Background to this inspection
Updated
8 February 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service did not currently have a manager registered with the Care Quality Commission (CQC). This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A new manager had been appointed and they had applied for registration with CQC.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 12 December 2019 and ended on 7 January 2020. We visited the office location on 12 and 13 December 2019.
During the inspection
We reviewed a range of records. This included ten people’s care records and multiple medication records. We looked at 10 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We spoke with senior staff including the manager, quality manager, a clinical nurse manager, national clinical lead, the business manager, chief executive and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We also spoke with one person, 10 family members and five other staff members including three nurses and two care workers.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records. We spoke with one professional who commissioned care and support for people using the service.
Updated
8 February 2020
About the service
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.