Archived: Pinnacle Brit

Updated 21 February 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

Our inspection was completed by 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 5 May 2023 and ended on 15 May 2023. We visited the location’s office on 5 May 2023.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We gained feedback from the local authority.

During the inspection

We called and spoke with 3 people and 5 relatives of people who used the service about their experience of the care provided. At the office we spoke with the provider who is also the registered manager and 2 members of staff. We called and spoke with 3 members of staff.

We reviewed a range of records including 8 people's care plans, daily care notes, staff rotas, multiple medication records, safeguarding records and complaints. We reviewed a variety of records relating to the management of the service including 3 staff recruitment files and spot checks.

Updated 21 February 2024

About the service

Pinnacle Brit provides personal care and support to older people and people with disabilities living in their own homes. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. At the time of our inspection, all 14 people received personal care.

People’s experience of using this service and what we found

As in the last 3inspections, risks associated with people’s care were not being managed safely. The provider did not have robust systems in place to ensure staff attended the care call and stayed for the full length of the call. Medicines were not being managed in a safe way.

Staff training and supervision were not effective in ensuring good quality of care or identifying and addressing shortfalls. People were not always supported to have maximum choice and control of their lives.

People's independence was impacted as staff were not always advising them when they were going to be late. People and their families did not always have input into their preferred call times which they fed back impacted on their lives.

As from the previous inspection, there was a lack of personalisation and detailed guidance for staff specific to each person's needs. There was a lack of detailed information on people's preferences, their likes and dislikes and life histories and staff confirmed to us they did not know this information. There was a lack of evidence of robust investigation into the complaints or actions taken to make the necessary improvements. People and relatives were not always confident complaints would be addressed.

There remained a lack of robust systems in place to monitor the delivery of care and this impacted on the care people received. The provider had failed to ensure there were robust systems in place where staff either arrived late for a call or did not stay for the full length of the call. Audits taking place were not identifying or preventing issues occurring or continuing at the service. The provider failed to have effective systems in place to gain feedback from people, relatives and staff about the quality of care.

People fed back staff were not always adhering to infection prevention controls. We also found staff were not always recording how much people had eaten and drunk. We have made recommendations around both areas.

There were people and relatives that fed back they had developed good relationships with their regular carers. We saw external professionals were contacted where staff had a concern about a person’s health.

Rating at last inspection

The last rating for this service was inadequate (published 29 September 2022) and there were multiple breaches of regulation. At this inspection, we found the provider remained in breach of regulations. The service remains rated as inadequate overall. This service remains in Special Measures

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Enforcement and Recommendations

We have identified breaches in relation to risks associated with people's care, and the management of medicines. We identified breaches in relation to the deployment of staff and lack of robust training and supervision. We identified breaches in relation to care not being planned and provided around people's needs and wishes and there was a lack of robust oversight of the quality of care and responding and acting on complaints.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service remains 'Inadequate' and the service remains in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk