Paramount Options Ltd

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.
At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.
This meant people’s needs were not always met.
The service was in breach of legal regulation in relation to person centred care.

This service scored 62 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.
The provider developed care plans for the people they supported but these did not always reflect the person’s current care needs or their wishes in relation to their care. This meant staff were not always provided with the information they required to ensure people received the care they needed in the way that they wanted.
The care plan for one person indicated it should be reviewed within 6 months of the last review, or sooner if required, as the person was living with medical conditions which could cause a change or increase in support needs. The care plan had not been reviewed within 18 months of the last review. This meant the provider did not ensure the care plan being used by staff during their visits reflected the person’s current care needs. The records completed by staff describing the support they provided during each visit demonstrated the care the person required did not reflect the existing care plan. The staff were providing support which they had identified during each visit as required but this had not been assessed by the provider to ensure it was provided in an appropriate manner.
People’s care plans identified the support they required during each visit, but this was not always detailed. The visit information in some care plans was a list of the tasks required but did not provide staff with information on the person’s wishes and how to provide the care. This meant care plans were not always focused on the person’s preferences to ensure care was provided to meet people’s needs.
A person’s care plan indicated that staff were to support the person with exercises required by physiotherapists. There was no information in the care plan on what these exercises were or how staff should support the person with them. This meant staff could not ensure the exercises were supported as directed.
A person’s care plan indicated they used British Sign Language (BSL) to communicate but the nominated individual stated no one they supported used BSL. This meant staff were not provided accurate information on a person’s communication support needs.
People and relatives confirmed they had been involved in the develop of the care plan but not always in the ongoing review of the care plan.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.
People confirmed they were usually visited by the same staff so they could get to know them and there was consistency in the care provided. People’s comments included, “I have one carer come in during the week and another at weekends. Continuity of care is important”, and “I have one regular carer and other staff who will stand in for them. Once or twice someone completely different will turn up but I do know them as well.”
A person explained the provider arranged for a staff member to attend hospital appointments with them and they scheduled the same staff member who knew the person. The staff member also arrived early to ensure the person was not rushed getting to their appointment.
The health and care professionals involved in the person’s care were identified. Staff completed records of the care they have provided during each visit which meant information was shared with other staff visiting the person.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
People’s care plans identified their communication needs. People’s care plans included information on the person’s hearing, vision and their preferred language. People told us the information they received from the service was clear and it was in a suitable format to meet their needs.
People explained the provider kept in contact with them through emails, text messages and telephone calls. Their comments included, “I get texts or the manager calls me directly. The carers and manager talk to each other, and the carers will tell me and make sure I know what is going on”, and “They phone me and I phone them. I have very good communication with the manager.”

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.
People and relatives told us they knew who to contact if they had any questions or concerns about the care provided. Their comments included “I have very good communication with the nominated individual. When I have had any questions, they have acted very quickly”, and “I would call the manager or the duty manager if I have an issue.”
People and relatives confirmed they had been involved in the development of care plans, but some people told us they had not always been involved when the care plan was reviewed.
People told us they were asked for feedback about the service and the care their received. They said, “They do ask and I am very much satisfied”, and “I have very good communication with the manager.”
The nominated individual told us they obtained feedback from people and their relatives from an annual survey which was currently being completed. The nominated individual stated they also received feedback though the spot check visits. The records for spot checks were reviewed during the assessment, and these did not contain any feedback from the person on their care.
People and relatives told us they had a survey form but had not always been able to provide feedback or had not received any information on the outcomes. Their comments included, “I had a form to fill in; a survey about my care. I filled it in where I could and I don’t know what has happened to it. I didn’t make any suggestions”, “They did send me some paperwork, but I don’t do paperwork that is why they call me” and “We did get a feedback form but there was no return address, so we didn’t fill it in.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.
Staff supported people, when indicated, to access other services such as hospital appointments. People told us staff supported them to go shopping, to the bank or for other activities outside their home when required.

Staff and leaders identified people’s preferences in relation to gender specific care, religious and cultural preferences to provide tailored care, support and treatment to meet these needs.
People told us they had been asked if they had a preference for the gender of the staff member who visited them. A person said, “I specified female carers and I have always had a female carer.” Staff explained how they communicated and supported people when they provided care. A staff member told us, “I use person's preferred name, I listen to their views, beliefs, preference and concerns, I involve them in decision about their care whenever possible.”
Care plans identified the person’s religious and cultural preferences. Staff completed training in relation equality and diversity which included supporting people’s human rights.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.
At the time of the assessment the nominated individual confirmed the service was not supporting anyone with end-of-life care. People and relatives told us they had not discussed their wishes in relation to the care if their health needs were to deteriorate. The nominated individual explained a template had been developed for end-of-life care plans. The template had sections on medicines, communication, the details of professional in involved in the care and how people wanted their care provided.