Hartwig Care (Weybridge)

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the service had not been consistently managed and well-led.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had not established a sufficiently clear and inclusive culture that consistently reflected the principles of transparency, equality, diversity, human rights and engagement. They had not always understood the challenges and the needs of people who used the service and staff.

Feedback from people using the service, relatives and staff demonstrated that communication had not always been effective during the period in which there had not been a registered manager or a care coordinator in place. As a result, people and staff did not always feel well informed or actively involved in decisions affecting their care or employment.

For example, one person told us, “I got a rota in the post but I may get something different by email. I relied on the carers to tell me when they were coming”, and a member of staff said, “It has been a difficult time at Weybridge branch as we have seen many changes in our office staff and management.” The member of staff added, “Care assistants were not kept well informed of contact points or immediate management at this point.”

Communication and support for staff had also been affected by the infrequency of team meetings and individual supervision sessions. This limited opportunities for staff to receive updates, share concerns and discuss their development and wellbeing. One member of staff told us, “Team meetings are not a regular thing. I've been to 1 this year and only 4 people turned up.”

People who used the service, relatives, and staff all told us communication had improved since the appointment of the current care coordinator, an interim manager, and operational support from the provider’s head office. One person said, “The girls that have taken over are brilliant. You weren’t always kept informed before. Things like letting you know if the carer was going to be late; they often didn’t used to let you know, but now they do. Or if you rang the office because you wanted to know something, they wouldn’t pick up the phone, and they didn’t reply to messages, but now the communication is much better.”

A relative said of the new management team, “The current management is really good. They try their best. You can reach out to them. They want to know what is going well. They ask whether there is anything they can improve.”

Leaders had not always maintained sufficient oversight of people’s care to ensure care and support remained responsive to their needs.

Care reviews had not always been completed in a timely way, and some people told us they had not been contacted to discuss their care for an extended period. This meant leaders did not always have up-to-date information about people’s experiences and changing needs. This limited the provider’s ability to effectively monitor the quality of care being delivered and to ensure care plans continued to reflect people’s needs.

People told us the new management team had started to address this issue, and several people confirmed they had recently had a review. One person told us, “I had a face-to-face assessment yesterday with [care coordinator]. I had not had anything like that before. It was very thorough; she was here about two and a half hours doing it.”

A relative said, “I have met the new manager. She seems on the ball. I sent a message saying we need to review [family member’s] care. She came and we did a complete re-assessment. She was here about 3 hours. It was much more thorough than the first one we had.”

Another relative described the care coordinator as proactive and helpful, explaining they had visited to demonstrate how to use equipment safely and had arranged a follow-up visit to provide further support. The relative said, “[Care coordinator] is very nice. She came to show me how to use the sheets that go on the hospital bed. She helped with a demo. She is going to come out again next week. It is more proactive than it has been previously.”

Staff did not always feel their voice would be heard if they spoke up.

The provider had systems in place to gather staff feedback, including annual staff surveys and opportunities to submit feedback anonymously. However, these mechanisms had not always been effective in demonstrating that staff concerns were listened to and used to drive improvements. As a result, some staff did not feel confident that their views influenced decision-making or led to changes within the service. For example, one member of staff told us, “I am more than happy to raise concerns; however I have rarely been confident that very much is done at a higher level.” Another member of staff said, “I have reported concerns in the past; they have been looked into but I am not always informed of the outcome.”

People and relatives told us they knew how to raise concerns and said they would feel comfortable doing so if necessary. People who had raised concerns in the past told us the provider had investigated their complaints and responded appropriately. They said their concerns had been taken seriously, and the issues were resolved to their satisfaction.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider demonstrated a commitment to equality, diversity and inclusion by recognising and responding to the individual needs of staff. For example, a tailored risk assessment was completed for one member of staff, ensuring appropriate adjustments were made to support their health, safety and wellbeing.

The provider valued and recognised the contributions of its workforce through schemes that celebrated staff achievements and positive impact. For example, staff who received compliments from people using the service, their relatives, or colleagues were recognised, and services were encouraged to nominate staff for ‘Carer of the Month’ awards.

Staff said they supported one another well and worked well as a team. They told us this sense of teamwork had been important during the recent instability in the management team to ensure people’s needs were met. One member of staff said, “I know that I and my fellow carers do our level best to look after the clients despite the changes in management.”

Staff said care workers from another of the provider’s services had demonstrated a positive approach to supporting them when necessary. One member of staff said, “We have all been working hard to cover calls and we have a strong team. The [provider’s other service] team were helpful, approachable and efficient.”

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes.

The provider had governance systems in place to monitor key aspects of service delivery, including safeguarding concerns, events, accidents and incidents. Information from these systems was reviewed and analysed to identify trends, themes and opportunities for learning.

However, the period of instability within the management team exposed weaknesses in the provider’s contingency arrangements. The absence of effective leadership oversight impacted the day-to-day running of the service, resulting in disruption to some people’s care, poor communication, and some people’s needs not being reviewed in a timely manner. The provider’s governance systems had not been effective in identifying and addressing these issues at an early stage.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The service had established effective working relationships with health and social care professionals involved in people’s care, such as GPs and community nurses. Information was shared with partners appropriately and in a timely way, helping to ensure people received coordinated, timely care.

The provider worked collaboratively with community partners to create opportunities for people to participate in local activities. For example, partnership working with a local care home enabled people to attend initiatives such as a Dementia Café. This supported people’s wellbeing and reduced the risk of social connections isolation.

The provider focused on learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The provider demonstrated a commitment to learning and improvement by reviewing incidents and safeguarding concerns to identify themes, share learning and strengthen practice. For example, a recent review highlighted the importance of recognising and responding appropriately when people repeatedly declined care and support. Learning from the review was shared with staff to strengthen practice. Staff were reminded of the importance of accurate recording, monitoring, and escalating concerns in line with the provider’s policies and procedures.

The provider sought opportunities to keep up to date with developments and innovation across the care sector. For example, the operations manager attended a collaboration event where ideas on the use of artificial intelligence in social care and more effective ways of working were discussed.