Portsmouth drug rehab centre is slated in report by Care Quality Commission – but manager hits back
THE SAFETY of service users at an addiction recovery centre in the city was put at risk according to a report by the CQC.
Lack of staff training, misrepresentation of treatments delivered and using derogatory language in clients’ records were just some of the reasons the Addiction Recovery Centres Ltd (ARC) based in Portsmouth was rated Inadequate and two warning notices were served in September concerning client safety and service management.
The private centre did not take on any new clients for their treatment programs voluntarily until they had addressed the safety concerns raised.
The CQC also had issues over staff who had positive criminal disclosures on their DBS certificates but were not assessed to work with adults at risk.
An extract from the report read: ‘Addiction Recovery Centre did not provide safe residential detoxification for clients that was in line with national guidance and best practice.
‘There were no clinical staff employed by the provider to oversee detoxification and the staff who were supporting clients through detoxifications were not trained or assessed as competent to support them safely.
‘Staff had not received up-to-date training in basic life support and were not trained in safeguarding adults at risk or in child protection.’
In response to the lack of training, manager Siamak Diba said: ‘Staff training has been thorough since ARC first opened its doors in 2006.
‘Whilst all staff are trained in the 'care certificate' and this was accepted and praised in 2016, we were informed in 2018 that the 'care certificate' was not enough.
‘Since September 2018 we have introduced an entirely new system of documenting all internal training as well as the creation of a training matrix where all core competences are covered and additional desirable external training included.’
ARC is a small, 19 bed, independent drug and alcohol treatment centre with four houses where the clients live when they are not in treatment during the day with 50 per cent of users paying privately for the services and the other half getting referred by councils and health bodies across the UK.
ARC could not confirm figures to The News regarding how many people have been referred from council and health bodies and how much this has cost local authorities.
However the CQC report said current service users’ feedback was mainly positive about the interaction they had with staff although there was problems with language and privacy.
An extract from the report read: ‘The terminology used in one of the client’s records was derogatory and offensive. There were inappropriate statements in the service user guide which had caused offence to clients.
‘Staff did not respect clients’ privacy. They had looked through client’s phones and did not see a problem with doing this. Clients told us they were concerned about having to let staff see their personal mobile phones.’
Mr Diba said: ‘In the first instance, the language used by the CQC in the paragraph above is highly subjective and not what we would expect in a document that reflects the objective assessment of our service.
‘Secondly, it is objective fact that individuals who have experienced extended periods of addiction or alcoholism exhibit personally harmful behavioural traits beyond the use of alcohol or drugs. These behavioural traits extend to varying forms of dishonesty.’
However the company has blamed the CQC for moving the goal posts and not understanding private rehab centres.
Mr Diba said: ‘The CQC was initially set up for care homes and hospitals and has recently been trying to become more familiar with substance misuse services.
‘Unfortunately this means that often the outcomes of inspections depend on subjective interpretations by individual inspectors who may not have any experience with how a substance misuse facility functions.’
He added: ‘This statement is ambiguous, out of context, and lacking additional information that was provided to inspectors when they enquired about this.
‘At no point were the clients forced to show their mobile phones. Both clients gave informed permission in discussion with staff, and staff only reviewed relevant information under supervision by the client.’
There was also issue taken with misrepresentation of services on the ARC’s website which advertised therapies such as cognitive behavioural therapy (CBT), dialectical behavioural therapy and transactional analysis however staff told the CQC these therapies were not delivered and they used an approach based on CBT.
The CQC returned to the ARC in November to reassess the progress that had been made since the first inspection.
The report read: ‘We found that whilst there was still much more improvement required we were assured that the provider was now able to deliver low level detoxification safely.
‘Clients' risk assessments now included detailed plans to manage individual risks, including risks posed through undergoing detoxification. Staff demonstrated a clear understanding of what action they should take in an emergency, including how to carry out first aid.
‘The provider had amended its website to more accurately describe the service it was able to offer.’
Mr Diba added: ‘Of course we do feel we have a major responsibility to deliver the best treatment to any of our clients, and all our clients are treated equally, paying or not.
‘For 12 years we have delivered an exceptionally high quality of treatment and we aim to continue doing that.’
UPDATE: In June 2019 the centre was taken out of special measures. The centre has been praised for treating visitors with compassion and kindness, with staff recognising best practice and taking on additional training to make up for past faults.