Inspection on 30/08/05 for Charton Manor

This inspection was carried out on 30th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Charton Manor 27/02/09

Charton Manor 21/11/06

Charton Manor 09/01/06

Charton Manor 13/12/04

Charton Manor 29/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Charton Manor Gorse Hill Farningham Kent DA4 0JT Lead Inspector Elizabeth Baker Announced 30 August 2005 09:30 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 Older People. 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. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Charton Manor Address Gorse Hill Farningham Kent DA4 0JT 01322 863116 01322 866248 mail@chartonmanor.org Hawthorne Trust Limited 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) Category(ies) of registration, with number of places Mrs Ednah Lawal Care Home 17 Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) Care provided to Service Users who are 18 years of age and over on admission. Date of last inspection 13 December 2004 Brief Description of the Service: Charton Manor is a facility registered solely for Christian Scientists who require non-medical nursing care and or study and rest for short-term periods. The facility’s Statement of Purpose states “Charton Manor provides 24 hour shortterm Christian Science nursing care to men and women aged 18 and over who have chosen to rely solely upon the Bible-based method of spiritual healing, Christian Science. This is set out in Science and Health with Key to the Scriptures by Mary Baker Eddy, the Discoverer and Founder of Christian Science.” Hawthorn Trust is the registered provider. Charton Manor is a purpose built facility, which was first registered with the Commission on 23 March 2003. Patient accommodation is located on the ground floor. There are 15 single bedrooms and one double bedroom. All bedrooms have ensuite shower/WC facilities and telephone points. All rooms used by patients are connected to the call alarm system. The home sits within a six-acre site, made up of woodland and lawns. There is ample car parking for visitors and staff. The home is about two miles from the main M20/M25 inter-junction. The villages of Farningham and Eynsford are nearby and Sevenoaks, Swanley and Dartford are easily accessible by private transport. The term “Nurse” used throughout this report refers to a person who has completed the Christian Science Nurse Training and whose name has subsequently been recorded in The Christian Science Journal, ie is a Journal-listed Nurse. It does not refer to a nurse qualified or registered with the Nursing and Midwifery Council. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over eight hours on the 30 August 2005. This is the Lead Inspector’s first inspection of Charton Manor. Regulation Inspector Wendy Jones accompanied the Lead Inspector for part of the inspection visit. A partial tour of the home and grounds took place. Of the nine patients currently staying at the home, six were spoken with in private. A number of staff were spoken with and one was interviewed in private. The Registered Manager Mrs E Lawal was in attendance throughout the inspection. The Inspectors also briefly met the Responsible Individual Mr Bruce Morgan for introductory purposes. Some judgements about the quality of care, life and choices were taken from conversations with the patients, as well as direct and indirect observations. Some records were seen as part of case tracking and to assess work on the requirements and recommendations made at the last inspection. In response to the announcement of this inspection the Commission received a total of 13 comment cards from patients (12) and one relative. Some of their comments have been incorporated into this report. The inspection report template used for this inspection is that developed for long-term health and social care for older people. The model uses the criteria set out in the Department of Health’s National Minimum Standards, which underpin good quality care. Charton Manor provides religious non-medical nursing care. Therefore certain standards are not applicable to this service and indeed some are contradictory to the philosophy and ethos of the actual care and support provided. This has been acknowledged by the Commission, which is currently reviewing certain standards to reflect this. What the service does well: Charton Manor provides a comforting, reassuring and serene environment for patients requiring Christian Science nursing care. The standard of cleaning throughout the home is very good and staff should be complemented on this. Comment card respondents stated “I am more than satisfied”; “I am very happy here, and well satisfied with all the attention to detail given by the staff. Food is excellent, and everyone is very helpful and co-operative”; “It is wonderful to be here. It meets all my needs and the staff are all wonderful, so loving, kind and considerate. They can anticipate whatever the patient needs”; “All I can say is that I am completely satisfied, and have known the home for a number of years. I have no complaints at all.”; “My mother is receiving excellent care at Charton Manor. I am very impressed by the standard of hygiene and the nursing care is of the highest quality”. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 4 Prospective patients are provided with the information they need to make an informed decision about staying at Charton Manor. Prospective patients know Charton Manor will support their goals and aspirations. EVIDENCE: Charton Manor has produced a Service User Guide and Statement of Purpose, which clearly sets out the services provided by this facility. Information as to patients’ right to seek conventional medical intervention and treatment if they choose to is included in the Statement of Purpose. Also, if a patient requires permanent long-term residential care, they are assisted in finding suitable alternative accommodation. Patients spoken with had in depth knowledge of the home from previous associations and were fully aware of what to expect on admission. Each bedroom has been provided with a detailed information pack, including meal times, complaints procedure, fee levels and additional charges. Patients have a contract of terms and conditions of stay. This information provides patients with all the information they need to know about their stay. