Inspection on 24/11/06 for Ark House

This inspection was carried out on 24th November 2006.

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 03/02/06

Ark House 17/08/05

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 Mr M. A. Tomlinson Key Unannounced Inspection 24th November 2006 09:30 Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 1 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 Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 2 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 Stationery 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 DS0000007627.V319148.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ark House Address 15 Valley Road Scarborough North Yorkshire YO11 2LY 01723 371869 01723 375678 ark.house@virgin.net www.arkhouse2005.com Mr Bjorn Roswald Telephone number Fax number Email address Provider Web 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 Gerard Schofield Care Home 20 Category(ies) of Past or present alcohol dependence (20) registration, with number of places Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for Alcohol Dependence some of whom may also have Drug Dependence Date of last inspection 3rd February 2006 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. This is based on the twelve step programme originally developed by Alcoholics Anonymous. Sobriety is achieved through adherence 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 and still require support. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was an integral part of the Commission for Social Care Inspection’s (C.S.C.I.) ‘key inspection’ cycle for Ark House. The inspection visit included discussions with the registered manager, the registered provider and the staff on duty. The opportunity was also taken to discuss the quality of the service provided with the service users being accommodated at the time of the inspection. These included people at various stages of the recovery programme. Discussions were also held with service users who were being provided with support after their successful completion of the programme. An inspection of the premises, including the service users’ personal accommodation was undertaken. Time was also spent in observing the service users in the classroom setting and their interaction with the staff. A number of statutory records were examined. Comments cards were sent to all of the service users and representatives of the service users’ placing authority. This report also includes information received by the C.S.C.I. prior to the inspection visit. The service users’ fees currently range from £420 to £460 a week. What the service does well: What has improved since the last inspection? During the past ten years Ark House had developed into a credible and professional recovery centre. It is evident, however, that the registered persons are not complacent and continue to look at ways of improving the service. For example, lines of communication between the home and placing authorities have been further developed so that there is a more seamless transition for prospective service users between a detoxification unit and their admission into Ark House. The manager has continued to look at ways of Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 6 improving internal communication and has introduced a more formal handover between the night staff and the day staff. He has also continued to look at ways of providing support for those ex-service users who are living in the community but still require occasional support. Ongoing consideration is being given to the use of IT in order to improve the service and in particular the use of the Internet. It is the stated aim of the registered provider and the manager to become a ‘centre of excellence’ for recovery from alcohol including the provision of training for external agencies. What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Ark House DS0000007627.V319148.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Quality in this outcome area is excellent. The service users are provided with excellent standards of pre-admission information and advice to enable them, or their placing authority, to make a considered decision as to the appropriateness of Ark House. Comprehensive assessments on prospective service users ensure that the home is able to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered persons had developed a comprehensive Statement of Purpose and Service Users’ Guide. In addition to this an Information Pack was provided for all prospective service users that identified specific details of the service. The registered manager had regularly reviewed the Guide and the Information Pack to ensure that it accurately reflected the service and facilities provided. It clearly stated that Ark House is not a medical establishment. Those service users spoken to confirmed that they had received a copy of the Guide at the point of their admission into the home and the Information Pack prior to their admission. The Information Pack was either posted to the service user or they could download it from the Internet. One service user stated, “Ark House were more than helpful. I could contact Ark with any questions I had before my Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 9 treatment began” and another said, “I pulled off the last inspection report off the internet”. Whilst the service users had been encouraged to make a decision as to whether they wished to be admitted into Ark House, some, due to the effect of their alcohol/drug dependency, did not have the capacity to do so for themselves and had to rely on others making the decision for them. One service user stated, “I was on medication at the time so my initial decision was a bit hazy”. Others said that the home had been commended to them by ex service users. 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. According to the manager this was particularly important if a service user had been referred through the courts/probation service. The registered manager said that time was spent on clarifying any ‘grey areas’ prior to a service user’s admission such as their motivation and criminal offences. Since the previous inspection, more detailed information had been obtained on specific areas such as a service user’s medication, state of their mental and physical health, special needs and dietary needs. The manager provided examples of situations where further information had been requested from the service user or their placing authority. Considerable emphasis was placed by the 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 was 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 the use of other forms of communication (e.g. telephone). 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’. The service users spoken to confirmed the thoroughness of the admission process including the fact that they had been provided with the opportunity to meet and speak with current service users. The service users saw this as being reassuring. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 10 Where possible the admission process for a service user started when they were undergoing detoxification at a medical unit to ensure a smooth and continuous passage into the rehabilitation programme provided at Ark House. This required good lines of communication between Ark House and the respective unit. The registered manger provided evidence that agreement to a prospective service user’s admission was also confirmed in writing or by email for the placing authority. In addition to the initial assessment, the counselling staff assessed the service users each morning to identify areas of progress or regression. These meetings were fully recorded. 