This inspection took place on 26 June 2018. We gave the provider 24 hours’ notice of the inspection to make sure the registered manager would be available to assist us with the inspection. The last comprehensive inspection of the service was on 14 March 2016 when we rated it as Good for each of the five questions we ask.

Paramount Options Ltd is a domiciliary care service that provides care and support to people living in their own homes in the community. When we inspected, the service was supporting four people. The provider had appointed a manager who registered with the Care Quality Commission (CQC) on 3 June 2013. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Not everyone using Paramount Options Ltd receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The provider had systems in place to protect people from abuse and care workers completed training to enable them to use these systems.

The provider assessed risks to people using the service and care workers and acted when they identified possible risks to mitigate these.

There were enough care workers to care for and support people and the provider carried out checks to make sure they were suitable to work with people using the service.

The provider had systems to ensure people received the medicines they needed safely and as prescribed.

Care workers had access to personal protective equipment and infection control training.

The provider assessed people’s care needs and recorded their preferences about how they received care and support.

Care workers had access to the training they needed to deliver effective care and support.

Where it was part of their care plan, care workers supported people to maintain a balanced diet. Care workers also completed training in nutrition and food safety.

Where needed, care workers supported people to meet their healthcare needs. People’s care plans included details of these needs and the provider shared these appropriately with other agencies.

The provider and registered manager understood their responsibilities under the Mental Capacity Act 2005 and only provided care and support with people’s consent or in their agreed best interests.

People told us their care workers treated them with kindness, respect and compassion. Care workers understood the importance of respecting people’s privacy, dignity and independence.

The provider consulted people about the care and support they received and responded to their views and experiences.

The provider assessed people’s care and support needs and developed an individual care plan to meet needs they identified.

The provider had systems for responding to any complaints they received.

The provider had appointed a qualified and experienced manager who had registered with the Care Quality Commission.

People told us managers were accessible and they could contact people when necessary.

The provider had systems in place to monitor quality in the service and make improvements.

This inspection took place on 14 March 2016 and was announced. We gave the provider short notice of the inspection because the location provides a domiciliary and we needed to be sure that someone would be available to assist with the inspection.

We last inspected the service in January 2014 when we found it was meeting all of the standards we inspected.

Paramount Options Ltd is a home care agency providing personal care and support to people in their own homes. When we inspected, the agency was supporting four people with their personal care.

The agency had a manager who was registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Relatives of people using the service told us their family members felt safe with their care workers.

The provider had a policy and procedures for safeguarding people using the service.

Care workers told us they had completed safeguarding adults training and the training records confirmed this.

People were looked after by staff who were trained and knowledgeable about how to meet their needs effectively.

Care workers were able to demonstrate that they knew people’s needs well.

Care workers supported people to maintain a healthy and balanced diet.

Care workers respected people’s wishes, gave them choices and supported them to be as independent as they could.

People received a reliable service from care workers who knew and understood their needs.

People’s support plans covered their care needs and detailed the support their care workers provided on each visit.

People told us that staff listened to them, and gave them time to express their views and preferences about the way care is delivered.

Relatives of people using the service and care workers told us they felt able to approach the management team and felt valued by them.

The provider and registered manager had systems to monitor the quality of the service that people received and to make improvements.

The provider and registered manager were active in seeking feedback from people with regard to their experiences of the service and used this to drive improvement.

We spoke with one person using the service, one relative and four staff. The staff included the nominated individual, the registered manager and two care staff.

The service started to provide care and support to people at the end of November 2013. At the time of inspection there were two people using the service.

Staff understood the importance of treating people with dignity and respecting their choices and wishes.

Care was planned to meet people’s needs. Risks were assessed and plans put in place to minimise these. Care and risk management was reviewed monthly to ensure information was kept up to date.

People told us they would be confident to raise concerns with the service so they could be addressed.

Recruitment processes were in place and were being followed, to protect people using the service.

Systems were in place for monitoring the quality of care being provided and for obtaining feedback from people using the service so any necessary changes could be planned and implemented.