During an assessment under our new approach
Date of assessment: 13 January to 30 January 2026.
Pivotal Home Care is registered as a domiciliary care agency providing personal care to people in their own homes. The service was supporting 1 person with a regulated activity at the time of the assessment.
The assessment was triggered by several concerns. The Home Office had revoked Pivotal Home Care’s license to sponsor care workers from abroad. CQC also had concerns Pivotal Home Care was not operating from a registered location. We had not been informed of any changes to the registration details including change of address, contact numbers and website. The provider was asked to submit the appropriate documentation to update their details to avoid a fixed penalty notice or potential prosecution. This was completed prior to the assessment in November 2025. We had also received concerns about poor care prior to the assessment from ex staff members and from health and social care professionals.
The service has been rated as requires improvement. The provider had failed to maintain effective governance systems. We identified 3 breaches of the legal regulations. The service was in breach for safe care and treatment, fit and proper persons employed and good governance.
Medicines policies and procedures had not been followed. Processes were not followed correctly to ensure people’s medicines were ordered, administered, recorded, stored and disposed of safely. Staff had not been recruited safely, as references had not been verified. Governance of the service had been poor and had not identified the shortfalls recorded in the assessment.
However, we also received positive feedback from health and social care professionals about their experience of the service and the caring nature of the staff. We also found the 4 carers we spoke to were caring and had a good relationship with the people they supported.
We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
At the time of the assessment, the service was not supporting any autistic people or people with a learning disability. The service was registered to deliver this type of specialist support. We therefore assessed the care provision under right support, right care, right culture as they may provide this care in future. Right support, right care, right culture is statutory guidance that underpins our approach to regulating services for autistic people and people with a learning disability.
Systems and processes did not align with, ‘Right support, right care, right culture’. This guidance was not reflected in any of their policies or procedures. The registered manager agreed they would need to research this area further if they were to continue to provide this specialist service and decided during the inspection to submit a notification to cease working in this area.
We have asked the provider for an action plan in response to the concerns found at this assessment.