Exemplar Homecare Limited, a domiciliary care agency in Nottinghamshire serving 23 people, was rated Good overall and across all five key questions at its first inspection. Minor improvements were identified around emergency 'make safe' plans, formal analysis of feedback, annual surveys, Accessible Information Standard knowledge, and end of life care planning.
Concerns (6)
moderate
Care planning
: “plans were not in place to guide staff on how to make people safe in an emergency if staff were present at their home.”
minorIncident learning: “there was no recorded evidence that the actions recommended by the registered manager had been reviewed.”
minorGovernance: “No formal analysis of these calls was completed. We also noted there had not been an annual survey completed.”
minorCommunication with families: “The registered manager told us their knowledge of this standard [Accessible Information Standard] was limited.”
minorEnd-of-life care: “End of life care plans were not always in place and the registered manager was aware of their responsibility to ensure that people were able to express their wishes”
minorStaff training: “Staff were offered the opportunity to complete nationally recognised qualifications in adult social care. The numbers who had completed this were low”
Strengths
· People felt safe with staff and staff arrived on time, with less than 1% of calls late outside the agreed grace period
· Medicines were managed safely with an electronic recording system being introduced to alert the office of missed doses
· Staff were described as respectful, kind, caring, patient and understanding by people and relatives
· Care records were person-centred, including life history, hobbies, religious beliefs and communication needs
· Complaints were handled in line with the provider's policy and dealt with immediately to families' satisfaction
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
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; 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 supportGood
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: Engaging and involving people using the service, the public and staff, continuous learning and developmentGood