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 DS0000007627.V319148.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10. Quality in this outcome area is excellent. Excellent care planning and support on an individual basis underpin the service users’ care. The service users have direct involvement with their care plans thereby providing them with a degree of control over their programme of recovery. This judgement has been made using available evidence including a visit to this service. 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. The care plans were comprehensive, were subdivided into elements of care including medical, financial and general risk assessments and were ‘tailored’ to the needs of the individual service user. The service users Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 12 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 important due to a service user’s possible rapid change in needs over a short period of time. Whilst all of the service users had common needs associated with alcohol dependency, several also had additional problems such as eating disorders, mental health needs (e.g. depression) and low self esteem. These ‘additional needs were all incorporated into the individual’s care plan. Gender needs were also appropriately addressed through the use of same gender and compatible counselling staff. 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, or regression, of the service user concerned. Emphasis was placed on the need for confidentiality of service users’ personal information. The manager said that this was particularly important as the recovery process was based on trust between the service user and their respective counsellor. Where access to service users personal information was required, the agreement of the respective service user was first obtained. Since the previous inspection visit, following comments from a Care Manger, the registered manager had endeavoured to keep representatives of placing authorities informed as to a service user’s progress during the programme of rehabilitation. Four Comment Cards were received from Placement Officers and without exception they all expressed satisfaction with the service provided by Ark House. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is excellent. The service has been tailored specifically to meet the assessed needs of the service users with emphasis being placed on their rehabilitation within the community. This judgement has been made using available evidence including a visit to this service. 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 could develop greater independence and Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 14 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. For example, the service users were encouraged to do their own shopping albeit with supervision. 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 have visitors even during the early stages of the programme again with a degree of supervision. In the latter stages the service users are encouraged to visit relatives at weekends. The service users confirmed this. According to the service users the programme of recovery was 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. One service user stated in the survey form, ‘After education (classes) we do group activities of our own choice’. The service users had a structured programme that involved classroom work in the mornings and group work in the afternoon. They were also expected to undertake evening study to consolidate the information and advice they had received during the day. It was observed that the classroom work was based on the twelve-step programme and was conducted by a qualified and experienced counsellor. The service users were encouraged, but not pressurised, to participate. A sense of humour and a good level of interaction between the service users were very evident. The counsellor emphasised to the service users, “I can’t make you do or achieve anything – it’s entirely up to you”. This was the accepted philosophy of all the staff spoken to. One service user stated in the survey form, ‘The days are quite structured which is good. Plus you can make decisions for yourself the longer you are here’. This indicated the progressive nature of the recovery and rehabilitation 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. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 15 Lunchtime consisted of a snack type meal prepared by the service users. Since the previous inspection visit the menus had been reviewed and a more varied menu introduced. The service users confirmed that they were able to make their views known regarding the standard of meals and that their views were taken seriously by the staff. It was observed that meals were social affairs with the service users being directly involved in the preparation and clearing of the dining tables. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is excellent. The service users health and personal care needs are met through excellent support from the staff and good levels of input from health and social care professionals. This judgement has been made using available evidence including a visit to this service. 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, for many had previous 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 Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 17 an exceptionally high level of success in enabling the service users to remain alcohol and drug free on completion of the recovery programme. A ‘zero tolerance’ rule was in place regarding the use of drugs and alcohol during the recovery programme. Breach of this ‘rule’ would necessitate immediate exclusion from the programme. Arrangements were, however, in place to ensure that in such circumstances the service user involved was provided with appropriate support. The service users were encouraged to achieve and maintain high standards of personal hygiene as part of the rehabilitation process. Several of the service users said that on admission into Ark House they had low levels of self-esteem and consequently at that time their personal appearance was not important to them. On the day of the inspection visit the service users were well groomed and dressed in clean and appropriate clothing. According to the manager assistance would be provided for those service users who were admitted with few, if any, personal belongings. On admission the majority of the service users had health care needs associated with substance abuse. Consequently they were registered with a local medical practice that, according to the manager, provided excellent support. From correspondence received from Ark House and an examination of the home’s records, it was apparent that healthcare needs of service users were closely monitored and appropriate and timely action was taken as necessary. The service users confirmed this. On the day of the inspection visit a service user was attending the local dental centre for emergency treatment. 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. Since the previous inspection visit a new lockable drugs cabinet had been purchased and the system for drug storage had been improved. The service users’ medication was stored in named boxes. In general the service users came to the office to receive their medication and the records were updated at the time of administration. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. The service users are protected by having access to an appropriate complaints procedure and by the development of good, internal and external, lines of communication. This judgement has been made using available evidence including a visit to this service. 