Lime Tree House

Lime Tree House is a residential care home providing personal care to up to 6 people. Lime Tree House provides both short and long-term residential accommodation for people (who prefer to be referred to as patients) who follow the Christian Science faith. People are supported by Christian Science Nurses (CSNs), who are non-medical nurses trained in spiritual healing through Christian Science practices. At the time of the inspection the service supported 4 people.

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

People’s faith and individual wishes were at the heart of the service. The ethos of the home was founded on the values of Christian Science, and this was evident throughout the inspection. One patient said, “The staff live their Christian Science values, and these align with my own beliefs.” Without exception, people and relatives were full of praise about Lime Tree House; the staff team, registered manager, and atmosphere at the home.

The home was exceptionally well led by a registered manager who was valued and respected by all the staff, people living at the home, relatives, and the wider Christian Science community. The home had become the only training provider for CSNs in the UK and had regular links with other Christian Science homes throughout the world.

There was an open and transparent culture at the home, with the involvement of people and staff in agreeing the care and support people wanted. A robust quality assurance system was in place to drive standards. People were supported to ensure their care and faith needs were met when they moved on from the home, either returning to their own home or to another care home.

Morale at the home was extremely high, with staff being proud and motivated to work at Lime Tree House. Staff demonstrated extremely compassionate, kind, and caring approaches, consistently encouraging people’s independence. People were treated with the utmost dignity and respect.

Lime Tree House provided a safe service for the people. Effective systems were in place to minimise risks, with the home being fully adapted to meet people’s needs. There was a high number of staff on duty. Staff were safely recruited and received the training for their roles. All CSNs had completed additional training to become mentors for trainee CSNs being trained at Lime Tree House.

People’s nutritional needs were met, with any dietary requirements being catered for on an individual basis. People’s health needs were met within the ethos of the Christian Science faith.

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. People’s wishes to be supported in line with their faith were fully discussed and recorded.

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 (published 7 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lime Tree House provides both short term and long term residential accommodation for people (who prefer to be referred to as patients) who follow Christian Science practice. People are supported by Christian Science Nurses (CSN’s) who are non medical nurses trained in healing through Christian Science practices. The nurses have completed an in depth Christian Science nursing programme and were qualified in spiritual healing to enable them to support people in line with their beliefs and Christian Science practices. At the time of the inspection the service supported five people.

There was a registered manager at the service. 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 service is run.

Without exception the feedback we received about care people received was excellent. Relatives told us how the service had made a difference to people’s lives and people had become more independent with the caring and patient support they had received from staff.

People’s religious beliefs and practices were considered throughout the support provided, which was an important part of people’s daily lives and this was promoted and respected by all staff.

People’s independence was promoted throughout the support provided and the positive support staff provided had enabled people to regain their independence in line with their wishes and agreed outcomes.

People were supported to spend their time in a way that promoted their health and spiritual wellbeing, which was important to them.

The registered manager was highly regarded by people, relatives and staff and led the staff by example. The values of the service were promoted and understood by staff. The registered manager monitored the service and had a clear overview of people’s needs. There was clear evidence that the registered manager strived to make improvements to ensure people received high quality care and support.

The provider also had a good overview of the service because they were kept informed of any issues by the registered manager and supported areas of improvements that were put forward by the registered manager.

The registered manager encouraged and supported staff to gain further knowledge and experience through extensive training in Christian Science practices and staff received regular updates which ensured people received safe and effective care that met people’s needs.

People’s risks were planned and managed in a way that promoted their independence whilst keeping people safe from harm.

People were protected from the risk of abuse because staff had a good understanding of the signs of abuse and their responsibilities to report any concerns.

We found there were enough suitably recruited and qualified staff available to meet people’s needs. Staff received intensive induction and further training to ensure that they were confident to provide support to people.

People’s nutritional risks were managed and monitored and people were supported to access health professionals to maintain their health and wellbeing.

People were supported to consent to their care. Plans had been implemented to ensure that if people lost the ability to consent the care provided was in line with their future wishes and they would receive care in their best interests.

People and relatives knew how to complain and complaints were dealt with in line with the provider’s policies.

Patients told us: 'I like all the people here. I'm happy' and 'The night nurse checks in on me every couple of hours, if I am awake and need anything like shutting my window they help. You can always ask for a drink and they will bring you a drink. I'm comfortable and warm.'

We saw policies and procedures were in place to ensure patients were cared for appropriately, including privacy and dignity, and moving and handling. We observed staff respecting patients' privacy and dignity during our inspection. During our inspection we observed positive interactions between staff and patients; staff had a clear understanding of patients' needs and were kind and respectful.

All members of staff we spoke with understood the principles of obtaining consent, including issues relating to mental capacity.

We discussed with staff on the day of our visit their understanding of and training in protection of vulnerable adults and children. The staff were able to demonstrate a clear understanding of their roles and responsibility to safeguard patients.

We found Lime tree house to be bright, clean, airy environment. We saw all areas had been cleaned to a high standard including communal areas, and patient's en-suite facilities.

Lime Tree House provided holistic, religious, non medical Christian Science nursing care.

We found a bright, clean, airy, homely environment. All patient rooms were en-suite and situated on the ground floor.

We found that nursing care was delivered by Christian Science nurses who have completed an in depth nursing programme and are all named in the Journal of Christian Science. They were supported by a Christian Science practitioner.

People we spoke to told us: "I am very well looked after here, they address my every need, nothing is too much trouble for them".

"We are such a close team we get on well together and all work for a common purpose our patients".