Inspection on 17/08/05 for Ark House

This inspection was carried out on 17th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ark House 25/11/08

Ark House 24/11/06

Ark House 03/02/06

Ark House 23/12/04

Ark House 15/07/04

Similar services:

Oakmount Hostel

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Ark House 15 Valley Road Scarborough North Yorkshire YO11 2LY Lead Inspector M.A. Tomlinson Unannounced 17 August 2005 09:30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ark House Address 15 Valley Road Scarborough North Yorkshire YO11 2LY 01723 371869 01723 375678 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Bjorn Roswald Mr Gerard Scholfield PC Care home only 20 Category(ies) of A Alcohol dependent past/present (20) registration, with number of places Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Registered for alcohol dependent some of whom may also have drug dependence. Date of last inspection 23rd December 2004 Brief Description of the Service: Ark House provides accommodation and personal care for a maximum of twenty younger adults who are recovering from alcohol and/or drug dependence. The home does not provide nursing or medical services. The care home is a large detached property located in a residential area of Scarborough. It is conveniently situated for all main community facilities including the public transport network. The home has parking facilities for several vehicles. Time restricted on-road parking is also available. The property has three floors. The main communal rooms, group rooms and classroom are located on the ground floor. The service users bedrooms are located on the upper floors. The home does not have a passenger lift and consequently is only considered suitable for people who are fully ambulant. The service users undergo a programme of recovery known as recovery dynamics. This is based on the twelve step programme originally developed by Alcoholics Anonymous. Sobriety is achieved through adherance to the programme which involves a combination of group and classroom work, assignments and professional and mutual support. On average a service user will take between ten and twelve weeks to complete the primary programme. During the latter stages of recovery the service user is provided with an opportunity to learn, or re-learn, life skills to enable them to live independently within the community. This is known as extended care. An after care service is available for ex.service users who have completed the programme. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two statutory unannounced inspections to be undertaken by the commission for social care inspection during this inspectoral year. The registered manager and the registered person were available throughout the inspection. The inspection took a total of seven hours including one hour of preparation time. All of the service users were spoken to either in a group setting or individually without staff being present. This included several service users who were either on ‘after care’ or ‘extended care’. Observation of the service users and staff was undertaken in the classroom environment. The majority of the staff on duty were also spoken to. A number of statutory records were examined and a limited inspection of the premises carried out. What the service does well: What has improved since the last inspection? What they could do better: It was not possible during the inspection to identify any particular practice that would benefit from improvement. It was evident, however, that the registered manager had kept all practices under review and had made appropriate changes in order to improve the service. He was, for example, looking at the Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 6 possibility of improving the home’s web site to make it interactive for prospective and ex. service users. The registered provider was also implementing a package for people to undergo the recovery programme through the use of CD ROMs and the Internet. In summary the management of the home had a very innovative approach and were not complacent or satisfied with just maintaining the status quo. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 and 5 The service users are provided with comprehensive information prior to their admission into the home regarding the service provided thereby enabling them to make a considered decision as to whether they wish to undertake the programme of recovery EVIDENCE: The registered persons had developed a comprehensive Statement of Purpose and Service Users’ Guide that formed an integral part of the Information Pack provided for all prospective service users. The registered manager had regularly reviewed the Guide to ensure that it accurately reflected the service and facilities provided. Those service users spoken to confirmed that they had received a copy of the Guide. The home continued to provide all prospective service users with a comprehensive pre-admission assessment. In the majority of cases this had taken place in the care home and doubled as the initial visit by the service user. The assessments had been undertaken either by the registered manager or the administrator on one-to-one basis with the service user. The assessment form covered all aspects of a service user’s background and identified their primary care needs. Evidence was available to confirm that where necessary further information had been obtained on an individual from social and health care professionals. Considerable emphasis was placed by the Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 9 manager on the importance of this assessment and in particular the level of motivation of the prospective service user to achieve recovery. The manager explained that where there was doubt as to the suitability of a prospective service user, it would be discussed by the management and counsellors before a final decision is made. Where due to circumstances, such as the travelling distance, a prospective service user was unable to attend the pre-admission assessment then the assessment would be undertaken through other forms of communication. In such cases a pre-admission assessment would still be undertaken on the arrival of the service user at the home. The manager indicated that by such a stringent admission process the chance of a service user failing to achieve recovery was minimised. The service users confirmed that they had all undertaken the admission and assessment process and that they had been given an opportunity to clarify any part of the recovery programme that they did not understand. They had also been made fully aware of any restrictions or codes of conduct expected during their stay at Ark House and of the consequences for a breach of the ‘house rules’. As an integral part of the admission process the service users had been provided with the terms and conditions of residence and had signed them in agreement. