ARC Drug & Alcohol Rehab Centre – Best in UK

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ARC’s CQC Story – How an Underdog Won Back the Watchdog’s Praise
by Siamak Diba

This is for you!

What follows is the recent story of ARC’s inspections and ratings by the Care Quality Commission who are the regulating body for the care industry.

We believe this to be an extraordinary story and worthy of telling as it impacts the care industry as a whole, but more importantly, this speaks directly to you, parents, partners and family members seeking help, the right help, for their loved ones who are struggling with drug and alcohol addiction.

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ARC Drug & Alcohol Rehab Centre – Best in UK

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ARC’s CQC Story – How an Underdog Won Back the Watchdog’s Praise

by Siamak Diba

This is for you!

What follows is the recent story of ARC’s inspections and ratings by the Care Quality Commission who are the regulating body for the care industry.

We believe this to be an extraordinary story and worthy of telling as it impacts the care industry as a whole, but more importantly, this speaks directly to you, parents, partners and family members seeking help, the right help, for their loved ones who are struggling with drug and alcohol addiction.

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Our CQC Journey

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In September 2018 the ARC rehab was inspected by the CQC and handed a rating of “inadequate”, issued with two warning notices and placed on “special measures”. What preceded and what followed this, is an incredible journey.

I am Siamak Diba, the CQC registered manager of ARC for the past 11 years and our director Graham Foster has asked me to guest write this story as it is identified to be significantly and specifically informative and valuable to you the parent, partner, family member of your drug and/or alcohol addicted loved one. 

In 2007, ARC volunteered and became the first ever drug and alcohol rehab in the country to be registered by the CQC (known as CSCI back then).

They had little knowledge of rehabs and almost zero expertise as the care industry for them, consisted of hospitals, care homes and caring for people in their own homes.

We got ourselves registered however, in line with our intention to be the leading centre in the country on all crucial and “mattering” fronts.

ARC was regularly inspected from then on, on a yearly or two-yearly basis. The results were consistently positive and complimentary reports.

In September 2016 we again underwent a routine inspection by the CQC where 3 inspectors visited our centre for two days and scrutinised any and all aspects of our treatment.

We again received a glowing report and were particularly congratulated for our thorough assessment and care planning procedures.

At that time, all care services received ratings from the CQC. The ratings were:

Outstanding

Good

Requires Improvement

Inadequate

That is all care services except drug and alcohol rehabs, as the CQC struggled (and still do) to develop tailored standards to measure.

So, we didn’t have a rating but the outcome and the report was very positive.

Allow me to tell you something here:

In September 2018 the ARC rehab was inspected by the CQC and handed a rating of “inadequate”, issued with two warning notices and placed on “special measures”. What preceded and what followed this, is an incredible journey.

How residential drug centers can help you

I am Siamak Diba, the CQC registered manager of ARC for the past 11 years and our director Graham Foster has asked me to guest write this story as it is identified to be significantly and specifically informative and valuable to you the parent, partner, family member of your drug and/or alcohol addicted loved one.

 

In 2007, ARC volunteered and became the first ever drug and alcohol rehab in the country to be registered by the CQC (known as CSCI back then).

They had little knowledge of rehabs and almost zero expertise as the care industry for them, consisted of hospitals, care homes and caring for people in their own homes.

We got ourselves registered however, in line with our intention to be the leading centre in the country on all crucial and “mattering” fronts.

ARC was regularly inspected from then on, on a yearly or two-yearly basis. The results were consistently positive and complimentary reports.

In September 2016 we again underwent a routine inspection by the CQC where 3 inspectors visited our centre for two days and scrutinised any and all aspects of our treatment.

We again received a glowing report and were particularly congratulated for our thorough assessment and care planning procedures.

At that time, all care services received ratings from the CQC. The ratings were:

Outstanding

Good

Requires Improvement

Inadequate

That is all care services except drug and alcohol rehabs, as the CQC struggled (and still do) to develop tailored standards to measure.

So, we didn’t have a rating but the outcome and the report was very positive.

Allow me to tell you something here:

We are experts in the field of addiction and recovery. We have years and years of lived, studied, qualified and applied experience.

We have total, evidence-backed faith in our unique approach. We are witnessing, every day, people’s lives being transformed by our treatment, and this is how we do it:

We are experts in the field of addiction and recovery. We have years and years of lived, studied, qualified and applied experience.

We have total, evidence-backed faith in our unique approach. We are witnessing, every day, people’s lives being transformed by our treatment, and this is how we do it:

  • We know that the important truth not to be overlooked, is that our fundamental job is to facilitate a change of perception in a suffering person.
  • We are extremely effective in introducing, implementing and consolidating new cognitive pathways in and for the drug/alcohol addicted person.
  • we are experts in introducing, implementing and making habitual, new and healthy behaviours for the person.
  • We back these new behaviours up and fuel them by helping the addicted person understand the massive benefits, but more than that, for the person to develop growing enthusiasm to live this potentially fantastic life.

