First inspection of M N Pulse Solutions rated Requires Improvement overall, with shortfalls in care call monitoring, recruitment checks, training/competency oversight, medication information, capacity assessments and governance audits. Caring and responsive domains were rated Good, and the registered manager took immediate action on issues identified during the assessment.
Concerns (11)
critical
Missed or late visits
: “People had experienced missed and late care calls.”
criticalGovernance: “The registered manager did not have an effective care call monitoring system and people had experienced missed and late calls.”
moderateStaff training: “Staff are kind, but they are 'green' and not knowing what to do, they need more training.”
moderateStaff competency: “spot checks had taken place, these had not always assessed staff's skills and competencies to ensure learning had taken place from the training given.”
moderateRecord keeping: “improvement was needed to the records maintained such as to include dates and full detail about the incident and investigation.”
moderateMedication management: “Staff did not currently have information available to them about a person's medication to refer to in the event of an emergency.”
moderateCare planning: “one care plan reviewed had contradictory information which in one section stated a person was at low risk of dehydration and in another section recorded they were at moderate risk”
moderateConsent / capacity: “Improvement was needed to include mental capacity assessment information in people's care plans.”
moderateLeadership: “the service was not consistently well managed and well-led. Leaders and the culture they created did not always promote high-quality, person-centred care.”
moderateOther: “One staff file had gaps in employment and education history, and these gaps had not been explored by the registered manager at interview stage.”
minorCommunication with families: “Due to some staff's accent, some people and relatives could not always understand what was being said to them.”
Strengths
· Staff were described as having a kind and caring approach and promoted people's independence.
· People and their relatives felt safe with staff in their homes and protected from the risks of abuse.
· Registered manager took immediate action to implement an electronic care call monitoring system.
· People felt involved in their care and staff respected privacy, dignity, and gender preferences.
· Collaborative working with social workers, GPs and mental health teams.
Quality-Statement breakdown (20)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff work with other agencies to provide consistent, effective, timely careNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: Planning personalised care to ensure people have choice and controlNot rated
responsive: End of life care and supportNot rated
well-led: Managers being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Continuous learning and improving care; Working in partnership with othersNot rated