Pulse Birmingham was registered with the Care Quality Commission [CQC] in June 2011. The service re-registered due to a change in their address in July 2017. The service is located in central Birmingham and at the time of this inspection, provided high healthcare support to people living in the West and East Midlands, Slough, Uxbridge, Northampton and Milton Keynes.

Pulse Birmingham is registered to provide personal care and complex community healthcare services to adults and children living in their own homes with physical disabilities, learning disabilities, sensory impairments and mental health conditions. At the time of our inspection, the service provided care to 22 people. This was the first announced inspection of the service at the current location and took place over two days on 22 and 29 July 2018. We gave the provider 48 hours’ notice that we would be visiting the service because we wanted to make sure staff and people would be available for us to speak with.

There was a registered manager in post. 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.

At the last inspection on 07 and 10 October 2016, we rated the provider ‘Good’ under all the key questions. At this inspection we found the evidence continued to support the rating of an overall ‘Good’ and whilst there was no information from our inspection and ongoing monitoring that demonstrated serious risks or concerns, there were some improvements to be made under the question, ‘is the service effective?’

People received support from staff that had the skills required to support them safely. However, we found that there were some improvements to be made to ensure a consistent approach in providing nursing staff with supervision and assessing their competencies.

People were kept safe. Staff understood how to protect people from risk of harm. Any safeguarding concerns had been investigated by the provider and actions were taken to help protect people from risk of avoidable harm. People's risks were assessed, monitored and managed to ensure they remained safe. People were protected by safe recruitment procedures and sufficient numbers of staff were available to meet people's support needs. People received their medicines as required. Staff understood their responsibilities in relation to hygiene and infection control.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The provider’s policies and systems supported this practice. People were effectively supported to ensure their nutritional needs were met. People had access to healthcare professionals when needed, in order to maintain their health and wellbeing.

People were encouraged to be as independent as much as possible and they received a service from staff that was caring and respected their privacy. People were supported by staff who knew them well.

People continued to receive a service that was responsive to their individual needs. Support plans, although clinical due to peoples’ complex health and care needs, were also personalised and contained details about people's preferences and their routines. Processes were in place to respond to any issues or complaints.

The service was well led, the registered manager and nominated individual understood their role and responsibilities. People and staff were encouraged to give feedback and their views were acted on to enhance the quality of service provided to people. The provider worked in conjunction with other agencies to provide people with effective care.

Further information is in the detailed findings below