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8, 9 and 10 The service users’ needs and expectations are met through a combination of the ‘twelve step’ recovery programme and the implementation of personal care plans. EVIDENCE: The ‘core care plan’ was the twelve-step programme on which the programme of recovery was based. Either a health or local authority had placed all of the service users accommodated at the time of the inspection. In addition to the care plans provided by the various placing agencies, the service users had a care plan developed by the home and based on their pre-admission assessment. Three care plans were inspected. The care plans were reasonably comprehensive and were subdivided into elements of care including medical, financial and general risk assessments. The service users had been directly involved in the development of their care plans and were aware of the contents. Due to the needs and the backgrounds of the service users, the care plans were treated with considerable confidentiality to protect the information they contained. There was recorded evidence that the care plans had been continuously reviewed and where necessary amended. According to the staff this was necessary due to a service user’s rapid change in needs over a short Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 11 period of time. In addition to their care plans the service users were provided with support from an allocated and qualified counsellor. This included frequent one-to-one sessions to assess and discuss the progress of the service user concerned. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 and 17 The development of the service users’ life skills and their re-introduction into the community is an integral part of the recovery programme. EVIDENCE: The lifestyle of the service users was directly linked with the programme of recovery. For example, during the initial stages of the programme the service users are subjected to certain restrictions to their independence and contact with friends and family. These restrictions had been assessed by the home as being necessary if the service users were to achieve sobriety. They had been fully explained to the service users and agreed by them as part of their admission process. As the programme developed so these restrictions were relaxed in order that the service user can develop greater independence and re-establish links with the community. One of the primary aims of the home was to enable the service users develop their personal and life skills to enable them to eventually live independently. Consequently an important part of the programme was the element of rehabilitation that this entailed. The service users considered that this approach improved their self-confidence and enabled them to accept their public responsibilities. The service users were allowed to Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 13 have visitors even during the early stages of the programme albeit with a degree of supervision. In the latter stages the service users are encouraged to visit relatives at weekends. According to the service users the programme of recovery is relatively intense leaving little time to engage in social activities. It was evident, however, that the service users are provided with the opportunity to develop their social skills particularly during the latter stages of the programme. The home provided a service for both male and female clients. Efforts had been made to ensure that their respective privacy and dignity was maintained. For example, where possible female service users were accommodated on a different floor to the male service users, they were allocated a female counsellor and both sexes had their own meetings to discuss topics that were relevant to their particular gender. The service users spoken to during the inspection confirmed that they were treated with respect by the staff and spoken to as equals. The home has a dedicated cook who prepares and cooks the evening meal. The menus were displayed in the dining area and indicated that the meals were varied and provided a reasonably balanced diet. The service users said that whilst the meals were not of a ‘five star standard’ they were appropriate for them. The service users were encouraged to get their own breakfast. Lunchtime consisted of a snack type meal prepared by the service users. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 The service users receive excellent levels of support from the staff both during and after the completion of the recovery programme. EVIDENCE: All of the service users spoken to felt that the programme of recovery provided by the staff of Ark House was the best they had encountered and many had previously had experience of other recovery programmes. They stated that they were provided with excellent support by the staff and could discuss problems with staff at any time. It was evident that the programme was nonconfrontational and did not bring undue pressure to bear on the service users. Considerable emphasis was also placed on the need for peer group support and encouragement. The main area of support provided by the home was with regard to the service users’ emotional needs in order to improve their selfesteem and confidence. Evidence was provided to confirm that the home has an exceptionally high level of success in enabling the service users to remain alcohol and drug free on completion of the recovery programme. It was a requirement of the home that all medication used by service users was declared on admission and its administration supervised by the staff. Certain medication, in particular those with mood changing qualities, were not acceptable. Random checks had been undertaken to check service users for the use of alcohol, drugs or non-approved medication. The medication was appropriately secured and the administration records were up to date. