Inspection on 09/01/06 for Charton Manor

This inspection was carried out on 9th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Charton Manor 27/02/09

Charton Manor 21/11/06

Charton Manor 30/08/05

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 Unannounced Inspection 9th January 2006 10:00 X10015.doc Version 1.40 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 Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 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 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 DS0000040103.V272802.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Charton Manor Address Gorse Hill Farningham Kent DA4 0JT 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) Category(ies) of registration, with number of places 01322 863116 01322 866248 mail@chartonmanor.org www.chartonmanor.org Hawthorne Trust Limited Mrs Ednah Lawal Care Home 17 Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care provided to Service Users who are 18 years of age and over on admission 30th August 2005 Date of last inspection 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 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 and a half 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 Nursing 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 DS0000040103.V272802.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours on the 9 January 2006. Lead Inspector Elizabeth Baker carried out the inspection. A partial tour of the home took place. A number of patients were spoken with and two agreed to be interviewed in private. Five members of staff were also spoken with. The inspection was carried out with assistance from Deputy Nursing Manager Alistair Budd. Some judgements about the quality of care, life and choices were taken from direct conversations with patients and staff. Some records were inspected as part of case tracking and to assess work on recommendations made at the previous inspection. This is the second inspection of this home for the year 2005/06. Not all standards have been inspected on this occasion where they were met at the first visit. This report should therefore be read in conjunction with the inspection report dated 30 August 2005. At the time of the inspection ten patients requiring Christian Science nursing care and/or Christian Science care and/or rest and study on a short-term basis were resident at the home. 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: What has improved since the last inspection? The extended lounge has enhanced the communal facilities and patients are very pleased with this. Although the home does not provide medical nursing care, chair scales have been obtained so patients can be safely weighed where there is an assessed need. Specialist advice from a tissue viability nurse is Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 6 being arranged to ensure the home provides pressure relief and preventative equipment in accordance with current good practice. 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 DS0000040103.V272802.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 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 the following standard(s): 5 Patients are fully aware of the home’s philosophy of care. EVIDENCE: Standards 1, 2, 3 and 4 were inspected and met at the last inspection. They have not been reassessed on this occasion. The home is not registered for intermediate care. Standard 6 is not applicable. Only short-term patients are admitted to Charton Manor. Patients of the Christian Science faith know of the home’s existence and of the particular care it provides. Generally this is through past associations and contact with the home, Hawthorne Trust and Christian Science churches. One patient said she felt part of the community straight away, despite not having met most of the staff before. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 7, 8 and 11 Patients stay at the home knowing their spiritual needs will be met and their independence will be maximised and promoted. EVIDENCE: The home does not administer medications to patients. Standard 9 is not applicable. Two care records were inspected as part of the case tracking process. Both files contained care plans, daily report sheets and moving and handling assessments. The care plans generally reflected the care and support provided as described by patients during the inspection. However one plan was more descriptive in respect of the level of detail staff provide when assisting patients with personal care needs. The format of the documents has not changed since the last visit and make it difficult for staff to write comprehensive notes. Mr Budd said it is the home’s intention to transfer from manual to computerised care records, at which time the format will change. This should allow nurses to record more detail, invite the signature of the patient to the composition of the care plan, if that is their wish, and include a re-affirmation statement for their preference of continuing with non-medical nursing care. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 10 Since the last inspection the home has acquired “sit on” scales to ensure lifting equipment is used appropriately, when required. Details of patients’ next of kin are obtained on admission. home has a policy for death and dying. It was stated the Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 11 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 the following standard(s): EVIDENCE: All the above standards were assessed and met at the last inspection. They have not been reassessed on this occasion. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 12 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 the following standard(s): EVIDENCE: The key standards were assessed and met at the last visit. They have not been reassessed on this occasion. