Archived: Pulse Essex

Updated 14 September 2017

This inspection took place on the 22 and 24 of August 2017 and was announced.

The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be there to greet us.

The inspection team consisted of one inspector due to the size of the service.

Prior to the inspection we reviewed all the information we held about the service, including any statuary notifications we may have received that the provider is required to send to us by law.

We also requested information from other professionals, for example the local health commissioners, the local authority and health watch.

At the time of the inspection, the Provider Information Return was in the process of being completed by the provider. This 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 took this into consideration when making our judgements.

As part of the inspection we talked to one person using the service, and four relatives. We visited a person in their home and reviewed the information that was kept to inform people and carers of the interventions that person received.

We reviewed five care plan records and associated risk assessments for individuals using the service, and a selection of the services policies and clinical procedures.

We spoke to the registered manager, clinical governance lead, community nurse and care co-ordinator working at the service. We also spoke to two care staff.

We looked at staff personnel files and records relating to the management of the service. This included recruitment, training, and systems for assessing and monitoring the quality of the service.

Updated 14 September 2017

This inspection was announced and took place on 24 and 26 August 2017. This was the first ratings inspection at this location.

Pulse is registered to provide care and support for people in their own homes including those that require nursing care. At the time of inspection Pulse Essex were providing care and support to eight people aged between one years old and 70 years. Most people receiving support from Pulse Essex had complex physical health needs requiring specialist care and support. As a result, many of them had limited communication skills so were unable to speak with us, although had nominated loved ones who had power of attorney for their care and welfare.

The service had 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.

Each person with complex needs had small teams of staff assigned to them who were specifically trained to meet the needs of that person. Risk assessments gave clear guidance to staff about how to minimise risks for people in line with their needs and preferences. Communication was robust and concerns about people's care was managed quickly.

Staff received excellent levels of on-going training, and were supervised regularly. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff had a good understanding of the Mental Capacity Act 2005, and how to support people who lacked capacity to make certain decisions. This meant their human rights were respected.

People’s privacy and dignity was respected at all times, regardless of their ability to communicate their needs to staff. Staff worked closely with peoples loved ones to ensure they received care and support in a respectful way.

Staff knew people very well and care was person centred. Care plans addressed every area of need to maintain and improve people’s health and wellbeing. However, parts of some care plans required additional information to ensure they were person centred. Although, information from, staff, relatives, and written daily notes demonstrated that staff knew people very well and that care was person centred.

The registered manager and clinical governance team actively listened to the views of people using the service, their loved ones, and of staff employed. The provider had a good oversight of issues at each location and supported managers to maintain standards of care. Robust systems were in place to audit the quality of the service and the service was continuously learning and adapting processes to provide quality care.