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Inspection carried out on 23 January 2016

During a routine inspection

We inspected Clubworthy house on the 23 January 2016 the inspection was announced. This was to ensure that the people would be at the service during the inspection. Clubworthy House provides accommodation and personal care for up to two people with a learning disability.

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.”

Inspection carried out on 1 February 2014

During a routine inspection

Before people received any care or treatment they were asked for their consent and staff acted in accordance with their wishes.

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.

Inspection carried out on 29 September 2012

During a routine inspection

We carried out an unannounced inspection on 29 September 2012. On the day of our visit there was one person living at Clubworthy House. We spoke with them and two staff members and looked at their care file.

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.

Reports under our old system of regulation (including those from before CQC was created)