5 May 2023
During a routine inspection
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