Archived: Pulse - Birmingham

Pules (Birmingham) is a domiciliary care agency registered to provide personal care to people living in their own homes. All care support is provided by staff that have set hours over a 24 hour period so staff and some staff would live in the person own home for the duration of their support

At the time of our inspection there was no registered manager in post this is a requirement of the organisation registration with us. There was an acting manager in post with a view to submitting an application to us to become the registered manager to ensure staff had leadership and someone to discuss issues or seek advice from when needed. 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.

The provider had processes and systems in place that kept people safe and protected them from the risk of harm. Staff had received training and understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm.

People had been involved in the planning of their care, make choices about their care and were with their medication when required and were involved in the care and support they received. The provider knew what appropriate action should be taken to protect people’s legal rights.

Staff were trained and supported so that they had the knowledge and skills to enable them to care for people in a way that met their individual needs and preferences. Where appropriate people were supported to access health and social care professionals.

Staff was caring and treated people with dignity and respect and people felt they could speak with the provider about their worries or concerns and felt they would be listened to.

The provider had quality assurance and audit systems in place to monitor the care and support people received to ensure the service remained consistent and effective.

The detailed evidence supporting our summary can be read in our full report.

This is a summary of what we found;

During our inspection we saw that the service supported 57 people in their own homes. The branch employed 60 care staff on a part time basis. There was one registered manager and two care co-ordinators. Clinical staff were available from a central team. We talked with the registered manager and looked in detail at the records for six people. The manager showed us the electronic records of all care staff. We talked with seven staff members and two people who use the service by telephone. We also spoke to three relatives of people who use the service. One member of staff said, 'The team work well together, they are always willing to help. They staff are care centred and ask for help if it's needed.'

Is the service safe?

Staff had the information they needed if they had any concerns or there was an allegation of abuse. The registered manager told us that a member of the management team was available at all times in case of emergencies, by using an electronic out of hours system. People told us they felt safe. Safeguarding procedures were in place and recruitment practice was safe and thorough. Staff had not had any training in issues around mental capacity.

There was a comprehensive induction process and ongoing learning around safeguarding for the staff team. A senior member of staff organised the staff rota and any cover that was needed. They take people's care needs into account when making decisions about the numbers, qualifications, skills and experience required in the staff team. There were policies and procedures in place to make sure that unsafe practice was identified and people were protected. This helped to ensure that people were kept safe.

Is the service effective?

All the people we spoke with told us that they were very happy with the care that had been delivered and that their needs had been well met. It was clear from the records we sampled and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well.

We saw that wherever possible people received care from the same staff members. We found that the service was person centred and staff were aware of peoples choices, preferences and support needs. We found evidence that people and their relatives had been involved in planning the care and support. A relative told us 'The carer is very amenable and very conscientious. They always arrive on time and we're happy.'

There were sufficient staff who were trained and supported in their role to meet the needs of people. This helped to ensure that people received a good quality service at all times.

Is the service caring?

One person told us, 'They are absolutely excellent, she is so good to me, and I get lots of cups of tea. They will do anything to help you. The managers are excellent they change anything that needs changing.' People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People had information about how to make a complaint if they were unhappy. People had care and support delivered to them in a way they were happy with. People's needs were assessed and planned. One relative told us 'It's a mixed bag, there's some good and some bad management from the office'. People received care in the way they wanted and as identified.

Is the service well-led?

The service had a robust quality assurance system, and records showed that identified problems were addressed promptly. Staff told us they were clear about their roles and responsibilities. There were clear processes in place to keep people safe and the manager knew what to do if there was a problem or concern. The manager was aware of their responsibilities in order to comply with current legislation. One relative said 'The team are always ringing to check if we're happy, they have been very understanding.'

Records showed that the people who used the service and their relatives were involved in planning their care. The relative of a person who used the service told us, 'I am always involved. The nurse is always visiting us'.

The provider had robust recruitment procedures in place to ensure that people employed at the service were of good character and had the necessary skills, qualifications and knowledge to meet the needs of the people who used the service.

There were good arrangements for making sure that standards of care and support were monitored and improved, where necessary. We saw that the provider supported the people who used the service and their relatives to comment on the quality of care people received.

People were protected from the risks of unsafe or inappropriate care and treatment

because records were kept up to date and could be easily accessed.

During our visit we spoke to staff and looked at documents to see if they received suitable training and support. We spoke to the provider's national quality services manager to identify how the provider ensured there were always enough suitably qualified staff available to support people. We also checked to see if the provider had done what they said they would do to put things right after our last inspection.

We found that the provider had now recruited to a full complement of senior staff with the appropriate skills and competencies to support both the people who use the service and staff.

We noted that there was a new manager in post however they were not registered. The provider informed us they were currently in the process of applying to remove the previous manager's registration and apply for the new manager to become the registered manager in accordance with the relevant legislation.

People who used the service told us that the staff caring for them had a good manner and respected their dignity. The provider was able to speak to people who used the service according to their needs and age. One person who used the service told us, 'The staff are great. They know all my needs and we have become friends'.

Care was planned and designed to meet the individual health and welfare needs of the people who used the service. A relative told us they were confident that their relative's care was planned, managed and delivered in the way that was promised.

We saw that the provider had made suitable arrangements to ensure that service users were safeguarded against the risk of abuse.

We found that care workers were skilled, qualified and competent to provide people with the care they required to meet their individual needs. However the provider had not ensured there was a sufficient number of staff employed with managerial skills to support people.

The provider was able to protect people from unsafe care and treatment by regularly assessing and monitoring the quality of the service provided. There were regular review meetings with the Interim Manager, people who use the service, their relatives and staff.