Hays House Nursing Home provides nursing care and accommodation to up to 43 people. 10 of the beds were part of the discharge to assess initiative. This supports people to leave hospital, when safe and appropriate to do so, whilst continuing their care and assessment in a care environment. There were 41 people using the service at the time of the inspection.We found the following examples of good practice.
Clear focus was given to enabling relatives and friends to visit in a safe way. The service had introduced strict measures to prevent visitors from catching and spreading infections. Visitors were screened for symptoms of COVID-19 and were provided with personal protective equipment (PPE) to wear whilst in the home. A communal lounge on the ground floor had been designated in the early stages of the pandemic, as a safe space to enable visiting. A visiting pod had also been built with its own external access. The pod had an integral intercom system to enable effective communication. More phones, iPads and laptops were purchased to help people have regular contact with their family and friends.
Systems and routines had been reviewed to ensure safety was maximised. This included staggered times for staff breaks and working in designated areas, rather than across the whole home. Social distancing was promoted, and seating arrangements had been reduced within communal areas. Other aspects such as sourcing more clinical waste bins for the safe disposal of PPE, had taken place.
Robust cleaning regimes were in place and deemed an integral part of ensuring a safe environment. There were three domestic staff on duty and another who worked in the laundry. There were cleaning schedules for all areas of the home, and these were regularly reviewed to ensure maximum effectiveness. All areas seen were clean, with no unpleasant odours.
Staff had received regular infection prevention and control training, with additional elements related to the pandemic. Areas covered included how to put on and safely take off PPE, and good hand hygiene. Observation and monitoring were undertaken to ensure these practices were adhered to at all times. There was further auditing, to check the overall effectiveness of the infection prevention and control framework. Staff told us this enabled things to be identified and addressed, before becoming an issue.
The provider and registered manager kept up to date with government guidance. This was through general reading, management forums, other agencies and shared learning within the organisation. The information was regularly cascaded to staff, and practice was adjusted as required. The registered manager kept relatives and friends updated with any changes to guidance, both verbally and in writing.
Regular testing for COVID-19 was being carried out for people using the service and staff. Staff undertook their tests before they came to work, or in a completely separate part of the building. This ensured only staff who were safe to enter the home, could do so. The tests were recorded and registered in line with current guidance.
The registered manager and provider were appreciative of the staff team, and maintained morale well. They did this by gestures such as providing takeaways, and additional money for overtime working. Staff were paid if they were unwell, and unable to work. The registered manager and provider gave staff time and listened and communicated effectively. A whole team approach had been developed, which also enabled staff to be supportive of each other. Risks had been assessed for those staff who were deemed more vulnerable than others. Any concerns were addressed, with additional measures to maximise safety if required.
There were effective systems in place to check staff and professional visitors were vaccinated against COVID-19. All professional visitors were required to show their vaccination status before being allowed into the home. The registered manager and some registered nurses had completed training and an assessment of their competence, to enable them to administer vaccinations on site. This had been positive, and enabled vaccinations to take place in a timely manner. All staff were pleased to support the vaccination programme and were vaccinated as required, at that time.