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 9 Independent Christian Science Practitioners support patients in the pre admission process as well as throughout their length of stay, which is in addition to the support provided the facility’s Nurses. This ensures patients expectations as to the level of care and support they receive whilst staying at Charton Manor are met. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Patients know their personal and spiritual goals are reflected in their individual plans and know their views are listened to and respected. EVIDENCE: The home does not administer medications to patients. Standard 9 is not applicable. For case tracking purposes, care records of two of the six residents interviewed, were inspected. Both care plans reflected the level of care, assistance and support the patients require. However it was difficult to decipher some of the information on one of the care plans, as the care plan model does not provide sufficient space for nurses to make legible notes for care staff and the patient to easily follow. Care plans are reviewed weekly and detailed daily report sheets are maintained. Since the last inspection patients have been invited to partake the composition and review of their care plans if they so wish. Indeed one patient said how very important this is to her, as she likes to be fully involved in all aspects of her nursing care. It is not the home’s practice to obtain details of patients weight on admission. A hoist has been obtained to assist nurses in transferring patients where there Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 11 is an assessed need. Hoists are designed to take loads of varying maximum weights. Whilst recognising the sensitivities and philosophies of the home in not obtaining this information, this practice could result in a potential incident occurring because the incorrect hoist has been used. Whilst pressure area medical care is not provided, a range of pressure relief and preventative equipment is available for patients’ use and comfort. To ensure the current provision does not compromise patients’ skin integrity, Mrs Lawal is to seek specialist advice. As stated previously, the home’s documentation informs the reader that medical care is not provided but if a patient decides they wish to receive this treatment, the home will assist the patient in accessing this by transferring them to another facility, including hospital. Patients are assisted in arranging and attending dental appointments where they have a need to do so. Patients make and receive personal telephone calls from the privacy of their own bedrooms. This enables them to remain in regular contact with their Independent Christian Science Practitioners, as well as families and friends. All twelve returned comment cards from patients indicated their privacy is respected and they feel well cared for. One patient commented on the happy atmosphere which is helping her recovery and another remarked that the comfort and encouragement she receives is conducive to her wellbeing. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Patients are served appetising and varied meals and choose where to eat them. Patients are enabled to continue their links with the community and choose how to spend their day. EVIDENCE: The home employs three activity co-ordinators, who provide a range of group and individual activities. Patients are provided with a weekly programme of all events, including bible readings, hymns and prayers. A people carrier vehicle is available to take patients out on country rides as well as to the weekly Christian Science service held in a nearby town. All twelve comment cards returned from patients indicated the home provides suitable activities. The home is situated in six acres of grounds, comprising mainly of woodland and lawns. Patients said how much they enjoy being assisted in walking around the grounds. A small quiet room is available for patients to meet their visitors in private. As well as a day room, there is a separate wellstocked library, which enables patients to read in private or to continue with their Christian Science studies. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 13 All twelve returned comment cards from patients indicated they all like the food. Indeed patients spoken with were also complementary of the food and referred to meals being excellent. The home has a dining room in which patients may choose to take their meals if they so wish. Hot and cold drinks are readily available throughout the day and a choice of appetising meals is served at mealtimes, which patients can eat in the dining room if they so wish. The good practice of providing patients with daily menus to choose from ensures they receive their preferred meals. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Patients are protected from risk by the home’s complaint and adult protection procedures. EVIDENCE: Patients spoken with knew what action to take if they had a complaint or concern about the service provided at Charton Manor. The information pack available in all bedrooms refers to the home’s complaints procedure as well as the Commission’s area office contact address. The nurse interviewed said she had received adult abuse/protection training and described appropriately what she would do if she suspected this. Ten of the twelve comment cards from patients indicated they know who to speak to if they are unhappy with their care. The one returned comment card received from a relative indicated they are not aware of the home’s complaint procedure. