Hartwig Care (Bexley)

Updated 2 September 2023

The inspection

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

Inspection team

This inspection was carried out by 2 inspectors on the 1st day of the inspection and 3 Experts by Experience also supported this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The 2nd day of the inspection was carried out by 1 inspector.

Service and service type

Hartwig Limited is a domiciliary care agency, it provides personal care to people living in their

own houses and flats

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there were 2 registered managers in post.

Notice of inspection

We gave the service 48 hours' notice of the inspection as we needed to be sure that the registered manager would be in the office to support the inspection. This inspection site visit took place on 02 June 2023 and 13 June 2023 and was announced.

What we did before the inspection

We checked the information we had about the service including notifications they had sent us. A notification is information about incidents or events that providers are required to inform us about. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people and 6 relatives to seek their views about the service. We spoke with 6 members of care staff, the operations manager, a field supervisor and the 2 registered managers. We reviewed records, including the care records of 5 people using the service and recruitment files and training records of 8 staff members. We also looked at records related to the management of the service such as quality audits, accident and incident, and policies and procedures.

Updated 2 September 2023

About the service: Hartwig Care Ltd (Bexley) is a domiciliary care agency. It provides personal care to people living in their own homes, At the time of the inspection there were 66 People using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People's experience of using this service

We found that the provider failed to carry out pre-assessments before people used the service. Appropriate risk assessments were not always completed, and risk management plans were not always in place to manage these risks, which included choking, skin integrity, equipment, falls, malnutrition, bedrails, Parkinson’s, multiple sclerosis and epilepsy.

Staff were not always deployed to meet people's needs in a timely manner. There was a system in place to log and investigate accidents and incidents, however, these were not analysed and learning from this was not disseminated to staff. Staff had not received training in catheter care that could be evidenced. People’s independence was not always promoted, and people’s privacy and dignity was not always respected.

People or their relatives were not always involved in planning their care and support. People or their relatives’ consent to care and support was not always documented. Governance systems were not always effective at identifying and reducing risks to people's safety.

Overall, medicines were safely managed. People were protected from the risk of infection. Appropriate recruitment checks were carried out before staff joined the service. There was a complaints system in place to manage people concerns effectively. Staff were supported through regular supervisions.

Rating:

This was the first inspection of the service.

Why we inspected - This was a planned comprehensive inspection.

Enforcement and Recommendations:

We have identified breaches in relation to safe care and treatment, staffing, person-centred care, dignity and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

You can see what action we have asked the provider to take at the end of this full report. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hartwig Care Limited – Bexley on our website at www.cqc.org.uk.