Archived: Pulse@Home

Pulse@Home is a domiciliary care agency providing personal and nursing care to children and adults living in their own homes. The service specialises in providing care to people with complex physical and healthcare needs. At the time of our inspection the service was supporting 80 children and adults, all of whom received personal care.

People’s experience of using this service and what we found

The care and support provided to people were person centred. People’s care plans and risk assessments included information about their preferred care and support needs and preferences. Guidance for staff on ensuring that people were supported safely and in accordance with their wishes was included in people’s care records.

Staff had received training about safeguarding and knew how to respond to and report any allegation or suspicion of harm or abuse. They understood the importance of reporting concerns immediately.

The service’s recruitment procedures were designed to ensure that staff were suitable for the work they would be undertaking. New staff members were not assigned work until satisfactory references and criminal records disclosures had been received.

New staff received an induction to the service before starting work. All staff received regular training to ensure that they were able to meet the needs of the people they supported. Staff had not always received in regular supervision sessions from their manager to support them in carrying out their roles. The service had identified this failure and had taken action to ensure that regular supervision was provided to staff.

People and their family were involved in decisions about their care. People had been involved in agreeing their care plans and participated in reviews of the care and support provided to them. People and family members said that staff asked people for their consent to carry out care and support tasks.

Information about people’s religious, cultural and communication needs was included in their care plans. People had been matched with staff who were knowledgeable about their needs.

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 supported this practice.

People were regularly asked about their views of the care and support that they received.

Processes were in place to manage and respond to complaints and concerns. People and family members were aware of the service’s complaints procedure and knew how to make a complaint if they needed to.

The provider undertook a range of audits to check on the quality of care provided. Actions had been taken to address any concerns.

People, family members and staff confirmed they were satisfied with recent changes to the service.

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

Rating at last inspection:

The last rating for this service was Good (published 14 January 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to inspect as part of our re-inspection programme. If we receive any concerning information we may inspect sooner.

Pulse@Home is a domiciliary care service registered to provide personal care in people's own homes. The provider employs a combination of registered nurses and care workers to support people who currently use the service. At the time of the inspection there were 40 people using the service. Some of the people who used the service had complex nursing needs.

The home does not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. An interim manager was in post and had applied to become the registered manager for the service.

People told us they were safe. Medicines were managed safely. Risk assessments identified the risks to people and how these could be minimised. Staff were available to meet people's needs.

People were involved in decisions about their care and how their needs would be met. Managers and staff had received training on the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005.

Staff had access to ongoing training. They were knowledgeable about their roles and responsibilities.

Staff knew how to respond to people's needs in a way that promoted their individual preferences and choices regarding their care. People were supported to eat and drink.

People were treated with dignity and respect. Staff understood people's preferences, likes and dislikes regarding their care and support needs.

Care was planned and delivered in ways that enhanced people's safety and welfare according to their needs and preferences.

People were supported to maintain good health and had access to healthcare services. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people's needs.

The service regularly requested feedback from people who used the service. People, relatives and staff said the management were approachable and supportive.

Systems were in place to monitor the quality of the service. People felt confident to express any concerns and these were addressed by the manager.

The provider had policies to safeguard adults and children and staff told us that they were trained to recognise abuse and to respond appropriately. We saw that staff had different levels of training depending on their clients.

We saw that the provider had clear guidance for staff when dealing with medicines, including a policy and advice sheets in care records to assist them. People we spoke with told us that they were clear as to who obtained and administered the medicines.

Staff were supported through extensive and regular training. The provider had a system to remind staff that their training was due. One member of staff told us, "It is a brilliant employer and I get a lot of support." We saw that staff received supervision and appraisal regularly and they were able to discuss their professional development with their manager.

The provider used a range of methods to monitor the quality of services.

The manager said that all staff had received induction and were familiar with people's needs. She said there was a robust recruitment process and all staff had been vetted to ensure that they had appropriate skills, qualification and experience to provide care and treatment that people needed. We saw evidence of criminal record bureau (CRB) checks and written references in the staff files. This indicated that staff were vetted properly and were fit to provide care and treatment for people who used the service.

Care plans and risk assessments were updated to ensure people received appropriate care. We noted that systems were in place for safe administration of medication. This included training for staff in the administration of medication. All the medicines administered to people were recorded and monitored by the staff to ensure people had received their medication as prescribed by their doctors.

Information relating to the people who used the service was recorded accurately and was kept securely at the agency's office. This meant that people received care and treatment that reflected their needs.