Hartwig Care (Enfield)

Updated 2 June 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 1 inspector and an Expert by Experience who contacted people and relatives by telephone for feedback on the care and support they received. 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

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and/or specialist housing. The service also provides care and support to people living in 3 ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service a short notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed the provider’s action plan from the last inspection and 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited 1 of the supported living units and spoke to 3 of its residents and the staff on duty. We spoke with a total of 7 staff members including 3 care workers, a team leader, a care coordinator, an administrative assistant, and the registered manager.

We reviewed a range of records. This included care records for 4 people and multiple medicines records.

We looked at 3 staff files in relation to recruitment and supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures, staff training records, audits and meeting minutes.

Following our visit to the service, we spoke with another person using the service and 4 relatives on the telephone.

Updated 2 June 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

New Directions Specialist Support Services is a domiciliary care agency. It provides the regulated activity 'personal care' to people with mental health needs, learning disabilities and physical disabilities living in their own homes and in supported living units. At the time of this inspection, 49 people were 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. At the time of the inspection, the service supported 8 people who received personal care.

People’s experience of using this service and what we found

Right Support:

The approach used by the service maximised people’s choice, control and independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, improvement was needed around legal authorisations where people’s freedom was restricted.

Systems were in place to monitor and ensure people received their medicines safely.

Risks in relation to people's care and welfare were thoroughly assessed. This meant staff had the right guidance to support people safely.

Staff supported people to make decisions following best practice in decision-making.

Staff enabled people to access specialist health and social care support in the community.

Right Care:

The service had enough appropriately skilled staff to meet people's needs and keep them safe.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and knew how to apply it.

Staff promoted equality and diversity in their support for people.

People's care and support plans reflected their range of needs and this promoted their wellbeing and independence.

Right Culture:

The service evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Quality assurance systems helped the staff team to monitor the service they provided and promoted ongoing learning.

Staff knew and understood people well and were responsive to their individual needs. This meant people received compassionate and empowering care that was tailored to their needs.

People and those important to them were involved in planning their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 May 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 24 and 28 March 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for New Directions Specialist Support Services on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about the requirements of the Mental Capacity Act (MCA).

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.