Hartwig Care (Camden)

Updated 22 May 2021

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 Care Act 2014.

Inspection team

This inspection was carried out by two inspectors, one pharmacy inspector, one nurse specialist advisor and six Experts by Experience (ExE's). 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

Hartwig Care Ltd - 5 Ella Mews is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

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

This inspection was unannounced.

Inspection activity started on 8 April 2021 and ended on 13 April 2021. We visited the office location on 8 April 2021.

What we did before the inspection

Before the inspection, we used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We also reviewed information we received about the service since our previous inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with 6 members of staff including the operations director, two managers including the registered manager, one care calls monitoring officer, one field supervisor and care manager.

We reviewed 28 people's care records, which included care plans, risk assessments and multiple medicines records. We also looked at 8 newly employed staff files in relation to recruitment, and a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate the evidence found. We looked at training data and quality assurance records. Our Experts by Experience spoke with 74 people using the service and 29 family members. We received further feedback from 56 staff employed by the service and four professionals who regularly work with the service.

Updated 22 May 2021

About the service

Hartwig Care Limited is a domiciliary care agency that provides personal care to people in their own homes. The people who used the service had a variety of care needs and included elderly and frail people and those with learning disabilities. At the time of the inspection, the agency provided care to approximately 480 people across three London boroughs. 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 and what we found

Before this inspection, we received concerns about allocating and monitoring care visits for people who used the service. We were also told that there was limited support for care and office staff, and that the service was not always following guidelines on COVID-19 safety. During this inspection, we identified that the service had been experiencing some shortfalls in how care visits were scheduled and monitored. We made a recommendation about it.

Overall, the care and office staff told us they felt supported by their managers during the COVID-19 pandemic. This included appropriate training, supply of personal protective equipment (PPE) and the managers always being available to guide and support. Overall, both the care and the office staff thought the service supported them when they had to self-isolate due to the COVID-19 risks. A few staff said this support was not sufficient. We fed this back to the members of the senior management team.

We reviewed infection control processes and procedures at the service. Overall, we were assured that these were sufficient to protect people and staff during the coronavirus pandemic. When people, relatives, or the staff identified shortfalls in infection prevention and control, the managers addressed this.

At this visit, we identified the service needed to make improvements in relation to the management of high-risk medicines. We made a recommendation about this. The service managed other aspects of medicines management well, and people received their medicines as prescribed.

The service had appropriate safeguarding procedures in place to protect people from abuse. The service recruited staff safely, and staff received safeguarding training to help them recognise different types of abuse. The service assessed risks to people’s health and well-being. We highlighted to the senior management team that some risk assessments needed more personalisation to reflect specific risks for specific individuals. When an accident or incident happened, staff notified the service about it, and respective managers acted to ensure people were safe.

Overall, people and their relatives spoke positively about the care staff and the managers at the service. They thought care staff were kind and caring, and people felt comfortable in their presence. People had care plans describing their care needs and preferences. We noted that some care plans needed more information on specific aspects of care for individual people. People and relatives told us that some staff, who did not visit people regularly, would benefit from more information about people before visiting for the first time. We fed this back to the managers at the service.

People, relatives and care staff said that overall, it was easy to contact the service when they needed support and advice.

The managers undertook a range of quality checks to ensure people were supported as agreed. We noted that the senior management team knew about most shortfalls highlighted by us during this inspection and acted on improvements.

External health and care professionals said Hartwig provided effective care to people, and when they identified issues with care, the managers acted on improvements to ensure people received safe care.

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

Rating at last inspection

The last rating for this service was good (published 01 February 2019).

Why we inspected

We received information of concern about following COVID-19 safety guidelines, scheduling and monitoring of care visits and care and support provided for staff at the service. A decision was made for us to undertake a focused inspection to examine these concerns by reviewing the key questions of safe and Well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We, therefore, did not inspect these. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make some improvements. We made two recommendations about management of high risk medicines and care visits planning and staff allocation. Please see the safe sections of this full report.

The overall rating for the service has remained 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 Hartwig Care Ltd - 5 Ella Mews on our website at www.cqc.org.uk.

Follow up

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