Archived: Charton Manor

Updated 27 September 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Charton Manor known as the Christian Science residential nursing home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Charton Manor is also a domiciliary care agency known as the Visiting Christian Science Nursing Services, London Field. It provides personal care to people living in their own houses and flats.

There were two registered managers employed. One, at the Christian Science residential nursing home and one for the Visiting Christian Science Nursing Services, London Field (domiciliary care). This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The Christian Science residential nursing home inspection was unannounced while the Visiting Christian Science Nursing Services, London Field (domiciliary care) was announced. The provider was given 48 hours' notice of the inspection as we needed to be sure that the office was open, and staff would be available to speak with us.

What we did before the inspection

We reviewed information we had received about both services since the last inspection. This included details about incidents the provider must notify us about. The provider completed a Provider Information Return (PIR) which we used to plan the inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We contacted healthcare professionals for feedback. We received no feedback.

During the inspection

During the inspection, we spoke with six people who lived at Christian Science residential nursing home, three people who used Visiting Christian Science Nursing Services, London Field, two Christian Science Nurses (CSN), the cook, deputy manager and the two registered managers.

We reviewed a range of records. This included two people's care records from Christian Science residential nursing home and four from Visiting Christian Science Nursing Services, London Field. We also looked at three staff (CSN) files including their recruitment, supervision and training records. We reviewed records relating to the management of the service, quality assurance records and a variety of policies and procedures implemented by the provider. We also looked at other records the provider kept, such as meetings with people and surveys they completed to share their views.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received the training data and risk assessments sent to us in a timely manner.

Updated 27 September 2019

About the service

The Christian Science residential nursing home and the Visiting Christian Science Nursing Services, London Field (domiciliary service) are run as a charitable trust. Both are located at Charton Manor.

The Christian Science residential nursing home provides residential and respite accommodation and personal care for up to 19 people. At the time we inspected, seven people were using the service. They choose to receive care based on their religious convictions, which were consistent with the theology and ethics of the Christian Science Church.

Visiting Christian Science Nursing Services, London Field (domiciliary care) is based in an office on the first floor of Charton Manor. There were 16 people using the domiciliary care service when we inspected. The service only provides care based on Christian Science teachings, such as, assistance with mobility, assistance with meal preparation, wound dressing and companionship to people living in their own homes. Visiting Christian Science Nursing Services, London Field (domiciliary care) does not administer medicines, or medicated, herbal, or vitamin-based products and remedies.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People were positive in their feedback. Comments included; “The nurses look after us suitably”; “Marvellous” and “Oh yes, they are very good.”

However, the registered manager for Visiting Christian Science Nursing Services, London Field (domiciliary care) had not carried out appropriate risk assessments before people started using the service. There were no environmental risk assessments or care related risk assessments for people receiving domiciliary care. This meant that the service had not mitigated possible and potential risks to people who received care and support.

Accidents and incidents, for people living in the residential nursing home had been recorded in care plans and monitored by the registered manager to try to prevent similar incidents being repeated. However, we found no records of any incidents or accidents for people receiving support from the Christian Science visiting nursing service. We have made a recommendation about this.

Visiting Christian Science Nursing Services, London Field (domiciliary care) did not have adequate processes in place to audit and monitor the delivery of the service. However, the residential nursing home had a robust quality audit system in place which allowed the registered manager to have an oversight on the service.

People were protected from abuse. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices.

People who lived in the residential nursing home received the support they needed to stay healthy and to access healthcare services. Each person had an up to date care plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.

People continued to receive care from staff who were well supported with induction and training. Staff received the training and updates they required to successfully carry out their role.

Staff understood the importance of promoting people’s choices and provided the support people required while assisting and maintaining independence. This enabled people to achieve positive outcomes and promoted a good quality of life.

The staff were caring and knew people, their preferences, likes and dislikes well. We received good feedback from people and relatives about the quality of care provided by staff.

We observed people’s rights, their dignity and privacy were respected. People continued to be supported to maintain a balanced diet and staff monitored their nutritional health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We saw that people participated in activities, pursued their interests and maintained relationships with people that mattered to them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (Report published on 24 January 2017).

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well Led sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.