Archived: Exmoor Community Care

Updated 28 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 25 April 2017. It was an unannounced inspection. The inspection team consisted of one adult social care inspector. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.

Before our inspection we reviewed the information we held about the home. This included information held by the Care Quality Commission (CQC), such as statutory notifications. A notification is information about important events which the service is required to send us by law. Prior to the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The CQC sent 23 questionnaires out to people who use the service, their relatives and friends; 18 were returned. This information was used during the inspection.

We spoke with the two providers, (one of whom was the registered manager), two care staff and a visiting community nurse. We visited two people in their own homes and spoke to two relatives. Following the inspection, we received feedback from the local GP, community nursing team, an occupational therapist, eight care staff and two relatives. We also spoke with the local authority, commissioners of the service and safeguarding teams. This enabled us to ensure we were addressing any potential areas of concern.

We reviewed information about people’s care and how the service was managed. These included: two people's care files and medicine records; staff files which included recruitment records of the last three staff to be appointed; staff schedules; staff training and supervision records; quality monitoring systems such as audits, spot checks and competency checks; complaints and compliments; incidents and accident reporting; minutes of meetings and the most recent quality survey returned from people, relatives and staff.

Updated 28 July 2017

This comprehensive inspection took place on 25 April 2017 and was announced.

Exmoor Community Care is a small domiciliary care agency situated in Lynton, North Devon. It was registered with the Care Quality Commission (CQC) in 2014 and this was its first inspection. Professionals told us how the service had been set up initially in response to there being no care for people living in their homes in this specific area.

The service provides personal care and support to older people in their own homes. The service was set up in response to there being no care for people living in their own homes in the Lynton area. Approximately half of the people using the service live there. The remaining people live in the nearby towns of Combe Martin and Ilfracombe.

At the time of our inspection, the service provided a service to approximately 31 people. The times of visits ranged from half an hour up to two and half hours. The frequency of visits ranged from one visit per week to 28 visits per week dependent upon people’s individual needs. The service employed 14 care workers who worked both full and part-time.

The service has a registered manager who was present during the inspection. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service cared for people, relatives and their pets keeping them at the heart of the service. There was a strong emphasis on compassion, kindness, caring and respect. Feedback from people, relatives and health and social care professionals was excellent. They all expressed great satisfaction with the management of the service and spoke highly of the providers and the care workers. People spoke of them being “part of the family.” Words repeatedly used about care workers included that they “go the extra mile” and “go above and beyond.” People said, “They go above and beyond what they need to do … they deserve the highest score”, “They’ll do anything for me, I just have to ask” and “They are very good … I don’t know what I would do without them … they do extra jobs and always have time to sit and talk to me.”

People felt the care was faultless and could not be improved upon. People felt their needs and wishes were the focus of the service and the care workers who supported them. The management team had a ‘can do’ attitude and tailor made the service to fit around people. People, relatives and healthcare professionals gave us examples of how the service had responded to meet people’s individual needs, sometimes at very short notice. Care workers also took into account people’s well-being and undertook jobs like dropping items off at charity shops; taking dogs for a walk; picking up shopping; picking up medicines; picking up newspapers; picking up fish and chips; picking up pet medication from the vets, and returning to take people’s washing in.

Care and support was planned on people’s individual needs, choices and preferences. The service responded positively and quickly to any changes in people’s conditions. They worked hard to keep people in their own homes and worked closely with the local GP’s and community nurses. One healthcare professional commented, “The service is faultless … they are extremely flexible and very good at what they do … I can’t speak highly enough of them.”

People’s independence was promoted and people were encouraged to help themselves as much as possible. People were assisted to eat and drink meals of their choice. Medicines were given in a safe way by staff who had been well trained in this area. The service sought to care for people at the end of their life. They worked closely with the local GP and community nursing teams to do this. They also closely supported family members and relatives. This enabled people to remain in their own homes for as long as possible.

The safety of the service was taken seriously and the providers and care workers were aware of their responsibility to protect people’s health and well-being. There were systems in place to ensure any identified risks were managed and reduced as much as possible.

People benefitted from care workers who were safely recruited, trained and supported to do their jobs properly. They received consistent care from care workers who knew them well. Meaningful and strong relationships had developed over time with teams of regular care workers. People’s comments included, “They are excellent … all of them are excellent … they do everything for me and nothing is too much trouble”, “They are lovely, wonderful, very nice … they are all very good to me” and “They are truly wonderful … absolutely so kind and lovely.”

Exmoor Community Care had operated for two years and was managed jointly by the providers. They both had many years of management and leadership experience. The service was open and inclusive and regular feedback was sought. People, staff and professionals were complimentary about the style and leadership of the service. A healthcare professional commented, “… for personal, individualised care and multi-disciplinary team working, I would commend Exmoor Care as outstanding care provider.”

The provider had a range of quality monitoring systems in place which included spot

checks, regular staff meetings, surveys and a range of audits. People knew how to raise any concerns or complaints and felt confident to do so. Where concerns were raised these were investigated and the appropriate action taken.