ExemplaCare

Updated 4 March 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

The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They made telephone calls to people who use the service and relatives.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses.

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

This inspection was announced.

We gave the service 72 hours' notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 31 January 2023 when we requested initial information from the service. We visited the location's office on 3 and 8 February 2023. We continued to review evidence until 14 February 2023.

What we did before the inspection

We reviewed information we had received about the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used this information to plan our inspection.

During the inspection

We met with the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We checked a range of required records. These included care plans, staff personnel and training records, a sample of policies, procedures and other guidance, audits, observations of staff practice and medicines administration records. We spoke with 5 people who used the service and 6 relatives.

Emails were sent to all staff inviting them to provide feedback to us. We contacted community professionals who are involved in the care of people who use this service.

Updated 4 March 2023

About the service

ExemplaCare is registered as a domiciliary care service and nurses agency, it provides personal care to people in Buckingham and the surrounding villages. At the time of our inspection there were 31 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 and what we found

People and relatives told us they were happy with the service they received. Comments included, “My overall impression of this service is excellent,” “My carers are excellent. They are very good company for me. They take me for a walk and I am very happy with them all. I have no complaints at all” and “They are all very kind towards her and I know she enjoys having them with her.”

We found improvements could be made to recruitment practices. We found the service was unable to evidence all the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of safe recruitment. We have made a recommendation about this.

We found improvements could be made with ensuring records relating to people who may have dementia or other cognitive impairments were accurate. Some records referred to decisions being made in the person’s ‘best interest’ however other documents referred to the person as having capacity to consent. We have made a recommendation about this in the report.

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 could be improved to support this practice. For instance, the Mental Capacity Act policy referred to care homes and hospitals.

We found improvements could be made in how the service maintained and checked records for accuracy. We have made a recommendation about this in the report.

People were supported by staff who demonstrated they were kind and compassionate. Staff were interested in people and supported them with their own hobbies and interests.

People had support from staff who responded to any changes in needs. Referrals to external healthcare professionals were made in a timely manner. People were routinely treated with dignity and respect by office and care staff. People told us, “They show respect towards me just by how courteous they are, they are all kind and compassionate towards me” and “They do seem to respect people's life choices and will never just assume that they can carry on and do things without checking first that it is alright to carry on.”

The service worked well with external professionals and helped people to remain in their own home. One health care professional told us they found the service to be “extremely approachable, accommodating and knowledgeable.”

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

Rating at last inspection

This service was registered with us on 5 March 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service

Follow up

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