Inspection on 03/07/06 for The Hawthornes Care Home

This inspection was carried out on 3rd July 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Hawthornes Care Home 04/04/07

The Hawthornes Care Home 24/11/05

The Hawthornes Care Home 27/06/05

The Hawthornes Care Home 26/01/05

The Hawthornes Care Home 19/07/04

The Hawthornes Care Home 03/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Hawthornes Care Home Mill Lane Birkenshaw West Yorkshire BD11 2AN Lead Inspector Stephen French Unannounced Inspection 3rd July 2006 09.30 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 The Hawthornes Care Home DS0000035661.V291422.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. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hawthornes Care Home Address Mill Lane Birkenshaw West Yorkshire BD11 2AN 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) 01924 284200 Tri-Care Limited Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: The Hawthornes care home is a care home providing personal care and accommodation for 40 older people. It is owned by Tri-Care Homes Ltd., a private limited company with several other similar homes in the area. The home is situated in North Kirklees on the Bradford boundary. The home was purpose built and opened two years ago. It is built over two floors and there are gardens to two sides of the building and a large car park to the front. It is located on a main bus route. All the service users rooms are single with ensuite facilities. There is a passenger lift and good communal facilities. The provider informed the Commission for Social Care Inspection on 3rd July 2006 that fees range from £435.00 to £450.00 per week. Service users who are funded by the local authority are expected to provide an additional £15.00 per week top up. Additional charges include hairdressing, private chiropody, newspapers and some selected activities. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide, Which are available in the home on request. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on the 3rdRD June 2006. The inspector arrived at the home at 9:30am and left at 4:00pm. During this visit the inspector spoke to a number of the service users, some of the staff and the home’s management. The inspector read care records, audited a sample of medication, reviewed staff recruitment and training records and carried out a brief tour of the building. Prior to the inspection 10 service user questionnaires were sent to the home to obtain service users’ views about living at the home. Five completed questionnaires were returned. Comments received included “In terms of personal care the staff act A.S.A.P, however the cleanliness of the home has deteriorated over the last 12 months, frequent shortage of staff”, “If I was unhappy I would speak to one of the senior staff”, “Lunch usually later than 12 noon we are asked to be seated for 12 but wait ten minutes or more before we are served”. Some service users in the home are very frail and would not be able to complete a questionnaire. There were thirty- nine service users resident in the home on the day of this visit. Relative surveys were also sent out and seven were returned. Comments included, “Frequent management and staff changes and lack of continuity”, “Relatives bedroom not cleaned regularly, bins not emptied and bathroom not cleaned”. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider and a pre inspection questionnaire completed by the manager. What the service does well: The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 6 Service users needs are assessed prior to them moving into the home to ensure the home is able to meet those needs. The home offers a safe, comfortable, friendly environment in which the service users can live. There is a stable staff team who are aware of the needs of the service users. The manager is new in post and has made a number of improvements to ensure service users receive a satisfactory standard of care. Service users said that the meals were very nice and that there was plenty of choice on offer. Some service users said that they were happy with the social activities, which were on offer and that, they enjoyed the trips out that they had. What has improved since the last inspection? New care documentation has been introduced which includes risk assessments for such things as oral health care and nutrition. The documentation ensures service users care plans are completed more consistently and with a greater level of detail. A formal quality audit tool has been introduced which helps to identify any shortfalls within the home and these are then rectified. Care staff who also work in the laundry have received training in how to operate the washing machines at the correct temperatures and have received training in the control of substances hazardous to health. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 7 What they could do better: 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 Hawthornes Care Home DS0000035661.V291422.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 The Hawthornes Care Home DS0000035661.V291422.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Where possible no service user moves into the home without having had their needs assessed and been assured their needs can be met. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Service users confirmed when spoken to and in questionnaires that they had information about the home before they came to live there and that their needs had been assessed. The sample of case records audited showed that service users admitted to the home recently had been assessed prior to admission. One service user confirmed that they had had opportunity to visit the home before they made the decision to stay at the home. The manager said that the home does not offer intermediate care. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Service users are treated with respect, but their health would be better ensured if clear care planning systems were in place and if medication stock balances were maintained. Quality in the outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Service users spoken with at the time of the inspection said that they were satisfied with the care and support provided by the staff. This was also reflected in the comment cards received by the Commission. Each service user had a care plan. Six care files were examined and these contained assessments for such things as moving and handling, skin integrity and nutritional support; most of these had been reviewed at regular intervals, however a number had not. The home is currently reviewing their care documentation and records seen were a mixture of both old and new. