30 October 2020
During an inspection looking at part of the service
We found the following examples of good practice.
Staff kept the premises clean. The member of staff who regularly worked the waking night shift was designated the lead for cleaning and decontamination within the service. There were laundry processes in place, so clothes were not mixed and washed together, and the laundry room was subject to regular enhanced cleaning. All staff were responsible for the routine cleaning of high touch areas, such as handrails, light switches, door handles, telephones and keyboards.
There were suitable systems in place for visitors to the service to minimise the risks of spreading infection. For example, there were prearranged visiting times to minimise visitor numbers. Instructions were easily accessible on arrival at the care home to ensure visitors understood the infection prevention and control protocols they needed to follow to keep people safe. Visitors to the service were asked to wear appropriate personal protective equipment (PPE), have their temperature checked, wash their hands and use the hand sanitiser provided before they would be allowed to enter the main part of the building. Visitors were only permitted to see their relative or friend in the confines of people's single occupancy bedroom and were not allowed to have contact with anyone else who lived at the care home.
In addition, staff supported people to keep in touch with their family and friends without physically visiting the care home. This was done through a variety of alternative methods, including video and telephone call contact, and having one-to-one meetings with their relative or friend outside in the rear garden.
There were suitable arrangements in place to ensure people admitted to the care home were tested for Covid-19. For example, people readmitted to the care home having been discharged from hospital were always tested for Covid-19 and then required to isolate in their own single occupancy bedroom for at least 14 days.
Staff used PPE in accordance with current IPC guidance. We saw staff wearing PPE correctly in communal areas, including the main lounge and dining room, the kitchen and laundry room, where it was difficult to maintain two metres social distancing. Staff had up to date internal IPC training and had received additional external training in June 2020 from Public Health England, in relation to the use of PPE. The service had adequate supplies of PPE.
The provider had thoroughly assessed and mitigated infection risks to staff working at the care home, including staff in high risk groups. The registered manager confirmed the service did not currently use any temporary agency staff. They were also aware of the new Covid-19 regulations in relation to care staff, including part-time, bank and agency staff, only working in one care setting so as to reduce the risk of spreading infection.
A regular testing scheme for all staff and people living in the care home was in place. Staff were tested at least weekly and people living at the care home monthly. People were also tested without delay if they became symptomatic or if anyone in the household bubble of a member of staff displayed symptoms. The registered manager knew how to apply for coronavirus testing kits for people living in the care home and for staff. They had no issues with the supply of Covid-19 home testing kits. People living in the care home had received the flu vaccination and staff were being encouraged to follow suit. Most staff had taken COVID-19 antibody tests.
The provider had thorough assessed and mitigated infection risks to people living at the care home. The registered manager described how staff had helped people who were anxious about wearing face coverings, to do so whilst out in the wider community. This had enabled some people living in the care home to continue visiting local shops and cafes in the area.
There were a range of IPC policies and procedures which had been reviewed and updated since the start of the COVID-19 pandemic. These included contingency plans for managing adverse events, such as COVID-19 outbreaks and related staff shortages. The registered manager had routinely monitored and audited compliance with IPC practices. This included daily tours of the building to check the premises were clean and that staff wore their PPE correctly. The registered manager also supported people and their relatives to understand the isolation processes and how the service could help to alleviate them feeling lonely.
As cleaning schedules for staff to follow were not recorded, we recommended the provider consider current recognised best practice in relation to infection prevention and control (IPC) and establish recorded cleaning schedules for staff to follow. This should include the frequency of cleaning of high touch areas.
We were assured that this service met good infection prevention and control guidelines as a designated care setting.
Further information is in the detailed findings below.