Paramount Options Ltd

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.
At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.
This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.
Care plans were developed from the initial needs assessment, but we found the information was not always updated to reflect current care needs. People and relatives confirmed they had been involved in the initial assessment of support needs, development and reviews of care plans. Their comments included, “Before I started with them, they came to see me and we went through everything. I saw it when I started”, and “I have a care plan in place, and we have recently had a review with social services and gone through everything.” Other people told us their care plan had not been reviewed, “My care plan has not been reviewed”, and “They have not come here to review my care plan but if anything changes, I call the manager on their mobile.” We saw that a person’s care plan had not been reviewed to reflect their current needs.

The provider planned and delivered people’s care and treatment with them, but care plans did not always include information about what was important and mattered to them.

The nominated individual explained senior staff attended forums and meetings for adult social care providers where best practice and legislation was discussed. Staff completed a range of training which included supporting people with dementia, epilepsy and learning disabilities but training in relation to some specific support needs was not always provided. Some people’s support needs required specific training but there was no indication that staff had completed this training. Therefore, the provider could not ensure staff followed best practice when providing this support.

People’s care plans identified if they required support with preparing and eating meals. Where people received support with meals, their feedback included, “I am involved in picking what I eat and they help me eat. It is always cooked well, and they definitely give me enough to drink”, and “They will make me a coffee in the morning - I don’t have breakfast and that is my choice. They will help prepare my meals.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.
A health and social care professional told us, “I am able to get an in-depth handover from staff covering the needs of the [person].” The nominated individual explained the electronic messaging systems were used to share information with staff if there were any changes in a person’s support needs. Staff told us they felt able to raise any concerns or if they had identified a person’s care needs had changed with senior staff. There were team meetings where information on best practice, feedback on the effectiveness of the service and actions for improvement were discussed.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.
People’s care plans identified any medical conditions the person was living with, but staff were not always provided with information on the condition and how to support the person in relation to it. If a medical condition was identified, which could have an impact on how care was provided, for example increased falls or risk of infections, it was not indicated in the care plan with guidance for staff. Care plans identified any health or other professionals involved in the person’s care.
People told us, if required, staff would contact a relative if they felt the person was unwell. Their comments included, “They do a welfare check so if I am not well, they will call one of my [relatives] or the doctor – it gives my family peace of mind”, and “They know if I am not well because they have been coming for so long but they haven’t had to call a doctor.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. Records were not always reviewed, and care plans did not always include information about people’s expectations of their care.
Staff completed records for the care they provided during each visit. These records were reviewed to ensure they reflected the person’s care plan, but these checks were not always recorded. This meant the provider could not always ensure that the care being provided reflected the person’s care plan and the current identified support needs. The nominated individual explained they reviewed people’s care plans. If any changes in people needs were indicated, they would identify the person’s current care needs. The nominated individual told us where they felt a person’s support needs had improved, they would contact the local authority to amend or stop the care package. Relatives would be informed if there had been any changes in their family member’s care needs. People confirmed staff had contacted relatives about their health, if required.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
People told us staff explained what care they were going to provide, asked them what they wanted and listened to them. Their comments included, “Definitely, they do ask”, and “I tell them what I want when they first come in.”
People and their relatives provided written consent to the care described in their care plans. Where a person had been identified as being unable to make informed decisions about their care the provider worked with relatives to ensure care was provided in the person’s best interests.