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24 and 26 Charton Manor provides a clean, homely and well maintained environment, for patients to stay in when requiring Christian Science nursing care and assistance. EVIDENCE: Charton Manor is kept in a very clean and tidy state and decorated internally and externally to a good standard. The home has just successfully obtained planning permission to extend the main lounge. This will enhance patients’ day space facilities. To ensure the extension has the approval of the local fire service Mrs Lawal confirmed contact would be made with them. All bedrooms have ensuite shower/WC facilities. An assisted bathroom is available for those patients who prefer having a bath. Corridors are fitted with handrails and are of a width, which enables patients to move safely and independently around the home. Bedrooms have French windows, which open out, into the grounds. This provides patients with good views whether they Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 16 are in bed or sat in chairs. Indeed this was very much appreciated by a number of patients interviewed. Patients spoken with demonstrated how they are able to call for assistance by the use of the emergency call facilities and said staff respond promptly. The majority of beds are fully adjustable. Indeed a patient said how comfortable her bed is and that she can vary the positions herself by the use of the control facility. Charton Manor has two laundry rooms, one of which is designated a “dirty” facility and is used also as a sluice room. Both rooms were clean, tidy and odour free. This ensures patients are protected from any potential infection control hazards. Patients have a choice of conventional bed linen or duvets. Some bed linen is contracted out for laundering. Personal clothing is washed in house and patients indicated the service is excellent. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Patients are safely cared for by appropriate levels and mix of staff. EVIDENCE: In addition to Journal-listed Christian Science nurses and student Christian Science nurses, the home employs staff for administration, housekeeping, maintenance and activities. This provision ensures there are sufficient staff to operate the facility. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36, 37 and 38 Patients benefit from a well run home. EVIDENCE: Mrs Lawal is a Christine Science Journal-listed Nurse and has worked for the Hawthorne Trust at Charton Manor since 1995. Mrs Lawal became the Registered Manager of the Charton Manor in 2002. Mrs Lawal has also attained a requisite Registered Manager Award qualification. Patients and staff spoke openly about their experiences of staying and working at the home. Mrs Lawal said formal supervision had now commenced, which enables her to discuss with staff any problems and other pertinent matters. Mrs Lawal works on the floor for two days a week, which enables her to observe staff and to talk with patients. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 19 Patients are initially admitted for short-term stays. However, patients can stay for up to a year if there is a problem in discharging the patient back to their own home or if an alternative care facility is to be found for long-term care. Patients spoken with were aware of the conditions of length of stay and although were obviously saddened they might have to leave, fully understood that purpose of this facility is to provide short-term stays only. Patients are required to complete exit interview survey forms. It has not been the home’s practice to analyse this information and make it available to prospective patients. However Mrs Lawal is aware of the need to continue to develop the home’s quality assurance system. To remain accredited with the Commission for Accreditation of Christian Science Nursing Organizations/Facilities Inc, the home is audited every three years to ensure Charton Manor operates in accordance with the principles of Christian Science faith. Copies of the most recent CSCI inspection reports are included in the patients’ information packs available in all bedrooms. Residents spoken with were fully aware of the imminent inspection and were very interested in partaking with the process in order to voice their views. The home has a safe in which patients can use for the safe keeping of valuables. Mrs Lawal produced a record sheet, which is used to record details of any such items held on patients’ behalf. If requested the home maintains patients’ monies for safekeeping. The money is kept separately in plastic money bags. A balance sheet record is kept of all transactions and patients and staff are required to sign the form when transactions have been made. However, the current record does not require actual details of the source of the credit deposit to be stated. Not having this information could present auditing difficulties, if the need arose. The returned pre inspection questionnaire form indicates the home’s appliances and equipment are appropriately serviced, to maximise the safety of both patients and staff. Since the last inspection arrangements have been made for appropriate staff to undertake First Aid training. This is important in that not all staff or indeed visitors to Charton Manor are Christian Scientists, and would expect to be receive appropriate first aid assistance in the event of an accident when on site in accordance with health and safety legislation. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 N/A 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 x 4 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 3 2 3 Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 21 Yes 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 30 Regulation 18 Requirement Ensure that persons working in the home are provided with training appropriate to the work they perform. (Final CSCI policy decision is awaited.) Timescale for action 31/03/06 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. 2. 3. Refer to Standard 8 8 37 Good Practice Recommendations Patients weights should be obtained to ensure appropriate lifting and transferring equipment is provided, where there is an assessed need. Specialist advice should be sought as to the appropriateness of the current range of pressure relief and preventative equipment. Records in respect of patients monies and care should be enhanced for easier auditing and reading. Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Charton Manor H56-H06 S40103 Charton Manor V235743 300805 Stage 4.doc Version 1.40 Page 23 - 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. 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