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has a satisfactory complaints process and with the views of the service users being actively sought and acted upon. EVIDENCE: An appropriate complaints procedure was in place. The service users were aware of this although they could not envisage a situation where they would use it as they felt that they had the opportunity to discuss and resolve problems and issues before they became formal complaints. For example, the service users discussed issues each morning during their meeting without staff being present. Any issues were then passed on to the management for their consideration. The service users were confident that the staff took their views seriously and promptly acted upon. The service users also had the opportunity to discuss personal or confidential issues during their one-to-one sessions with their allocated counsellors. The majority of the service users had regular input from health and social care professionals representing their placing agency. The staff had received training in Adult Abuse procedures and presented as having a sound understanding of the subject. All of the service users accommodated at the time of the inspection had the intellect and capability to raise issues and make complaints to, if necessary, external organisations. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,28 and 30 The service users are provided with an environment that is appropriate for their needs. EVIDENCE: A limited inspection was undertaken of the premises on this occasion. It was evident that a rolling programme of refurbishment, decoration and improvement was in place. For example, an external smoking area had been provided for the service users and staff, several carpets had been replaced and the service users’ en suite facilities were being upgraded. The group room and classroom had also been re-decorated. The service users expressed their satisfaction with the quality of their accommodation. On the day of the inspection the home was clean and totally free of any offensive odours. As an integral part of their rehabilitation programme the service users were expected to undertake domestic tasks such as cleaning. The rear patio area had been considerably developed and it was observed that the majority of the service users chose to take their coffee break in this area. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33 and 35 Staff morale is high, resulting in an enthusiastic and knowledgeable workforce that works positively with service users to enable them to successfully achieve recovery. EVIDENCE: There had been no regression in terms of the staffing level since the previous inspection. The manager was in the process of employing an additional counsellor. The service users confirmed that there was always staff present to provide assistance and that they were readily accessible. The records confirmed that the staff had been provided with training in statutory and, where appropriate, professional subjects related to the client group and the service provision. All of the staff were previously service users and consequently had a good understanding of the service users’ needs and the programme of recovery. The service users considered that it was essential for the staff to have had personal experience of drug and/or alcohol dependency in other that they could have genuine empathy with the service users. The staff presented as a cohesive team with common aims. They had a clear understanding of their roles and of the overall aims of the home. Good lines of formal and informal communication had been established. Without exception the service users spoken to commended the qualities of the staff. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,41 and 42 The manager has a clear development plan for the home in order to further improve the service provided for the service users. EVIDENCE: The service users provided examples where they had the opportunity to voice their views and opinions. They felt that the staff took their views seriously and, where necessary, promptly addressed them. The home had established a quality assurance process that included an ‘exit questionnaire’ to be completed by the service users. A number of statutory records were inspected including three service users’ care records and the fire and accident records. It was evident that the records, policies and procedures had been regularly reviewed and, where necessary, updated. The records confirmed that appropriate action had been taken by the registered manager, including the development of risk assessments, to ensure a safe environment for the service users and the staff. Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 4 4 3 3 Standard No 22 23 ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 4 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ark House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 3 x J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 20 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard None Good Practice Recommendations Ark House J53-J04 S7627 Ark House V242713 170805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross Drive York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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