A resident and a visitor to the home were spoken with on the day of the inspection and confirmed that they are happy with social activities programme provided within the home. The resident and visitor stated that social activities include board games, movement to music, jigsaws, sing-songs and arts and crafts. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 14 The manager stated that an open door policy is promoted at the home. A resident and a visitor to the home confirmed the open door policy and stated that their family and friends could visit the home whenever they wish and they are always made very welcome by the staff at the home. We performed a partial inspection of the home which evidenced that a pleasant communal areas are available throughout the home where residents can receive and entertain their visitors in private if the wish. The service user guide states that the residents will benefit from a wide selection interesting and varied meals. The quality of meal provission at the home was discussed with a resident. The resident confirmed that a nice choice of meals is always made available, they are always asked their preference prior to meal provission and that they were very satisfied with the catering facilities at the home. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Standards 16 and 18 were inspected on this occasion. This judgement has been made using available evidence including a visit to this service. Residents felt confident that complaints will be listened to and taken seriously and stated that they feel very safe within the homes environment. The provision of staff training relating the protection of the vulnerable adult is effective in promoting the residents safety. EVIDENCE: Residents spoken with stated that they feel very safe, well looked after and could not identify any concerns whatsoever in relation to the conduct of the staff at the home. A resident and a visitor to the home said they felt confident that the manager of the home would address any complaints effectively and felt comfortable in discussing any matters of concern with the care staff at the home. The residents pre-inspection questionnaires asked, “do you know who to speak to if you are not happy”, 100 of the responses received by CSCI stated, “yes”. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 16 CSCI has not received any complaints relating to the service provision at the home since the last unannounced inspection and the manager was not investigating and concerns or complaints at the time of the inspection. The service user guide contains a complaints procedure, but the procedure did not include specific timescales by which a complaint would be dealt with, although the complaints procedure on display within the foyer of the home did include clear timescales of 28 days in which a complaint would be addressed. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Standards 19 and 26 were inspected on this occasion. This judgement has been made using available evidence including a visit to this service. Residents benefit from a safe, well-maintained environment which is a very pleasant, comfortable and clean, although the residents dining areas would benefit from redecoration. EVIDENCE: Cleaning rotas are in place to ensure that the home is maintained effectively. A resident and a visitor to the home expressed satisfaction with the standard of cleanliness within the home, which included the resident’s bedrooms. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 18 We inspected the resident’s bedrooms, which were found to be homely, safe and personalised with many personal possessions such as family pictures, small items of furniture, a television, radio and ornaments. To promote safety within the residents bedrooms window restrictors and radiator guards were evidenced, together with appropriately placed nurse call buttons to ensure staff can attend to the residents needs effectively over the 24-hour period. We performed a partial tour of the premises. On the whole the homes internal environment was clean and fresh throughout. Two members of the domestic staff confirmed that they had access to cleaning materials to ensure they can maintain the high standard of cleanliness throughout the home. The walls in both dining rooms were slightly scuffed by wheelchair footplates and minor stains were evident on the walls. The downstairs bathroom floor covering is not effectively sealed to the wall and the bath panel is cracked. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Standards 27, 28, 29 and 30 were inspected on this occasion. This judgement has been made using available evidence including a visit to this service. An appropriate number and skill mix of staff are employed at the home to meets the residents needs. The recruitment process utilised at the home is effective in promoting the residents safety and staff receive appropriate training to be competent in meeting the needs of the residents. EVIDENCE: Nineteen residents were accommodated at the home on the day of the inspection. We examined the staff rota and it was evident that two qualified nurses and four care staff were on duty, supported by a cook, kitchen assistant, two cleaners and the handyman. The pre inspection survey for relatives, carers and advocates asked “do you feel the care home meets the needs of your friend/relative”, 91 of the responses received by the CSCI stated, “yes”, with 9 stated “usually”. Comments made on the survey included “my mother is well looked after, she is comfortable, warm, well fed and clean. She is treated with respect and dignity” and “the care is excellent”. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 20 A visitor to the home stated that “there are always plenty of staff on duty and the residents are always supervised”. We examined a copy of the recruitment matrix. The matrix evidenced that members of staff only commence employment once satisfactory Protection of Vulnerable Adult (POVA) checks and Criminal Record Bureau (CRB) checks have been obtained, together with two satisfactory references. We examined a copy of the staff-training matrix, which evidenced that appropriate mandatory training opportunities are provided to staff employed at the home in relation to the Protection of the Vulnerable Adult (POVA), Moving and Handling, Infection Control, Food Hygiene, First Aid and Dementia Awareness. The pre inspection survey for relatives, carers and advocates asked “do the care staff have the right skills and experience to look after people properly”, 73 of the responses received by CSCI stated, “yes”, with 27 stated “usually”. Comments made within the questionnaire included “the staff appear to have the right skills as my mother is so well looked after”. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Standards 31, 32, 35 and 38 were inspected on this occasion. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is run and managed by a person who is fit to be in charge, although quality-monitoring systems would benefit from improvement. Appropriate measures are in place to ensure that residents’ financial interests are safeguarded and the health, safety and welfare of residents is promoted and protected. EVIDENCE: Residents and visitors were very complimentary about the manager’s abilities stating that “you can go to her at any time” and “ the manager has created a sensitive caring environment at the home”. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 22 Given the shortfalls identified within this report in relation to medication management and the care planning process it is evident that further development is required in relation to the quality monitoring processes utilised at the home, so as to effectively monitor practice and compliance with the homes policies and procedures. Documentation examined evidenced that residents and relatives satisfaction levels in relation to service provision is only determined through the distribution of annual residents/relative questionnaires and residents meeting are not performed. Staff at the home do not act as a financial agent for any residents. Should residents require any money they can access a small amount of petty cash. A record is maintained for each transaction and the resident’s financial appointees are invoiced appropriately. In determining that the service users are safe within the homes environment a range of Health and Safety records were provided by the manager in the preinspection questionnaire relating to gas safety certificate, fire safety drills, fire equipment checks, emergency lighting checks, hoist and adaptation checks and lift servicing, all were found to be satisfactory. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x 3 3 Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 OP8 Regulation 15 Requirement Care plans will developed to include all areas of identified needs following assessment; this would enable someone not familiar with the resident to deliver the appropriate care. The recording, handling, safekeeping, safe administration and disposal of medicines will be effective in maintaining the safety of residents at the home. 1, Medicine policies must be reviewed and include the systems in place for the disposal of medicines and controlled drugs. 2, The administration of controlled medicines must be witnessed by a second suitably trained person as per the homes medication policy 3, The medication fridge is monitored daily and is maintained between 2-8 degrees centigrade. 4, The reason for omissions on medication administration record must be recorded and the appropriate key utilised. Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 25 Timescale for action 31/05/07 2 OP9 13 31/05/07 3 OP33 24 Quality auditing will be effective to ensure that compliance with policies and procedures. 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations The residents and relative’s consultation process should be further developed to determine residents and relatives satisfaction levels in relation to service provision Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hawthorne Care Home DS0000026443.V332847.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!