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 11 Care plans did not give sufficient detail to enable staff to meet the health care needs of the service users. Care documentation generally did not reflect the current and changing needs of the service users and this must be addressed. There was evidence in some of the care plans that service users wishes regarding rising and retiring times have been taken into consideration. One service user said that the care staff were good and that when she had first been admitted to the home she had been very ill but the staff had nursed her back to health. Another service user said that due to staff shortages she sometimes had to wait for long periods before staff attend to her. Senior care staff are responsible for the administration of medication. Service users who wish to self medicate may do so following completion of a risk assessment. Six service users medications were audited against the medication administration records held by the home. Five stock balances did not tally with the records held. One service users medication audited had been signed as given but on further examination it was found that the service user had not received the medication. This is of serious concern and must be addressed. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service users’ social, cultural, religious and recreational needs could be better met if there was a dedicated activities co-ordinator employed. Service users are helped to maintain contact with their families and the local community. Service users are able to exercise choice and control over their lives. Meals provided are varied, wholesome and appealing. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home does not employ a social activities co-ordinator. The responsibility for arranging social activities lies with the deputy manager who arranges these during her lunch break. Records of activities, which the service users have joined in, are recorded in their care files. On the day of the inspection some service users were enjoying an organ recital and others were sat in the garden. A number of service users informed the inspector that they were looking forward to a trip to Blackpool the following day. One service user stated that social activities within the home were not very good of late but another said she was happy with the variety of things on offer. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 13 The manager said that relatives and friends of the service users are encouraged to visit the home as often as they like and are able to stay and have a meal; service users spoken to confirmed this. Within the care files examined, and service users spoken to it was confirmed that service users are able to exercise choice and control in most things they do this includes the time they rise and retire and where and how they spend their day. The home operates a four-week menu choice, which includes a full English breakfast and five options of meals for lunch. On the day of the inspection the starter consisted of prawn cocktail or fruit juice and a choice of Shepherds pie, Tuna Pasta bake, omelette or baked potatoes with various fillings. The meals seen were well presented and comment cards received all complimented the home on the quality and variety of food on offer. The Inspector observed the service users having lunch and noted that there was only one member of staff in the dining room whilst another member of staff assisted the cook in the kitchen. There were fourteen service users in the dining room and should any of these have required help with feeding then the remaining service users would have had to wait to be served. It was also noted that service users were asked by staff to be seated in the dining room at 11.50 am but meals were not served until 12.15. Two comment cards received mentioned the long wait service users sometimes had before their meals were served. The kitchens were clean and tidy and there appeared adequate stocks of fresh fruit and vegetables. The care staff are responsible for clearing the tables and filling the dishwasher as well as hovering the dining room following mealtimes. There is only one cook in the kitchen and the night staff are responsible for preparing the vegetables and cooking the meat for the following day. Care staff hours would be better deployed on the personal and social care of service users and adequate numbers of kitchen and domestic staff should be employed. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Service users and their relatives are confident that complaints will be handled appropriately. Service users are protected from abuse. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home displays its complaints policy in the reception area of the home. Service users also receive a copy of the policy within the service users guide. The manager investigates and records all complaints and these are audited on a monthly basis. If the complainant is not happy then the complaint is referred to the area manager. Service users spoken to, and comment cards received, all said that they were aware of the policy and were confident that any issues raised would be addressed by the home manager. Staff receive training in the protection of vulnerable adults as part of their induction and it is also discussed as part of staff supervision four staff have received training in this subject in 2006. The manager is aware that further staff training updates in this subject are required. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20,21,23,24,25,26 Service users live in a safe, well-maintained environment. The home is clean and pleasant. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: As part of the inspection a tour of the home was conducted. This included a number of service users bedrooms, communal areas, bathrooms and the laundry. Service users bedrooms were personalised with their own things such as ornaments and pictures and they are able to hold the key to their room if they wish. The standard of decoration and furniture throughout the home was very good. Service users and relatives comment cards received by the Commission mentioned that the standard of cleanliness was poor but on the day of inspection bathrooms and communal areas were clean and tidy and there were no unpleasant odours detected. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 16 There are a number of communal bathrooms with specialist baths to assist service users who have mobility problems. One bathroom on the ground floor was in need of redecoration and the blind was broken. The laundry was clean and tidy and staff have received instruction on how to operate the machines since the last inspection, however care staff are still responsible for the service users personal laundry. Comment cards received from both service users and relatives informed the Commission that they were not happy with the standard of clothing being laundered, however one comment card suggested that this was improving. