This inspection was undertaken on 22 and 23 August 2018 and was announced on both days. This was the first inspection since the service had been registered with the Care Quality Commission.

Pinnacle Caring is registered to provide personal care and support to people who live in their own homes. The agency office is based in Blacon, Chester and provides support to people within their local area. At the time of our inspection the service supported 10 people.

The service did not have a registered manager. The service has been without a registered manager for six months. A new manager had been appointed at the time of our inspection but had not commenced work. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers they are 'registered persons'. The registered persons have a legal responsibility to meet the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During this inspection we found a breach of regulation 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered providers audit systems had failed to identify areas for development and improvement that included DBS check, mandatory refresher training and supervision for staff. In addition, the registered provider had not undertaken regular reviews of daily care records.

You can see what action we told the provider to take at the back of the full version of the report.

Staff recruitment systems were not consistently robust to ensure only suitable staff were employed to work with the vulnerable people they supported. The service had a high turnover of staff and were undergoing further recruitment at the time of our inspection.

Support and supervision was not consistently undertaken in line with the registered provider’s policy and procedure.

All staff had undertaken an induction which included shadowing more experienced staff at the start of their employment. Staff had all completed essential training however they had not consistently completed refresher training in line with good practice guidelines.

The registered provider had a medicines policy and procedure in place. Staff had all undertaken medicines training however had not all completed annual refresher training in the subject. Staff had not had their medicines competency assessed. We received confirmation that this had been undertaken since our inspection visit.

Staff had a good understanding of safeguarding people from abuse. There were policies, procedures and systems in place to protect people from abuse.

People had their needs assessed prior to them using the service. A care plan and risk assessments were prepared using the information gained through assessments. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. People told us that staff understood their individual needs.

People told us that staff treated them with kindness and were caring. They said that their privacy and dignity was consistently respected.

People told us that staff supported them with their food and drink needs. They described being offered choice and we saw guidance was available for staff to follow to meet people's individual dietary needs.

The registered provider had up-to-date policies and procedures that were available to staff to support their role and employment. Policies included complaints that people and their relatives could follow to raise any concerns or complaints they had.

The Care Quality Commission as required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and report on what we found. We saw that the registered provider had policies and guidance available for staff in relation to the MCA. Staff demonstrated a basic understanding of this and had all completed training.