Crouch House and Crouch Cottage

Updated 27 January 2020

Crouch House and Crouch Cottage provides a unique, bespoke, residential psychosocial model of rehabilitation for addictions (including substance addiction) to a specific client group (professional sport personnel). Crouch House and Crouch Cottage are part of the wider addiction support service provided by the Sporting Chance charity.

The charity was set up to provide psychosocial support near to professional sport clients own home and if needed in a residential setting.

Crouch House and Crouch Cottage bases its therapeutic programme around a mutual aid approach and 12-step programme. It takes a cohort of four client, who might have a variety of addictions through an intensive 26-day programme. The ethos of the service focuses around an understanding of the specific struggles related to having a career in competitive sports and the difficulties related to the end of a professional sporting career (which could be when the client is still quite young).

The service is in the grounds of a large, sports resort complex, where clients have most of their meals provided and access to a wide range of sports and relaxation facilities. The residential service is provided from three separate buildings made up of client accommodation (Crouch House), staff offices and accommodation (Crouch Cottage) and a separate building where one-to-one and group activities take place.

The service is funded entirely by a number of professional sports associations. All clients are associated with these organisations.

Crouch House is registered to provide accommodation for persons who require treatment for substance misuse. It has a registered manager who is based at the site.

The service was last inspected in June 2017 at this inspection the service was not rated and met all the requirements of the Health and Social Care Act regulations.

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.