Ark House Rehab Ltd

Updated 11 December 2018

Ark House is a residential service provided by Ark House Rehab Limited. The service provides treatment to rehabilitate people with drug or alcohol dependency. It is registered with the Care Quality Commission to provide accommodation for persons who require treatment for substance misuse. The service accepted clients that both self-funded, and those funded by an appropriate authority, for example a local authority or clinical commissioning group. Ark House has a registered manager and a nominated individual.

The service is located in a large house in a residential area of Scarborough. It is close to amenities and public transport links. The service can take up to 20 clients at any time and has staff on duty 24 hours. At the time of our inspection, there were 17 clients in treatment. All clients must be free of any substance use before admission, so they often arrive at the service following a detoxification programme. Ark House does not offer clinical or prescription medicine treatments. It delivers psychosocial interventions and provides a therapeutic environment for recovery.

Ark House has been operating for more than 20 years. Clients take part in a therapeutic programme based on the 12-step principles of Alcoholics Anonymous. Staff deliver treatment for people whose main addiction is to alcohol or drugs. However, due to the model used, staff also consider secondary addictive behaviours, for example, eating disorders or gambling. The 12-step approach is a process to guide a person through the journey of recovery to a new way of life. The programme addresses the physical, mental, emotional and spiritual aspects of recovery. The principles behind this approach give a person the tools to continue to live their life following discharge free of alcohol and drugs. Ark House clients fall into one of four categories:

• Assessment – people who are awaiting an assessment of their suitability for the programme or who are preparing for admission.
• Primary – clients admitted and undertaking steps one to nine of the programme.
• Secondary – these clients are concentrating on daily maintenance and have progressed to step 10 of the programme.
• Aftercare – the service provides ongoing support to clients who have left Ark House.

The CQC have inspected this provider on four occasions. We last completed a comprehensive inspection of this service in November 2015 and follow up inspection in November 2017. We did not rate the provider on these occasions in line with the methodology at that time.

Updated 11 December 2018

Updated 11 December 2018

We rated Ark House as ‘requires improvement’ because:

• Training figures for four of the five mandatory training courses were low because access to training was not always available. This meant staff did not have all the necessary training as identified by the organisation.
• There was not a clear quality assurance management framework across all the organisational policies and procedures. Safeguarding and medicines policies did not have review dates and were not regularly reviewed. Lone working practices were not tailored to the needs of the service. Staff could not follow all operational procedures stipulated in policies as policies did not fully reflect the service’s needs.
• Initial risk assessments did not identify all potential risks, specifically, domestic abuse, conflicts or working in the sex industry and early leaving plans did not record harm reduction advice given.
• During the inspection, the service had not completed all of the necessary checks on volunteer staff to keep clients safe. One volunteer that led a group did not have a disclosure and barring service check in place and volunteer staff did not have a formal supervision or training programme in place.
• The service did not have a policy or formal arrangements to monitor adherence to the Mental Capacity Act and there was no process to identify and learn from treatment outcomes. 
• Although staff and clients were clear on the expectations surrounding client confidentiality, the service had not sought required consent to share information with the National Drug Treatment Monitoring Service.
• Incidents were investigated, and audits completed on an individual basis however there was no further analysis to prevent incidents from reoccurring in the future or formal feedback process to learn from investigations or audits completed.

However:

• Staff and clients told us that they felt safe and the premises were clean and tidy. Clients and staff understood the expectations around client confidentiality.
• All staff, including volunteers, had an induction to the service. Staff were experienced and had the skills and knowledge to meet the needs of the client group.
• Ongoing individualised risk information was captured twice a day and recorded and effectively shared at handover meetings. Staff clearly described incidents they reported and the process for reporting them.
• Care plans had clear client involvement and clients completed a personalised 12-step workbook to help them reflect on their behaviours and progress their treatment.
• The service had good working relationships with other services or professions. The service supported clients to acquire living skills.
• Staff were kind, approachable, and treated clients with respect. Clients told us they felt supported and that they could relate to most of the staff.
• Ark House had a clear vision and strategy that was fully embedded in the service. Staff and clients knew who the leaders were in the service and they could approach them for help and support. Staff were respected, supported and valued.
• Ark House had a clear pathway and treatment plan from assessment through to aftercare. Clients received assessments and a complete information pack prior to admission. The received ongoing support and treatment during their admission and additional support via the phone and social media for clients after discharge.
• Clients knew how to raise complaints and feedback on the service.