Archived: Clubworthy House

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 peoples’ needs.

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

This meant people’s needs were not always met.

This service scored 39 (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 always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

While there were some examples of person-centred approaches, these were undermined by a lack of meaningful choice and control in daily routines and decision-making. One staff member said, “[Completion of] tasks are expected and planned into the week. [People] know what they do in each room. If they don’t want to do it, it’s fine, but I’ll have to so we might be a bit later doing the next thing”.

Care planning lacked sufficient detail to support person-centred responses to distress or emotional needs. For example, one person’s care plan stated they should be reassured when anxious but did not specify how staff should do this. Staff described incidents where people became distressed and were met with controlling or punitive responses, such as being blocked from leaving a room or shouted at.

There were examples of people being supported to engage in activities they enjoyed, such as attending theatre performances and music events. However, staff questioned whether these reflected people’s preferences or those of the provider.

Care plans included some personalised details, such as people’s preferences for music, theatre, and animal care. One person told us they enjoyed brushing their horse and showed us a photograph of them together.

We received positive feedback from family, who felt that the care provided was well suited to their family member’s individual needs.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

While people’s physical health needs were well supported, the overall model of care did not reflect best practice or promote independence and community inclusion.

There was limited evidence of people being supported to build or maintain relationships outside of the service and people had limited contact with others outside the home placing them at risk of social isolation.

Staff told us activities were planned in advance and carried out as a group. While this promoted consistency, it did not allow for flexibility, spontaneity or individual choice.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Care plans included basic information about people’s preferences and routines but lacked detail about how information should be presented to support understanding and how staff should adapt communication to accommodate people’s individual needs.

A picture board was used to display the weekly planned activities and the provider described using leaflets and posters to support people to make choices, but there was limited evidence that these techniques were used in day-to-day care provision.

Mental capacity assessments were completed following the inspection; however, these did not demonstrate that people had been supported to understand the decisions being made.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

People’s views were not always respected, and there were examples of dismissive or coercive responses to expressed preferences.

One person told us they wanted to leave the service and described feeling scared and unable to sleep at night. They reported being called a liar by the provider and staff corroborated this, saying, “[Providers] call [name] a liar and say they cannot trust what they say”.

Staff described a culture where people were expected to comply with plans and routines, and where refusal was met with subtle consequences.

There were examples of people being involved in house meetings and recruitment discussions, but staff questioned the authenticity of this involvement.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People were supported to attend health appointments and received appropriate care from external professionals. However, access to wider community resources was restricted by the rural location of the service and the provider’s approach to supervision. Staff told us people were not allowed to go out independently with support staff and that one person was always accompanied by one or other of the providers. The providers confirmed this was the case, and recognised a need to ‘step back’

Access to transport was limited, and staff told us people could not choose to go somewhere spontaneously. The provider told us people’s funding did not include transport costs and that they funded those costs themselves, which meant they decided if and when transport would be made available to people.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

People were not supported to develop skills or pursue opportunities outside the service. One person was described as “very capable,” but there was no planning around education, employment or volunteering. Another person’s care plan stated they wanted to make their own choices where they were able to, but this was not reflected in practice.

Staff and people described differences in how people were treated, with one person being treated “like family” and another “like a co-worker”. One staff member said, “[Name] is treated differently”. This impacted their emotional wellbeing and sense of autonomy.

The provider did not demonstrate an understanding of how to tailor care to reduce inequalities or promote positive outcomes. This impacted people’s ability to live fulfilling lives.

People were not 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.

Care plans included basic information about people’s preferences and routines but lacked detail about aspirations or long-term goals.

One person told us they wanted to leave the service and described feeling scared and unhappy. Staff corroborated this and said the person had expressed a desire for more independence. However, there was no evidence of future planning to support this transition.