Ark House Rehab Ltd

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.