Pivotal Home Care

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service.

The current staff worked together to provide person centred care and had developed positive trusting relationships with people using the service.

We identified shortfalls in relation to governance, safe recruitment and medicines. The registered manager needed to take measures to improve the oversight and performance of the service to help ensure all the required skills, knowledge and experience were in place.

However, we did also receive positive information during the assessment about the registered managers values from staff and health and social care professionals. They told us, “[Registered manager] has always been very professional and seems very caring of the [people] that the team look after…They have been extremely open and transparent in the conversations that I have had with them and work extremely well with us” and “[Registered manager] has responded promptly to all communication, and himself and another carer made themselves available to attend the review meeting.” Staff told us the registered manager led by example. They told us, “Yes, I would not work for anyone else as he is attentive and very good.”

People did not always feel they could speak up and that their voice would be heard.

We received negative information about unfair treatment from former employees prior to the assessment. This was related to the Home Office decision to revoke the license to sponsor workers from abroad.

The staff we spoke with during the assessment had a different experience. They were clear about how and when to report concerns, and they were confident the registered manager would respond. They told us there was an open and transparent culture within the service.

We requested evidence of staff surveys and surveys with people who had used the service in the last 12 months. None were received.

There was a marked disparity in the experience of staff and how they told us they were treated. Staff who were sponsored on work visas felt unfairly treated and the current staff team told us they felt valued and told us they were treated well.

We received negative information about unfair treatment from former employees on sponsorship visas prior to the assessment. This resulted in the Home Office revoking Pivotal Home Care’s license to sponsor workers from abroad.

The staff we spoke with, who were not on visas, were very positive about the way they were treated and spoke highly of the registered manager. Staff spoke about how they were supported on both a personal and professional level. They told us, “[Registered manager] is a kind hearted person, [registered manager] does care about people” and “[Registered manager] is one of the best, [registered manager] is very supportive. If we are struggling with anything we can call [registered manager] he will help…[registered manager] is hands on and he helps.”

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Audits were not effective and did not identify the gaps identified during the assessment. These included shortfalls related to safe recruitment, induction, training and medication.

Several governance issues had not been addressed in the previous 12 months leading up to the assessment. The Statement of Purpose (SOP) had been updated incorrectly in October 2025. Schedule 3 of The Care Quality Commission (Registration) Regulations 2009 states what the SOP must contain. It did not contain an accurate list of service user’s needs which the service intended to meet, and it did not contain up to date contact details for the service. Providers are required to complete a Provider Information Return (PIR) every year to provide us with data, and some information on how they are ensuring the service is safe, effective, caring, responsive and well-led. The purpose of the PIR is to help us identify areas to explore in more detail as part of our continuous monitoring of a service. The PIR was not returned by the deadline of 12 December 2025. The registered manager informed us both the PIR and SOP were updated and submitted during the assessment.

The ‘Capacity Tracker’ enables providers to share vacancies and other information. From 31 July 2022, there is a core subset of data which is now mandated. This had not been completed. Providers are also required to notify the Care Quality Commission of key incidents. We had not been notified as required and these were submitted retrospectively during the assessment.

The registered manager acknowledged during the assessment further research was required to ensure they could adhere to the requirements of, “Right support, right care, right culture”. 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. A decision was made during the assessment to withdraw from this area of care.

The Health and Care Act 2022 also introduced a requirement that all CQC registered service providers must ensure their staff have training on learning disability and autism, including how to interact appropriately with autistic people and people with a learning disability. No evidence was provided to demonstrate how this training requirement had been met.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.