• Residential substance misuse service

Ark House

Overall: Good read more about inspection ratings

15 Valley Road, Scarborough, North Yorkshire, YO11 2LY (01723) 371869

Provided and run by:
Ark House Rehab Ltd

Important: We are carrying out a review of quality at Ark House. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

Other CQC inspections of services

Community & mental health inspection reports for Ark House can be found at Ark House Rehab Ltd. Each report covers findings for one service across multiple locations

Thursday 03 March - Friday 04 March 2022

During an inspection looking at part of the service

Our rating of this location improved. We rated it as good.

  • The service provided safe care. The premises where clients lived was safe and clean. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided treatment suitable to the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The teams had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training and supervision. Staff worked well together as a team and with relevant services outside the organisation.
  • Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
  • The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.
  • The service was well led, and the governance processes ensured that its procedures ran smoothly.

However:

  • The service had further environmental improvements to make. The service had an improvement plan and schedule of works to complete. We saw evidence that the service recorded and responded to maintenance issues quickly.
  • The new service user guide was not yet implemented so several restrictions remained within the current guide.
  • Not all staff had had a yearly appraisal.

9 and 10 June 2021

During a routine inspection

We have asked the provider to make urgent improvements and are placing Ark House in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate overall or for any key question or core service, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The provider is being supported to make the required improvements by the wider system, including the local authority and clinical commissioning group. The service will be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement, we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Our rating of this service went down. We rated it as inadequate because:

  • The service did not provide safe care. The premises where clients were seen were not safe and clean. The service did not have enough counselling staff. Staff did not assess and manage risk well.
  • Staff did not develop holistic, recovery-oriented care plans informed by a comprehensive assessment. Staff did not engage in clinical audit to evaluate the quality of care they provided. The team did not include or access the full range of specialists required to meet the needs of clients under their care.
  • Managers did not ensure that staff received training, supervision and appraisal.
  • Staff did not always treat clients with compassion and kindness. They did not actively involve clients in decisions and care planning.
  • The service was not well led, and the governance processes did not ensure that its procedures ran smoothly.

However:

  • The service was easy to access, and staff planned and managed discharge well.
  • They provided 12-step treatment suitable to the needs of the clients.
  • Staff worked well together as a team and with referring agencies.

2 October 2018

During a routine inspection

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.

28.11.17

During an inspection looking at part of the service

We do not currently rate independent standalone substance misuse services.

  • We found that each client had a current risk assessment and these were reviewed each week or when an incident occurred. 
  • Staff were aware of the risk assessments and told us they had a better understanding of the clients they were supporting.

15 March 2017

During an inspection looking at part of the service

We do not currently rate independent standalone, substance misuse services.

  • Following our inspection in November 2015 and September 2016, we found areas of good practice for effective, caring, responsive and well led. Since these inspections, we have received no information that would cause us to re-inspect these key questions.

  • During this most recent inspection, we found that the service had addressed most of the issues needed to improve safe following the November 2015 and September 2016 inspections.

Ark House was now meeting Regulations 13, 15 and 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014.

However:

  • The service needed to improve their records relating to identified risks to give assurances that all staff knew how to manage or minimise individual client risks. This meant they were not compliant with regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014 in respect of risk management.

5 September 2016

During an inspection looking at part of the service

We do not currently rate independent standalone substance misuse services.

  • We found there was a renewal plan in place for the fabric of the building and the soft furnishings such as bedding. The plan needed to be updated and actions to replace or repair the building or soft furnishings should be acted on in timelier manner.
  • Clients were aware of their responsibilities in keeping their laundry up to date and cleaning done, this was part of their recovery plan.

10 & 11 November 2016

During a routine inspection

We do not currently rate substance misuse services.

We found:

  • Staff did not manage risk effectively. Although staff identified some risks on admission, clients did not have risk management plans or have their risks reviewed regularly. Staff communicated risks verbally and recorded very limited detail in handover notes.
  • Staff did not have safeguarding training and did not know how to raise a safeguarding alert.
  • The service had no formal processes in place to record incidents. This meant that they were unable to identify patterns, effectively investigate or ensure that staff learnt and shared lessons. Staff did not fully understand what constituted an incident.

However, we found Ark House to be effective, caring, responsive and well led because:

  • Clients received assessments before their admission, identifying any areas that might compromise the effectiveness of the treatment provided by Ark House.
  • Clients and staff were clear on the steps they needed to take to make progress with treatment. Care plans were individual and detailed in workbooks that staff and clients reviewed on a weekly basis.
  • Staff established a therapeutic relationship with clients and involved them in their care. A therapeutic relationship is a working relationship between a worker and a client, which is built on mutual trust and respect with the aim of bringing about beneficial change.
  • Staff treated clients with respect and kindness and supported them throughout their stay with the service.
  • Staff provided aftercare following a client’s discharge from the service.
  • The facilities were welcoming and comfortable.
  • The service provided clients with a full structured programme of care, therapy and activities.
  • Staff felt supported and involved in the service. Morale was good and staff found their work rewarding while reinforcing their own recovery. All staff had previously experienced difficulties with drugs or alcohol.
  • The service and all staff understood the 12-step approach and used this effectively to treat clients.