Background to this inspection
Updated
19 June 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.
This inspection took place on 19, 20 and 23 April 2018, with visits and phone calls to people and their relatives who use the service on 20 and 23 April 2018. We told the service one day before our visit that we would be coming to ensure the people we needed to talk with would be available. The inspection was conducted by one Care Quality Commission inspector.
Before the inspection the provider completed a Provider Information Return (PIR). 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 reviewed the PIR and other information we held about the service; this included incidents they had notified us about. We also looked at the information we had received from notifications made to us by the service. Additionally, we contacted the local authority commissioning teams and healthcare professionals to obtain their views of the service.
The service provided complex nursing care and support to 21 children and people. We spoke with six people and their relatives on the telephone and visited two people and one child and their relative who received support from the service. We also spoke with the registered manager and four members of staff, which included a nurse, care staff and office staff. We reviewed in depth, three people’s care and medicine records in the office and with their permission, the records kept in their home. We also saw records about how the service was managed. These included three staff recruitment, training and supervision records, staff rotas, staff training records, accident and incident records, complaints, audits and quality assurance records as well as a range of the provider’s policies and procedures.
Updated
19 June 2018
Pulse Bournemouth is a domiciliary care agency. It provides personal and nursing care to children and adults living in their own houses and flats in the community. At the time of the inspection they were providing personal and nursing care and support to 21 children and adults with complex needs living in the general geographical area of Bournemouth and Poole.
We undertook an announced comprehensive inspection of Pulse Bournemouth on 19, 20 and 23 April 2018. One CQC Inspector conducted the inspection; we gave the provider one day’s notice of the inspection to be sure the people we needed to speak with would be available.
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.’
This was the first inspection of Pulse Bournemouth since they had moved their office location to Bournemouth.
People’s risks were assessed and care and support plans developed to ensure care was provided safely. Care plans provided detailed guidance for staff to ensure they received responsive care if their health needs changed. People told us they felt safe with their care staff, who they said were kind, supportive, caring and professional.
Accidents and incidents were recorded, reviewed and analysed to ensure any trends were identified to enable action to be taken to safeguard people.
People were provided with support and care by small, consistent teams of well trained staff who were supervised regularly to ensure they remained competent in their roles. Staff demonstrated good knowledge about people’s complex care needs and knew how people preferred their care and support to be given.
Medicines were managed safely. People were protected against the risks associated with the unsafe management and use of medicines. There were systems in place to ensure people received their medicines and creams as prescribed. Any medical procedures were overseen by a qualified nurse who provided clinical guidance. Staff spoke knowledgably about infection control procedures and were provided with supplies of personal protective equipment (PPE) to reduce the risk of cross contamination.
People told us and records showed, rotas were sent to people to highlight which nursing and care staff would be completing their visits and when. People said rotas were generally correct, although some changes would happen if care staff were off at short notice.
The service was in the process of recruiting further staff. There was a robust recruitment procedure in place which ensured staff were safe to work with vulnerable children and people before they commenced their employment. Some people told us they felt the recruitment process was too lengthy and that prospective staff found other jobs before the process was completed.
Generally, people were supported by sufficient numbers of staff to meet their needs. People were allocated small teams of regular staff to ensure continuity of care. There were systems in place to guard against staff absence such as unscheduled sickness and annual leave.
The provider had a schedule of training in place to ensure all staff received their mandatory and refresher training. This ensured staff had the required skills and knowledge to care and support people safely.
Staff knew how to recognise and report abuse. They received training in safeguarding people from abuse and knew the procedures to follow if they had any concerns.
There was an on-going system of supervision and appraisal for staff. Staff told us they found their supervisions useful and felt well supported to carry out their roles.
There were systems in place to manage and respond to complaints and concerns. People knew how to complain and most people told us they felt they would be listened to if they had any concerns or worries. However, some people had not received a good experience when they had needed to complain. We have made a recommendation regarding how the provider deals with complaints.
We received mixed views regarding some aspects of the management of the service. Some people told us they felt communication within the service could be improved. We have made a recommendation for the provider to review their communication processes.
There were quality assurance systems in place to monitor and assess the quality and safety of the service provided.