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 them. 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 DS0000007627.V319148.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. The service users are provided with accommodation that is designed to meet their needs in relation to the programme of recovery. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An 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. A replacement central heating boiler was in the process of being installed. There was a mix of shared and single occupancy bedrooms, the majority having en suite facilities. The service users had been made aware of the need Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 20 to share bedrooms, particularly during the early stages of recovery, to ensure good standards of peer group support. Privacy screening was available in the shared bedrooms. The service users had furnished their bedrooms with their personal belongings thereby providing them with a degree of ownership over their accommodation. The majority of the bedrooms had been provided with new matching furniture, including a desk so that the service users could study in the privacy of their rooms. Since the previous inspection greater use had been made of wall pictures thereby providing a more domestic feel to the accommodation. The service users expressed their satisfaction with the quality of their accommodation. On the day of the inspection the home was warm, 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. The service users said that they did not expect or want ‘five star’ accommodation as this would detract from the primary aim of the home. They considered their accommodation ‘suitable and appropriate for purpose’. All of the service users were fully ambulant and consequently could access all parts of the property. The home had a policy of openness and in the interest of service users’ safety and supervision; the bedroom doors did not have locks fitted. As far as could be ascertained from the home’s records the premises met the specific standards of the Fire and Environmental Health departments although the latter agency had not had contact with the home for some considerable time. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 21 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. The service users are supported by an experienced and competent staff team that enables them to achieve and maintain their aim of sobriety and prepare for rehabilitation within the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no regression in terms of the staffing level since the previous inspection. The manager had employed an additional counsellor, which consequently provided improved flexibility to the staffing arrangements. The service users confirmed that there was always staff present to provide assistance and that they were readily accessible both during the day and night. 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. The majority of the staff had obtained an appropriate National Vocational Qualification. The staff were provided with regular supervision. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 22 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 order that they might have genuine empathy with the service users. Service users comments relating to the staff included, ‘If there is anything you need you just have to ask and they (staff) will help willingly’ and ‘The staff are well trained and supportive’. It was observed that the staff treated the service users with respect and spoke to them in an appropriate manner. The staffing level was based on the number and needs of the service users being accommodated at any particular time. The staff presented as a cohesive and highly motivated 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. For example, since the previous inspection the morning staff handover had been modified to include greater input from the night staff particularly with regard to the well being of the service users over the night time period. The staff were provided with a range of staff meetings in order to discuss general and specific topics. They were also provided with regular supervision, which was fully recorded. The home has an appropriate staff recruitment, selection and vetting procedure. The staff records inspected confirmed this. All of the staff, at the time of the inspection, were ex-clients who had successfully achieved sobriety. They confirmed that they had been provided with employment contracts that included their terms and conditions of employment. Without exception the service users spoken to commended the qualities of the staff. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 23 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39,41and 42. Quality in this outcome area is good. The staff and service users are supported by a competent manager who has clear aims for the future of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users provided examples where they had the opportunity to voice their views and opinions. They felt that the manager and staff took their views seriously and, where necessary, promptly addressed them. It was observed that the manager had promoted an environment of openness. The service users, for example, did not hesitate to approach him for assistance Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 24 and advice. It was also noted that, quite correctly, they were given priority over other events, such as the inspection. The home had established a quality assurance process that included an ‘exit questionnaire’ to be completed by the service users. The registered manager demonstrated a good understanding of the principles of quality assurance and welcomed criticism as part of the process. It was evident from discussions with the manager that he continually looked at ways of improving the service and in particular the support for ex-service users so that they could maintain their sobriety. He had, for example, improved the home’s website. A number of statutory records were inspected including 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 the registered manager, including the development of risk assessments, had taken appropriate action. This helped ensure a safe environment for the service users and the staff. The manager continued to undertake the Registered Manager’s Award. He provided evidence that he had undertaken training of a statutory and professional nature. It was evident from discussions with the registered manager that his confidence had considerably improved over the last year and that he had a clear vision of what he would like the service to become. He presented as having a democratic style of management that was underpinned by excellent standards of professionalism. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 25 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 Standard No Score 1 4 2 4 3 4 4 4 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 3 27 4 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 3 LIFESTYLES Standard No Score 11 4 12 3 13 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 4 3 X 3 3 X Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation 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 YA37 Good Practice Recommendations Confirmation should be provided for the Commission of Social Care Inspection of the manager’s successful completion of the Registered Manager’s Award. Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Extracts may not be used or reproduced without the express permission of CSCI Ark House DS0000007627.V319148.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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