ExemplaCare received an overall Good rating at its first inspection, with people and relatives reporting high satisfaction and strong person-centred care delivered by compassionate staff. Recommendations were made regarding recruitment record-keeping, Mental Capacity Act documentation accuracy, and the completeness and contemporaneousness of records generally.
Concerns (6)
moderate
Record keeping
: “We found the policies and procedures did not routinely reflect best practice...were not routinely dated, did not have page numbers or version control.”
moderateRecord keeping: “We found not all decisions and discussions about people's care was recorded...the conversation...held with the GP...had not been recorded.”
moderateConsent / capacity: “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.”
moderateGovernance: “The application form used by the service did not always provide all of the requirements...the service did not routinely record a reason for staff leaving previous employment.”
minorStaff training: “Not all staff had completed the Care Certificate...widely accepted as good practice.”
minorGovernance: “We found risk assessments were not routinely dated...Other records which had been scanned onto the electronic system did not always contain names of people or page numbers.”
Strengths
· People and relatives reported high satisfaction, with comments describing carers as 'excellent' and 'kind and compassionate'.
· No missed visits reported by people using the service; staffing rosters had good oversight with flexible staff matching.
· Staff demonstrated strong safeguarding knowledge and incident reporting processes.
· Medicines were administered safely with trained and competency-assessed staff and app-based recording for relatives.
· Strong person-centred culture, including memory boxes for people with dementia and birthday gift coordination.
Quality-Statement breakdown (22)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires 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: Supporting people to live healthier lives, access healthcare services and supportGood
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
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
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
well-led: Continuous learning and improving care; Working in partnership with othersGood