Date of Assessment: 25 November 2025 to 8 December 2025. Walfinch Hampstead Camden is a domiciliary care service. It provides support and personal care to older people living in their own homes, some of whom live with dementia. At the time of our assessment there were 5 people receiving personal care. The Care Quality Commission (CQC) only inspect the service received by people provided with personal care; help with tasks related to personal hygiene and eating. We conducted this assessment to follow up on concerns we identified at the last inspection. These included a breach of Regulation relating to safe care and treatment. The last rating for this service was requires improvement (published 13 December 2021). At this assessment we found improvements had been made and the provider was no longer in breach of Regulation. The overall rating for the service has changed to good. Appropriate systems were now in place for people to receive medicines as prescribed. An electronic system was in place to monitor medicines administration and management had oversight of this. People received person centred care and support delivered by a staff team who treated them with dignity and respect. People's relatives told us care staff were kind, caring and professional. The provider had a good learning culture. There was an open culture where people and relatives were encouraged to provide feedback and speak openly about their experience of care and support. There were enough staff with the right skills, qualifications and experience. Management made sure staff received training and regular supervision to provide high-quality care and make improvements. People and those important to them were involved in the assessment of their needs. Management carried out assessments considering people’s communication and spiritual needs, their preferences and health needs. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions. They monitored people’s health to support healthy living. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff understood the principles of the Mental Capacity Act and involved those important to people regarding decisions made in people’s best interests where they did not have capacity. Staff said they felt supported by the registered manager and felt valued working at the service. Governance systems were in place to help monitor care provision. The service sought feedback from people and relatives as part of their quality monitoring to help ensure people were satisfied with their care and identify issues without delay. The culture in the service was positive. The registered manager was open and transparent and welcomed feedback.
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Walfinch Hampstead & Camden received an overall rating of Requires Improvement at its first CQC inspection, with a regulatory breach found for unsafe medicines management including inaccurate MARs, unexplained recording gaps and absent PRN protocols. Care delivery, staffing, safeguarding and leadership culture were broadly positive, with people and families reporting satisfaction and consistent, person-centred support.
Concerns (6)
criticalMedication management: “numerous instances where care workers were not accurately recording on the electronic MARs if medicines were being administered”
criticalMedication management: “on one person's MAR for one month, '?' was recorded 22 times in the box. There was no explanation recorded as to what this meant”
moderateMedication management: “Two people received 'as and when required' medicines (PRN) for pain relief using paracetamol. However, there was no formal PRN guidance”
moderateGovernance: “Medicines audits were not effective as they had failed to identify the shortfalls we found at this inspection.”
minorIncident learning: “there was a lack of information recorded about subsequent action taken by the provider following an accident/incident and mitigating action to take in future”
minorRecord keeping: “staff meetings...were not documented. The registered manager advised these would be documented in future so that follow up actions could be recorded.”
Strengths
· People and relatives expressed satisfaction with care; staff described as kind, respectful and empathetic by people, relatives and health professionals.
· Robust safeguarding training and procedures in place; people reported feeling safe with care workers.
· Individual risk assessments completed covering environment, moving and handling and physical health, with guidance for staff.
· Effective infection prevention and control measures including COVID-19, with adequate PPE supply and staff training.
· Staff received structured induction based on the Care Certificate, regular training and supervision; morale reported as positive.
Quality-Statement breakdown (23)
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood