15 February 2022
During an inspection looking at part of the service
The service had experienced staffing shortages and recruitment was a challenge. As a result of this, staffing levels had been reduced to two care staff during the day. This gave staff more people to support, and pressure to ensure all visits were undertaken on time. The service had stopped all night-time care, and after the inspection, we were informed the service was closing completely. The service liaised with the Local Authority, and supported people and their families to find alternative care provision if needed.
At the inspection, we identified systems were insufficient to prevent infection and minimise the risk of its transmission. The service was in the middle of an outbreak of COVID-19.
The night porter and evening staff cleaned the communal rooms. However, there were not enough housekeeping staff in the day to thoroughly clean other areas or complete additional cleaning, related to the management of COVID-19. Cleaning schedules had not been updated to reflect such cleaning, including that of high touch points.
Not all visitors or people living at the facility were supportive of the practices to keep people safe. This included not always ensuring social distancing, self-isolation, testing or wearing personal protective equipment (PPE). This impacted on staff and those receiving the regulatory activity of personal care.
One person’s support plan had not been updated to show they had tested positive for COVID-19. There was no guidance for staff to follow when needing to encourage the person to self-isolate in their apartment. Staff told us they often found this situation challenging to manage.
Guidance to staff regarding COVID-19 had been disseminated to the staff team. However, the registered manager had not been at work due to sickness. This meant staff needed to understand and implement the guidance themselves, rather than be guided by a manager. A duty manager has since been deployed to the service. Staff confirmed this had improved the situation.
We found the following examples of good practice.
Assessments had been completed for those staff more at risk of catching the virus. Adjustments to their role had been made to enhance safety.
There were ample supplies of PPE for staff to wear when needed. All staff were seen to wear masks, and said they wore aprons, gloves, visors and foot protectors when supporting a person with COVID-19.
Staff took part in testing, as per the government guidance at the time. They said this had included one PCT test and three LFTs a week, but they were now completing an LFT each day, before they started work. This was in line with changing guidance.