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Crouch House and Crouch Cottage Good

Inspection Summary


Overall summary & rating

Good

Updated 27 January 2020

During our comprehensive inspection in July 2019 we had serious concerns about some aspects of the safety of the environment in Crouch House (the accommodation for the service). The provider had not ensured that the premises where clients slept had appropriate locks on the external door, despite this being raised by previous clients, or that clients were able to call for assistance if needed. We served a warning notice which required the provider to make immediate improvements.

We also served a warning notice which related to the provider not having appropriate governance procedures in place. However, following the inspection the provider clarified the governance arrangements which we were assured were appropriate for the model of service it was delivering.

The provider took immediate action to make improvements and decided not to take another cohort of clients until we had completed a follow up inspection. The provider developed and implemented a comprehensive improvement action plan.

We undertook a follow up inspection a few months after our original inspection to ensure the provider had taken the appropriate action.

During this inspection we found that the provider had made all the required improvements and had taken the opportunity to ensure it was able to deliver a high quality, safe service prior to the next cohort of clients commencing the programme in January 2020.

We therefore lifted the warning notice.

  • The provider had installed a safe, coded lock on the external door and had installed an intercom system so clients could call for assistance if needed and speak to staff when they were in Crouch Cottage (outside of therapy hours and during the night).

  • The provider had contracted with a health and safety company to carry out a full range of health and safety inspections, including fire safety, environment and premises management, people safety and management and the assessment of health and safety risks. The company will also provide online health and safety training and advice for staff. The provider had a contract in place with its landlord to ensure any issues raised were addressed in a timely manner.

We also found that:

  • At the point of first contact with Sporting Chance clients were comprehensively risk assessed and the majority would start therapy with one of the community therapists within 48 hours or would enter a detoxification programme which was provided by another partner provider. Clients would only be admitted to Crouch House once detoxification had been completed; the provider had a very strict criteria for admission and would only take clients who had completed detoxification and were physically fit.

  • On admission, clients were assessed by a GP; this included physical health assessments. The GP would follow up on any physical health monitoring as needed and would visit the clients if they became unwell. Care plans were holistic and centred around the clients specific needs.

  • Crouch House provided a unique, bespoke psychosocial model of rehabilitation for addictions, including substance misuse, to a specific client group (professional sport personnel). It provided a range of therapies which were in line with best practice and national guidance. The therapeutic programme was based on the 12 step abstinence model but the service also provided other effective therapeutic activities such as equine therapy, meditation and yoga.

  • Clients could access a range of physical activities. For example, clients had access to an extensive gym, scuba diving and golf visualisation. For those clients still actively involved in professional sport, coaches and nutritionists from professional clubs would attend to monitor and ensure clients kept up their level of physical fitness in order to ensure they could resume their career following completion of the programme.

  • The service had a team of four psychotherapists/counsellors who were responsible for the delivery of the 12-step programme; all received regular mandatory training and could access additional training as required. Staff received regular supervision and appraisal. The service contracted with specialist therapists who provided therapies such as the equine therapy etc.

  • Clients had a wide choice of food to meet all their nutritional needs. There was a well equipped kitchen in the accommodation were clients could prepare food and drink when they wished.

  • Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning. Feedback from clients was overwhelmingly positive.
  • The service was easy to access. Staff planned and managed discharge well. Following discharge clients could be supported close to their home by therapists employed by the Sporting Chance charity. It could refer clients to alternative services if it could not meet client’s needs.
  • The design, layout, and furnishings at Crouch House supported clients privacy and dignity. There was one shared bedroom for two clients; clients agreed to share prior to admission, and two single bedrooms. Clients could keep their personal belongings safe. There were quiet areas for privacy. In addition, there was a separate therapy building in which group work and one to one session were held.

  • Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the services they managed, the specific needs of the clients and were visible in the service and approachable for staff and clients.
  • All working at Crouch House and the Sporting Chance service had a good understanding of the vision and purpose of the service – some of the team were founding members of the Sporting Chance charity.
  • All working at Crouch House felt respected, supported and valued. They felt able to raise concerns without fear of retribution. They were confident in the leaders.
  • The provider had good systems and processes in place for ensuring the service ran smoothly on a day to day basis and that it worked well with its detoxification provider and the wider Sporting Chance charity.
  • Although the service gathered feedback from clients on whether they felt the service had had a positive effect on their lives it was working with its stakeholders to establish the best measures to monitor the service and planned to implement these on commencement of the next 26-day programme.
Inspection areas

Safe

Good

Updated 27 January 2020

We rated safe as good because:

  • During our comprehensive inspection of the service in July 2019 we had serious concerns about some aspects of the safety of the environment. The provider had not ensured that the premises were clients slept had appropriate locks on the external door, despite this being raised with them by previous clients, or that clients were able to call for assistance if needed. We served a warning notice which required the provider to make immediate improvements.

  • The providers fire procedure stated that weekly fire checks should be completed but (in July 2019) we found that these had not been completed since April. In Crouch House two of the fire extinguishers were out of date.

    However:

  • The provider took immediate action to make improvements and decided not to take another cohort of clients until we had completed a follow up inspection. The provider developed and implemented a comprehensive action plan.

  • During the follow up inspection we found that the provider had made all the required improvements and had taken the opportunity to ensure it was able to deliver a high quality, safe service.

We therefore lifted the warning notice.

  • The provider had installed a safe, coded lock on the external door and had installed an intercom system so clients could call for assistance if needed and talk to staff when they were in Crouch Cottage.

  • The provider had employed a health and safety company to carry out a full range of health and safety inspections, including fire safety, environment and premises management, people safety and management and the assessment of health and safety risks. The company also provides online training health and safety training and advice for staff.