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 19 and 25 The home is maintained to a high standard, hygienically and environmentally; ensuring patients live in a very comfortable and clean home. EVIDENCE: Standards 20, 21, 22, 23, 24 and 26 were inspected and met at the last inspection. They have not been reassessed on this occasion. Since the last inspection the lounge has been extended. Patients said they are delighted with this as it makes the room much brighter and airier. The new windows have been designed specifically to allow better viewing into the grounds when patients are seated. Although there was no regulatory requirement for the home to formally apply for the extension to be registered, the inspector asked the home’s Administrator, to provide the Commission with a copy of the building completion certificate, including the Fire Safety Officer’s approval. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 14 All bedrooms have ensuite shower/WC facilities. In addition there is one communal bathroom. The bath hot water temperature is checked to ensure it complies with current legislation to prevent patients scalding themselves. However it has not been the home’s practise to obtain water temperatures from the showers or wash hand basins. Hot water taken from the washbasin taps in the visitor’s toilet, communal bathroom and patients’ bedrooms exceeded 50 degrees centigrade. There was no recorded evidence in the patients’ care plans that the risk had been assessed either. This situation could result in a resident or visitor scalding their hands. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Robust recruitment vetting practices are not in place, which potentially leave patients at risk. The home is fully committed to ensuring patients receive appropriate nursing support from qualified Journal-listed Christian Science nurses. EVIDENCE: Staff were seen carrying out their respective duties in an unhurried manner. As well as Journal-listed and student Christian Science nurses, staff are employed for administration, activities, training, maintenance, catering and cleaning. Ten of the 14 nurses employed at the home are Journal-Listed. This means the person has successfully completed Christian Science training and whose name appears recorded in the Christian Science Journal. Discussions are currently ongoing between the Commission and Christian Science representatives on how this qualification can be accredited to NVQ status. The final outcome is still awaited. Following recommendations made at two previous inspections, a number of staff have now received First Aid training. This is essential as not all staff or visitors are Christian Scientists and may require conventional medical assistance in an emergency situation. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 16 Two staff files were inspected. This identified that robust systems are not adequately in place for vetting new or returning staff. There were no references, current application form or criminal record bureau check for an employee who had returned to work at the home in 2005 after having left in 2001; and the other file did not evidence a criminal record bureau check had been carried out on employee from overseas. Current CRB guidance was provided to the home. It was also recommended that the home accesses the CSCI website which provides up to date information on vetting staff. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 17 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 and 37 Patients and staff records are securely maintained. Patients’ financial records would be enhanced if the detail were expanded. EVIDENCE: Standards 31, 32, 33, 34, 36 and 38 were inspected and met at the last inspection. They have not been reassessed on this occasion. A reassessment of records of monies held on patients’ behalf again identified that precise details of the actual source of the monies is not recorded. Separate records of patients’ monies are maintained to ensure confidentiality. However it was also noted on this visit that actual receipts of items purchased or services provided on behalf of patients are not retained. This could prove a problem if an audit had to be carried out in the event of a complaint being made. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 18 Patients and staff files are appropriately stored to maximise confidentiality. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 19 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 N/A 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X 2 X STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 3 2 Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 20 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 OP30 Regulation 18 Requirement Ensure that persons working in the home are provided with training appropriate to the work they perform. (Final CSCI policy decision still awaited) Ensure unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Ensure appropriate vetting checks are carried out on all new and returning members of staff Timescale for action 30/06/06 2 OP25 13(4) 30/06/06 3 OP29 19 31/01/06 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 OP37 OP7 OP28 Good Practice Recommendations Records in respect of patients’ monies should be enhanced for effective auditing. Care plans should evidence the patient had been involved in the compilation and should include treatment reaffirmation reference. Ensure 50 of care staff are trained to NVQ II or DS0000040103.V272802.R01.S.doc Version 5.0 Page 21 Charton Manor 4 OP19 equivalent by 2005. (Final CSCI policy decision still awaited) Provide the Commission with a copy of the building completion certificate, including the Fire Safety Officer’s approval, in respect of the lounge extension. Charton Manor DS0000040103.V272802.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone 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 DS0000040103.V272802.R01.S.doc Version 5.0 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. 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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