 

These are the comments we constantly receive from the person themselves and from family:

  • “I have my life back”
  • We have our son/daughter back
  • I have my children back (literally, often from a position of the children being in care)

 

All of this happens and is an every day reality of ARC regardless of any inspection or rating.

Our true rating is your loved one’s healing, the transformation of your loved one, the new life that the whole family experiences as a result of, or supported by, the work we do here, and the feedback from the many people we have worked with, and from their families.

emotional mum and son hugging

Back to the CQC story,

Sept 2018: CQC inspect us and we become the first treatment centre in the country to be rated. They implement the rating systems and parameters used for hospitals and care homes.

ARC is wildly misinterpreted due to the lack of documentation and recorded policies, procedures and systems as expected by the CQC inspectors.

An example of experienced and accepted practice mentioned was a place where people were put in an induced coma and detoxed in 5 days! This is not the type of place we are.

One question was whether we had an ambu-bag?!

counsellor with group

The reply that we are all fully 1stAid trained and have mouth shields to use if required (never needed in 13 years) and that the A&E is 3 minutes’ walk, and one minute’s drive from where we are, in extreme cases, does not satisfy.

The assessment and care planning processes which we had been especially complimented on in 2016, and which had been further refined to allow more thorough work, were criticised and condemned by the new inspectors.

At the end of the inspection and the inspector’s highly critical feedback, when I asked: “ so, were there anything positive you found in your inspection?”, the reluctant reply was:

 “well, your staff seem to be enthusiastic about what you do, and we had positive comments from your service users”!

As if anything else comes remotely close to being as important.

timeline

Following the inspection, we are issued with two warning notices, placed on special measures and handed an “inadequate” rating.

Needless to say, we felt devastated.

There was us, putting in incredible, life transforming work.

There was you, telling us your life and your loved ones life was transformed as a result of their stay at ARC.

And, there was CQC telling us we were inadequate.

What followed were many management meetings. Graham Foster the director, Ben Prior the operations manager and I, the CQC registered manager decided to fight and try to turn this round.

It was a big ask as the statistics and probabilities were against us. 33% of services had closed down from the position we were in.

Graham took on the day to day, hands-on management tasks as Ben and I went about working out how to approach this.

We conceded that much of the very high-quality work which goes on at ARC was not properly documented.

We didn’t have paper evidence for a lot of what we were doing and we felt the CQC motto seemed to be: “if it’s not written down, it ain’t happening!”

For example: we could not produce any records of the times we have sat on the floor of a clients bedroom at 2am and spoken and listened and supported and struggled with, until the crisis has passed, and that person has eventually gone on to live a rich, full and meaningful life.

Or: we had no written evidence of the times we have accompanied, counselled, and “ridden out together” a client’s panic attack, anxiety attack, obsession attack, and seen them out to the other side and witnessed them happy and thriving.

We did however decide to take personal responsibility for our part.

We did however decide to take personal responsibility for our part.

Listen, as part of our programme, we invite “taking total responsibility”. This is a crucial concept that psychologically, emotionally and behaviourally alters a person’s life.

It is a subtle but very significant shift in perception and attitude which contributes to the transformation of a person’s life.

Listen, as part of our programme, we invite “taking total responsibility”. This is a crucial concept that psychologically, emotionally and behaviourally alters a person’s life.

It is a subtle but very significant shift in perception and attitude which contributes to the transformation of a person’s life.

I have lost count of how many times I have heard parents and family members saying to us:

  • He just won’t take any responsibility

Or, have beseeched the addicted loved one:

  • You need to take responsibility for your life

 we at ARC are experts at this. We help the person explore, understand and then much more importantly, feel and experience the liberating and empowering effect of taking total responsibility.

decision taking person in front of two paths

This powerful work takes place, but we do much more than this:

We show the person “How To take total responsibility”.

And we show them “what to take responsibility for”.

And we teach them to “recognise when I’m not taking responsibility”.

These are powerful pieces of work done at ARC, but we do much more than this:

We remove any shaming or moralistic aspect of the “take responsibility” suggestion, and with understanding and compassion, show the client the science, mechanics and methods.

We consistently do all this, but we do much more still:

As staff, we try to model these behaviours and attitudes. Practice what we preach so to speak, and learning through “modelling” is without argument, the best way of learning.

This is true of children and it is true of all bigger children too. 😊

This happens, but there is still more:

When we as staff and treatment “deliverers” mess up, as we are bound to do as we are human (apart from myself of course, and possibly our director who are gods! 😊)

 

What we also hope to model is:

Don’t protect, Correct!

This means when we identify a mistake, we acknowledge it and go about correcting the mistake, and not protecting the original stance.

when there is more than direction to go or decision to make

So, getting back to the CQC story:

We decided to take responsibility, and accept our failure in communicating the fantastic work which is carried out here.

