An inspection was carried out of the Christian Science residential nursing home at Charton Manor on 10 November 2016, this inspection was unannounced. We returned to inspect the Christian Science Visiting Nurse Service for London (domiciliary care) based at Charton Manor on 15 November 2016. This inspection was announced.

The Christian Science residential nursing home at Charton Manor and the Christian Science visiting nursing domiciliary service are run as a charitable trust. Charton Manor provides residential and respite accommodation and personal care for up to 19 people. They choose to receive care based on their religious convictions, which are consistent with the theology and ethics of the Christian Science Church. Christian Science Visiting Nurse Service for London (domiciliary care) is based in an office on the first floor of Charton Manor.

Christian Science nurses are non-medical nurses trained in providing Christian Science nursing care through Christian Science teachings and practice. People received non-medical Christian Science nursing care at Charton Manor when there was a need for this. People also stayed for religious study and rest at Charton Manor. A Christian Science Visiting Nurse Service for London (domiciliary care) provides Christian Science nursing to people in their own homes. Access is based on reliance on Christian Science for healing rather than geographic location.

Charton Manor, which is set in large well-kept grounds has two floors and includes a cottage that is separated from the main building by a short covered walkway. Accommodation was provided on the ground floor at Charton Manor and in the Cottage. Christian Science nurses provided assistance to people with washing and dressing, practical assistance with mobility and wound cleaning and dressing. No medicines, medicated dressings or topical medical treatments were carried out at Charton Manor. There were nine people living in the home when we inspected, four of whom were virtually independent with their own care.

There were ten people using the Christian Science Visiting Nurse Service for London (domiciliary care) when we inspected. The care provided by both services was delivered so that people may rely on CS treatment for healing in accordance their needs and the teachings and practice of the Christian Science Church.

There were two registered managers employed. One, at the Charton Manor and one for the Christian Science Visiting Nurse Service for London (domiciliary care). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home and domically service are run. Both registered managers were Christian Science Nurses.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no-one living at Charton Manor was subject to a DoLS restriction the registered manager understood when an application should be made.

The registered manager of the Christian Science Visiting Nurse Service for London (domiciliary care) was also knowledgeable about the Mental Capacity Act (2005) and how it affected their work. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

People were provided with detailed information about what CS nurses could provide before they started using either service. Every person using Charton Manor and the Christian Science Visiting Nurse Service for London (domiciliary care) had capacity to consent to the care and treatment offered and to make informed decisions about how their care was delivered to them. The provider’s policies and procedures and the information provided to people ensured that people understood what CS nurses co

On the day of our inspection there were two people who required Christian Science care and eight people occupied the assisted living apartments, attached to Charton Manor. We spoke with four people who used the service, three members of staff, the Registered Manager for the home, the Registered Manager for the Christian Science visiting nurse service and the Nominated Individual for the service.

People told us they were "Happy" living at Charton Manor and felt they received an extremely high standard of care. One person said "I feel so blessed to be here" and "The care is excellent". People said that the food was "Exquisite" and they felt "Safe" and "Comfortable" in the home.

We found that people's care plans were personalised and had been reviewed regularly in order to reflect their individual care needs.

The home was bright, clean, tidy and well maintained in order to provide a safe and suitable environment for people to live in.

People spoke highly of staff and described them as "Wonderful", "Caring" and "Attentive". They said that if they needed support then staff came quickly. People also said that they felt able to report any concerns they had to a staff member, or to the manager, and were confident that the appropriate action would be taken.

We found that Charton Manor was a care home not providing medicines or medical treatment. People who used the service preferred to be referred to as patients. We found the home to be cheerful, bright and very clean. It provided a homely environment internally and patients were positive about the comfort and accessibility of their personal ensuite accommodation. We found that nursing care was delivered by Christian Science nurses who had completed an in depth nursing programme. They were supported by the Christian Science nursing manager. People were complimentary about the holistic, religious, non medical care provided and spoke very highly of the Christian Science nursing manager and the Christian Science nurses. People we spoke to told us, "I am so well looked after here, it is just simply heaven on earth” Another patient said, "I feel perfectly safe and secure here and I keep coming back” Patients were equally complimentary about the food provided. A patient told us, “The food is just marvellous. “We observed patients attending a morning service. A patient told us, “….we are able to contribute, we help to choose the hymns and readings, it is so nice to be involved.” The Christian Science visiting nurse services manager was not on the premises during our visit. We were told that the Christian Science visiting nurse service provided personal care and support to a small number of patients in London and the surrounding areas.

All the people we spoke with were very positive about the service they received. One person said, “It’s heaven on earth – it’s peaceful and harmonious. The staff are exemplary – I’ve been here a year now and I can’t fault the love and care we are given. It feels like a family and we all care for each other”.

Another person said, “We have plenty to do, there is a service every morning and we all contribute to this, sometimes someone does a reading and we help to choose the hymns for the services each week. There is transport to take us to church on Sundays and for drives in the countryside during the week. An activities person comes in and is marvellous”.

People spoke very highly of the registered manager and all the staff. Comments such as, “Ednah (the registered manager) is very good she does everything to accommodate our needs and does so with care and good humour that lifts our spirits”; and, “All the staff are so kind and caring – it makes it like family, you feel safe.

Other comments included “I came for kindness and friendship, and I’ve found it here”, another was “it’s a very good place”.

People also spoke highly of the food and the environment, “The food is very good” and “There is a lovely garden, and the room had everything you could want”.