  • The provider had a contract in place with its landlord to ensure any issues raised were addressed in a timely manner.

  • At the point of first contact with the provider (Crouch House being only part of the wider Sporting Chance service) clients were comprehensively risk assessed and the majority would start therapy with one of the community therapists within 48 hours or would enter a detoxification programme which was provided by another partner provider.

  • Clients would only be admitted to Crouch House once detoxification had been completed; the provider had a very strict criteria for admission and would only take clients who were, at the very least 72 hours our of detox and physically fit.

  • On admission, clients were assessed by a GP; this included physical health assessments. The GP would follow up on any physical health monitoring as needed and would visit the clients if they became unwell.

  • The GP monitored any client who might be taking medication. Clients had to be able to administer any prescribed or homely medicines themselves but the service kept these in a locked cupboard in Crouch Cottage for safety reasons. The care plans were holistic and centred around each client’s specific needs.

  • Staff had training on how to recognise and report adult abuse.

  • When things went wrong, staff apologised and gave clients honest information and suitable support.

Effective

Good

Updated 27 January 2020

We rated effective as good because:

  • Clients received a comprehensive assessment prior to admission to Crouch House by a Sporting Chance community therapist. The service did not provide a detoxification service and clients admitted were very low medical risk. Clients who required detoxification received this service from a detoxification provider that Sporting Chance worked in partnership with. Following detoxification clients would be admitted onto the therapy programme at Crouch House. A further assessment was carried out on admission. Care plans were holistic and based around the specific needs of the individual clients to enable them to live a healthier lifestyle and return to their sports career.

  • Crouch House provided a unique, bespoke psychosocial model of rehabilitation to a specific client group (professional sport personnel). It provided a range of therapies which were in line with best practice and national guidance. The therapeutic programme was based on the 12 step abstinence model but the service also provided other effective therapeutic activities such as equine therapy, meditation and yoga.

  • The service provided a range of physical activities. For example, clients had access to an extensive gym, swimming pool, scuba diving and golf visualisation.

  • For those clients still actively involved in professional sport, coaches and nutritionists from professional clubs would attend to monitor and ensure clients kept up their level of physical fitness in order to ensure they could resume their career following completion of the programme.

  • The service had a team of four psychotherapists/counsellors who were responsible for the delivery of the 12-step programme. Additional specialist therapists provided therapies such as the equine therapy and complimentary therapies.

  • All staff received regular mandatory training and could access additional training as required. Staff received regular supervision and appraisal.

  • Staff supported clients to make decisions about their care.

Caring

Good

Updated 27 January 2020

We rated caring as good because:

  • Clients were positive about the support they received; they felt that staff were responsive to their needs and treated them with compassion and respect. Clients felt that the service had benefited their lives and supported them to live a healthier lifestyle.

  • Staff treated clients with compassion had a thorough understanding of each clients individual needs. They actively involved clients in decisions and care planning.

  • Clients had regular one-to-one time with their recovery support therapist.

  • Staff were passionate about the service they provided and wanted to deliver the best care possible to their clients.

  • Clients were provided with information about how to complain on entering the service and it was clearly written in the contract that clients signed on admission.

  • Clients were encouraged to maintain relationships with their families. Families were encouraged to visit each Sunday and counselling was available to families who had been affected by the clients addictions or behaviours.

  • The service received feedback from the clients professional clubs about the positive effect the programme had had on their employees.

Responsive

Good

Updated 27 January 2020

We rated responsive as good because:

  • The facilities at Crouch House supported clients comfort, privacy and dignity. There were areas were clients could have quiet time alone if needed.

  • Clients could use their mobile phones to contact family and friends during set times outside of therapy sessions. Clients signed up to this as part of their contract on admission to the service.

  • Staff were passionate about ensuring they encouraged an accepting culture at the service.

  • Clients had a wide choice of food to meet their nutritional needs. There was a well equipped kitchen in the accommodation were clients could prepare food and drink when they wished.

  • The service was easy to access. Staff planned and managed discharge well. Following discharge clients could be supported close to their home by therapists employed by the Sporting Chance charity. It could refer clients to alternative services if the provider could not meet clients’ needs.

  • The staff at Crouch House worked well with the wider Sporting Chance therapy service, the private detoxification provider, the local GP and the therapists who provided the additional therapy. They supported one another as a team.

  • Clients were supported to attend local support groups. Before or after these meetings the clients had meals out in the local community.

Well-led

Good

Updated 27 January 2020

We rated well-led as good because:

  • Leaders had the skills, knowledge and experience to perform their roles. Leaders we spoke with were committed, knowledgeable, caring and professional. They had a good understanding of the services they managed, the specific needs of the clients and were visible in the service and approachable for staff and clients.

  • All working at Crouch House and the Sporting Chance service had a good understanding of the vision and purpose of the service – the registered manager was a founding members of the Sporting Chance charity.

  • All working at Crouch House felt respected, supported and valued. They felt able to raise concerns without fear of retribution. They were confident in the leaders.

  • The provider had good systems and processes in place for ensuring the service ran smoothly on a day to day basis and that it worked well with its private detoxification provider, local GP, contracted therapists and the wider Sporting Chance charity.

  • Although the service gathered feedback from clients on whether they felt the service had had a positive effect on their lives and the professional clubs clients were employed by it is working with its stakeholders to establish the best measures to monitor the service. It planned to implement these at commencement of the next 26-day programme.

Checks on specific services

Substance misuse services

Updated 13 July 2017

Residential substance misuse services

Good

Updated 27 January 2020

Good