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Due to the level of the dependency of the service users currently living at the home there are sufficient numbers of staff to meet the service users needs, however staffing levels should increase should the dependency of the service users change. Kitchen and laundry staff should be identified on a separate duty rota. The home has robust recruitment procedures, which protect the service users from abuse. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The staff duty rota was checked for the month of July and this confirmed that the numbers of staff on duty were: AM; the manager, 1 senior carer and four care staff. PM; 1Senior carer and four care staff and night duty 1 Senior carer and two care staff. The manager stated that staff holidays and sickness are covered by bank staff or the homes staff doing overtime. Previous copies of the duty rota could not be examined as these are destroyed. The manager was informed that she must keep a copy of all worked rotas. Service users spoken to said that there were often times when the home was short staffed, particularly at weekends. Staff spoken to also expressed concern that staff shortages often meant that they were only able to give the basic level of care The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 18 to service users and did not have time to spend socialising or spending time getting to know them. There are seven care staff that have an N.V.Q level 2 qualification and the remaining staff are working towards the award. New staff complete an induction program, which covers, amongst other things, moving and handling, fire training and health and safety. Carers spoken to who have been employed at the home for some months informed the inspector that they had completed induction training and had worked alongside a senior member of staff for the first week of employment until they felt confident. Carers stated they felt well supported by the manager and other care staff. Four staff details were checked for staff recently employed by the home and these confirmed that appropriate checks were being made prior to the employment of staff. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The home has a new manager and is run in the best interest of service users. Service users’ financial interests are safe guarded. The health, safety and welfare of service users and staff are promoted but are not always being fully protected. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There is a new manager in place who has previously managed care homes in the past. She has completed her Registered Manager’s Award and is aware of The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 20 the needs of the service users. She is currently undertaking the “fit persons assessment” which is conducted by the Commission for Social Care Inspection to register her as manager therefore this standard is scored as unmet. The company who owns the home has introduced formal quality audits, which are completed by the manager on a monthly basis. The areas, which are audited, include, amongst other things, accidents, complaints, staffing and care; evidence was seen that action plans are produced and acted upon. Service users and relatives are asked for their comments on the home and the care that they receive on an annual basis. Staff and service user meetings are held and the minutes of these meetings are displayed in the homes reception area. The last service user meeting was held on 2/5/06 where problems with the laundry were discussed. Service users are able to keep small amounts of money within the home. This enables them to purchase small items such as sweets, newspapers and pay for hairdressing. The manager said that where possible service users are advised to have their own bank accounts. Two amounts of service users monies where audited and the balances tallied with the records held by the home. Care staff receive formal supervision from the manager, which includes all aspects of their practice, the homes philosophy of care and the carers training needs. Records examined confirmed this. Regular fire safety checks are carried out and recorded. Staff receive training in fire prevention. A number of staff questioned on this subject gave different answers to what they would do if the home had to evacuate the service users in the event of a fire. Some staff said they would evacuate if there was a fire and others said they would wait for the fire brigade. The homes fire risk assessment and fire policy was examined and was found to be in need of updating. The Inspector noted that staffs understanding of the homes policy regarding fire evacuation was the same as in its sister home therefore more information is required within the policy on evacuation to ensure all staff are aware of their responsibilities. Certification in relation to servicing of gas electricity and electrical equipment was not examined as the manager stated there were all in place and up to date. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 21 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 3 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 X 3 3 X 4 4 4 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 1 x 3 x 3 3 x 2 The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 Regulation 15(1) Requirement The registered person must prepare a written plan setting out how the needs of service users will be met: Specific outcomes and goals must be set out in the care plan and daily records must evidence how these needs are being met. (outstanding from 24/11/05) The registered person must make arrangements for the safekeeping of medicines and account for medication held in the home. ( Outstanding from 24/11/05 ) The service provider must, having regard to the size of the care home, the statement of purpose number and needs of service users ensure that there are sufficient numbers of staff, especially domestic staff, to promote the health and welfare of service users. This is an outstanding requirement from 26/01/05, 31/7/05,24/11/06 Timescale for action 31/08/06 2. OP9 13(2) 03/07/06 4. OP27 18(1)(a) 31/08/06 The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 23 5. 6. OP31 OP38 9 23 (4)d,e The manager should register 31/08/06 with the commission for social care inspection. The registered provider must 31/08/06 ensure that staff are aware of their responsibilities and the procedures to be followed in case of fire. The fire policy and risk assessment must be updated. 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 OP12 Good Practice Recommendations Consideration should be given in employing a full time activities co-ordinator. 2. 3. OP21 OP28 The bathroom identified should be redecorated and the blind replaced The manager should be mindful that at least 50 of care staff complete the NVQ Level 2 in care as soon as possible. The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 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 The Hawthornes Care Home DS0000035661.V291422.R01.S.doc Version 5.2 Page 25 - 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. 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