Archived: Pulse - Plymouth

Updated 6 January 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 12, 18 and 20 October 2016 and was announced. The provider was given 24 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.

The inspection was made up of two inspectors.

Prior to the inspection we reviewed the records held on the service. This included the Provider Information Return (PIR) which 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. We also reviewed notifications. Notifications are specific events registered people have to tell us about by law.

During the inspection we reviewed four people’s records in detail. We also spoke with three staff members and reviewed three personnel records and the training records for all staff. We were supported on the inspection by the registered manager.

Other records we reviewed included the records held within the service to show how the registered manager reviewed the quality of the service. This included a range of audits, minutes of meetings and policies and procedures.

After the inspection we spoke with three staff members, a relative and a social care professional. This was a social care case manager who had referred people to Pulse for support.

Updated 6 January 2017

Pulse - Plymouth is part of Pulse Healthcare Ltd and is a domiciliary care service that provides complex care and support to adults of all ages in their own homes. The service supports people, at specific times of the day and/or night, who may have clinical and specialist care needs. At the time of the inspection ten people were receiving support with personal care needs.

A registered manager was employed to manage the service locally. 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.

People were supported, when required with their medicines and healthcare needs. People’s medicines administration records, (MAR) were not always completed accurately, which meant it was difficult to know which medicines had been administered and which hadn’t. Where people had been prescribed medicines to be taken, ‘as prescribed,’ people’s records did not always include details to guide staff when they would need administering. Staff had received training on administering medicines and people told us they responded to any health concerns quickly. Comments included, ““They’re straight on it. They don’t hang about.”

People had risk assessments in place to identify any risks related to their needs but these did not always include clear information about what staff needed to do to help mitigate the risks.

The quality of the service was regularly monitored by the provider who undertook a range of regular audits. The registered manager also spoke with people regularly to ensure they were happy with the service they received. However, these audits had not always identified the issues we highlighted during the inspection and where concerns had been identified, changes had not always reduced the risk of reoccurrence.

The service followed a thorough recruitment procedure. However, staff’s full career history was not routinely requested, as required, to help ensure people were only supported by staff who were suitable to work with vulnerable adults.

People told us they felt safe using the service. Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected.

There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service. People told us they received support from staff who knew them well, and had the knowledge and skills to meet their needs. People and their relatives spoke highly of the staff and the support provided. Comments included, “They’re thoroughly trained.”

People told us staff were caring and staff members described the importance of helping to maintain someone’s privacy and dignity. People were supported staff who gave them choice about how they received their care and used different forms of communication according to people’s needs.

The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and how to recognise that someone no longer had the mental capacity to make decisions for themselves.

There was a management structure in the service which provided clear lines of responsibility and accountability. A registered manager was in post who had overall responsibility for the service. They were supported by other senior staff who had designated management responsibilities. People told us they knew who to speak to in the office and had confidence in the management and staff team.

We saw accidents and incidents had been reported promptly and any actions had been overseen by the relevant staff team within Pulse Healthcare Limited, to ensure they were sufficient and timely.

We found a breach of the regulations. You can see what action we told the provider to take at the back of the full version of the report.