Archived: Clubworthy House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question outstanding. At this assessment the rating has changed to inadequate.

This meant people were not treated with compassion and people’s dignity was not always respected.

The service was in breach of legal regulation in relation to person centred care.

This service scored 30 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not treat colleagues from other organisations with kindness and respect.

During this assessment, staff and ex members of staff disclosed significant concerns about how people living at the service had been treated and the ways they were routinely spoken to. This included degrading and emotionally abusive language, punitive practice and the emotional impact of being exposed to a closed culture.

The evidence we heard and saw during this inspection strongly supported the staff view that this had been common practice for several years and had been normalised and accepted. For example, the routine use of foul language both in general conversation and aimed at people, name calling and restricting access to activities if people did not behave in the way the provider wanted.

Colleagues from other organisations told us they found it difficult to work with the provider, and that they felt it necessary to visit the service in pairs. A recent local authority assessment at the service was abandoned, because the health professional completing it felt uncomfortable and intimidated.

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s care plans contained limited information about their needs as individuals, their likes and dislikes, abilities or aspirations for the future.

Whilst staff knew people well, they told us their day-to-day care and support was planned for them in advance, and that there was limited flexibility around their individual preferences and needs. For example, one person’s care plan said they were able to make their own choices about what to eat, however, staff told us meals were planned in advance and there was little flexibility.

Staff told us people were expected to complete various tasks within the service, irrespective of their interests or preferences for that day. There was no evidence of developing different skill sets which might not align with those of the provider.

People’s care plans did not demonstrate people’s changing needs over time had been considered, or that people’s goals and aspirations were being explored.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

The provider told us people were involved in planning how they spent their time through bi-monthly ‘house meetings’ where upcoming events, activities, and meal plans were discussed. Advanced weekly plans were then created which included the chosen activities, including multiple theatre trips and live music events, appointments, and household tasks. Staff told us that whilst there might be some flexibility, people were not given real choice on a day-to-day basis.

A staff member said, “They don’t have any choice, it’s written down what will happen. They go and see the bands [the provider] wants to see, it’s not a real choice, it’s coerced”. Another staff member said, “You don’t have any choice, but we’re going to pretend you do”. A third staff member said, “[Name] can’t just decide to do something, they won’t let you out of their sight”.

People took part in daily household tasks including cleaning their own bedrooms, communal spaces, cooking communal meals and feeding and tending to the wide range of animals at the property. People clearly enjoyed some of these activities, for example, one person showed us a photograph of their horse and said they enjoyed spending time with him. However, people were not given an active choice about what they did each day or offered alternative activities to choose from. One staff member said, “[Name] can’t just decide to go into Exeter, they [the provider] will talk around any idea that doesn’t fit with what they want. The control is ridiculous. [Name] can’t even pick a DVD, it gets “suggested”.

People cooked and ate communally with both the providers and staff from a weekly planned menu. Whilst this communal approach to sharing meals had some positive benefits, it also meant people were not being given real choice on a day-to-day basis. One staff member said, “The food is the same week in week out. They can’t just ask for a glass of wine, but if [the provider] offers it it’s ok”. Another staff member said of having a social drink, “All of that is very controlled, they decide when it can happen”.

Similarly, people gained some benefit and enjoyment from completing household tasks and looking after the animals, but these tasks were pre-planned into the weekly schedule, and no active choice was given. One person had raised concerns with a health professional about how much they were allocated to do. A staff member said, “It’s expected, and planned into the week.” Another staff member said, “They don’t employ cleaners, so it’s how they keep the house clean, they call it promoting independence’. [Name] did so much, they were so capable, it was like having another staff member”. Despite this person being clearly capable, there was no planning around developing their skills or seeking either paid or voluntary work outside of the home.

Staff told us people rarely declined to follow the weekly plan or requested alternative activities, because the “[Provider] can get moody if plans change”.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

People’s needs, views, wishes and comfort were not placed at the centre of care delivery. Whilst we had no concern about people’s physical health needs being well responded to, staff told us people’s emotional needs were not always recognised or respected. For example, staff told us the providers did not always respond to people’s emotional distress in line with their care plans, and that their response often exacerbated the person’s distress, which on at least two occasions resulted in a person physically harming themselves. Records showed one staff member raised concerns several years ago that the provider told them they were “too soft” and needed to be “firm” in their approach.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff told us they felt de-skilled by the provider’s approach and felt unable to raise concerns through routine supervisions or using the provider’s policies. One staff member told us they were left “completely broken” by their time at the service. Another staff member said, “You can’t challenge them”. Another staff member said, “If you comply and do what they want it’s ok. They know who they can be themselves around”.

Staff also told us the providers could be generous and supportive and often gave them and their families cash gifts in addition to favourable employment terms. They described an unpredictable atmosphere, where “you just want to keep [provider] happy”.