This was a personal struggle for me but we understood this was bigger than any one of us.

So far at that point, we had worked with about 750 people throughout 12 years and many of those people had gone on and had become such shining and productive members of their community.

The chance for others to achieve what many of the 750 had achieved just could not be lost!

This was without even taking into account the multitude of family members whose lives had been so positively altered as the result of their loved ones stay and treatment at ARC.

I’m going to speed up with the story now, so keep up!

Staff meetings were held. Management meetings were held. The strategy was discussed. “St. Ben” and I spent many hours and days not wanting to have this torture and yet showing up.

We needed to make changes to policies and procedures and we needed clear communication of the high-quality work carried out at ARC. Everything had to be evidenced on paper.

By January 2019 the CQC had carried out two focused inspections and the warning notices and special measures had been lifted.

We had started helping them understand what we do and also to implement and demonstrate further improvements to them.

I was in awe of all the staff’s contribution in getting us so far, working on the CQC thing as well as churning out quality treatment with people continuing to get well and be thriving.

Our rating however, still read “inadequate” pending a comprehensive inspection.

The CQC re-inspected ARC on the 3rdApril 2019 for a full comprehensive inspection. There were 3 inspectors including a different expert in the field.

On the day of the inspection we had filled the back office with all the paperwork and evidence we could think of.

The walls were pasted with hundreds of “Thank you cards” sent to us over time.

Some ex-clients who were now “big in the field” had volunteered to present themselves and give testimonies to the inspectors.

Ben and I were walking around pretending to be calm and collected. I had to keep the staff calm and collected and they were looking to management for that.

This was the culmination of 7 months hard, hard work.

I had very rarely before practiced my “yoga breaths” as hard. I was in danger of hyper-ventilating.

We were excited, anxious, hyper-vigilant, motivated, afraid, defiant and determined.

At the end of the second day of a thorough inspection:

The lead Inspector to the registered manager Siamak and the operations manager Ben:

Would you like to come into the office for the end of inspection feedback?

Registered manager’s head: do we have to?!?

Registered manager’s mouth: ok.

Once in the office and sitting with the three inspectors:

Inspector: we need to congratulate you and say well done for what you have achieved. We have been thoroughly impressed and you and your staff need to be praised and the work you have done and are doing needs to be acknowledged. You needed to show all of everything that you do here and now you have.

You will receive our report soon and we will then also release a press statement.

Inspectors leave. Tentative hugs and high fives. The report has not yet come out and CQC does not usually change an “inadequate” rating easily.

In fact, in 84% of the documented cases, an “inadequate” rating turns into “requires improvement”, and nothing better. i.e.: red to amber!

We received our CQC report and rating on the 14thJune 2019:

ARC Rating: GOOD 

 

cropped part of our timeline
a part of the timeline highlighting CQC good rating


We had achieved what only 16% of places had achieved before us, and many of those places were big institutions like hospitals with massive resources and departments allocated to compliance.

We were now free to carry on delivering our unique and evidence-based and highly effective treatment. 

We now have the opportunity of reaching many more people nationwide and even internationally.

We have the chance of continuous improvement and fine-tuning and growing in our methods and material, for those centres who rest on their laurels and rely on old and tired methods just to be safe, miss out on the opportunity to reach more people more of the time, and that is not us!

To tell you about a deep part of myself: I was slightly disappointed we were not given “Outstanding”, as I know that’s what we are. I also think that as there was no precedent for a place to be given “outstanding” from “inadequate”, and the CQC did not set one this time either.

The CQC released a press statement in July 2019 acknowledging the incredible and extraordinary achievement of ARC.

We now have the determination to help the CQC understand that we run an “Outstanding” service and not just “Good”. 

We are working towards and looking forward to the next inspection and that “Outstanding “rating.

Number of clients treated at ARC: 900 and counting…..

 

Come join our journey and make it yours or your loved ones journey.

We are in the business of transforming lives.

Graham Foster is the Founding Director at ARC Portsmouth

About the Author

Graham Foster
Director of Treatment Programme

Expert of Addiction Psychology
Published Addiction Author
UKCP Contemporary Psychotherapy (Intermediate)
Master Practitioner of Neuro-Linguistic Programming
20+ Years helping People move beyond Addiction 

About the Author

Graham Foster is the Founding Director at ARC Portsmouth

Graham Foster
Director of Treatment Programme

Expert of Addiction Psychology
Published Addiction Author
UKCP Contemporary Psychotherapy (Intermediate)
Master Practitioner of Neuro-Linguistic Programming
20+ Years helping People move beyond Addiction 

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Any emails from ARC will never have any words in the subject line that could identify your issues. My contact database is kept on an encrypted server and safe from any third party. If at any time you think you want to stop receiving my emails or remove yourself from my contact list then please hit ‘unsubscribe’ at the bottom of any email. It’s effective & immediate.