Clubworthy House

Clubworthy House provides accommodation with personal care for up to two people. There were two people using the service at the time of our inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. ' Registering the Right Support' CQC policy.

What life is like for people using this service:

People were protected by a strong, comprehensive safety system, with a focus on openness, transparency and learning. The provider had systems in place to make sure the service was safe, with very good staffing levels and well skilled staff to deliver care. The service ensured that risks to people were fully assessed and well managed. People were empowered to take positive risks, to ensure they had as much choice and control of their lives as possible. The positive risk-taking approach demonstrated by the service showed they respected people's right for independence, their right to self -determination and their right to take risks.

The staff at Clubworthy House were highly committed to ensuring people lived fulfilling lives and were protected from social isolation. The whole focus of people's care was individualised and focused on promoting people's independence as well as their physical and mental well-being. People were empowered to make their own choices and staff were highly motivated with a 'can do' approach which meant they were able to achieve very positive outcomes for people.

People were involved and supported to safely recruit staff to work at the service. Staff were appropriately trained in all areas of people’s care. Robust arrangements were in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

Staff were caring and had built open and honest relationships with people. They were knowledgeable about how best to communicate with people and to advocate for them and ensure their views were heard. People, relatives and health and social care professionals all spoke of the commitment of staff, the family atmosphere at the service and the genuine interest staff took in their wellbeing. There was a strong culture within the service of treating people with dignity and respect and staff spent time getting to know people and their specific needs before they provided them with care and support.

There was strong leadership that put people first and set high expectations for staff. There was an open culture and a clear vision and values, which were put into practice. Staff were proud to work for the service and felt valued for their work. A positive culture was demonstrated by the attitudes of staff and management when we talked with them about how they supported people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (report published 20/08/2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection we found the service had improved to outstanding under the caring and responsive domains. The overall rating for this service is Outstanding.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The service has a registered manager in place. 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.

The person who currently lived at Clubworthy House was well cared for , relaxed and comfortable in their home. The person readily approached staff when they wished to be supported and their privacy was consistently respected by staff. We also spoke with a relative who shared with us positive examples of the care and support their family member received from the service. They commented “If you ever want an example of outstanding care, it’s here. They are all about life enhancement.”

People were happy and relaxed on the day of the inspection. The person moved around their home as they wished, interacting with staff and smiling and laughing. Staff were attentive and available. Staff encouraged people to engage in meaningful activity and spoke with them in a friendly and respectful manner. Staff knew the person they supported extremely well and spoke of them with affection.

Staff had high expectations for people and were positive in their attitude to support. The service offered flexible support to people and responded promptly to the person’s decisions and choices.

The service was known to the local community. The person actively participated in local community life and their relative told us, “(person’s name) has been adopted by the local community and that’s thanks to the (registered manager name) and (registered provider name).”

Care plans were informative and contained clear guidance for staff. They included information about people’s routines, personal histories, preferences and any situations which might cause anxiety or stress. Details of how the person wished to be supported with their care needs were highly personalised and provided clear information to enable staff to provide appropriate and effective support. The person shared their care plan with us. It was presented in written and pictorial formats to enable them to read their plan and be involved in any changes or updates.

Risk assessments were in place for day to day events such participating in sporting sessions. Where activities were done regularly risk assessments were included in people’s care documentation. People had access to a range of activities. These were arranged according to the person’s individual interests and preferences. Staff identified with people future goals and aspirations and worked with the person to achieve them.

Incidents and accidents were recorded. These records were reviewed regularly by all significant parties in order that trends were recognised so that identified risks could be addressed with the aim of minimising them in the future.

Where people did not have the capacity to make certain decisions, the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had a good understanding of the principles of the legislation and training was updated regularly.

Support was provided by a small, consistent, motivated and well trained staff team. Staff were well supported and attended and sought out relevant training to enhance their skills. Monthly staff meetings were held which were an opportunity to share any concerns or ideas they had to continuously improve their service. Staffing levels met the present care needs of the person that lived at the service.

There was a robust complaint system in place. There were plenty of opportunities for people, relatives and staff to voice how they felt about the service and any concerns they had. The person was supported to attend an advocacy group which allowed an opportunity to raise any issues.

The registered manager was keen to gather views from people, their relatives and stakeholders to ask for their feedback. Staff were committed to engaging with families who were kept informed of any changes in people’s needs or appointments.

There were clear lines of accountability and responsibility at Clubworthy house The organisational values were embedded in working practices and staff worked to provide a service which was designed around the needs of the individual. The registered manager commented “You’ve got to put your heart and soul into it. My day is to make sure (person’s name) is happy and we try to achieve this.”

We spent time talking with people living at Clubworthy House and observing how people's care and welfare needs were met. People were spending their time having a lay in and playing on their IPad. People did not appear rushed and the home was relaxed and homely. Comments included: 'That's my horse, Megan' and 'I like Snow White.' People spoke about the different activities that they enjoyed. These included, spending time with their horse, watching films, having parties and going on holiday. This demonstrated that the home recognised the value that activities gave to people to ensure their emotional and psychological wellbeing.

Medicines were safely administered. We saw the medicines records were appropriately signed by staff when administering a person's medicines.

Staff were able to speak confidently about the care practices they delivered and understood how they contributed to people's health and wellbeing.

Care plans and risk assessments demonstrated that they had been reviewed and updated on a regular basis or in response to changing needs.

We saw that the staff treated the person with consideration and respect. For example, we saw that the staff quickly responded to the person's care needs by supporting them with daily living skills and keeping them informed about the choices available to them for the day.

Staff had knowledge of privacy, dignity, independence and human rights. For example, how to maintain privacy and dignity when assisting with personal care. They showed an understanding of the need to encourage the person to be involved in their care. For example, staff recognised the need to promote positive experiences for the person to aid their wellbeing through offering a range of activities to take part in.

Care plans that we saw reflected the person's health and social care needs and demonstrated that other health and social care professionals were involved.

We spoke with the staff about their understanding of what constituted abuse and how to raise concerns. They demonstrated a good understanding of what kinds of things might constitute abuse, and knew where they should go to report any suspicions they may have. Staff we spoke with felt confident about responding to changing needs and knew what signs of abuse to look out for during their daily practice.