Granada House

We found the following examples of good practice:

Any visitors to Granada House had their temperature checked and had to complete a health questionnaire before they were permitted to enter the home. Each person who lived in Granada House was in the vulnerable age group. Signage was displayed on the front door that callers were not able to enter the home and any essential visits had to be pre-booked. The registered manager told us only one person had been having family visits and they had been informed of the visiting arrangements. Alternative arrangements were in place to keep other people and their relatives/friends in contact. For example, telephone, email and video calls. One person was being helped to write letters.

Temperature checks were also completed by all staff at the start of their shift. They were required to wear a face mask and use hand sanitising gel. Hand sanitising gels were also placed in various places throughout the home, along with other personal protective equipment (known as PPE). We have directed the registered manager to obtain further guidance around the placing of hand sanitising gel, to ensure any risks are mitigated. This would reduce the risk of it being ingested by anyone.

Each week staff were tested for COVID-19; twice a week a lateral flow test (LFT) and once a week a full PCR test. People who lived at Granada House were tested every four weeks. If any visitors were booked to visit they had to have a negative LFT before entering the home. At the time of this inspection these visitors would have to wait in their car until the results were known, however the provider was going to install a covered waiting area in the front garden. Staff we were able to speak with confirmed these arrangements.

Visits from healthcare professionals such as GPs and community-based nurses and allied healthcare professionals were kept to a minimum. People's health care needs were being met because the registered manager used telephone calls and emails to share information and gain advice. All 10 people had received their first dose of COVID-19 vaccination and 15 of the 18 staff team had as well.

Staff socially distanced from their workmates and people as much as they were able. When they were delivering personal care, they wore their face masks and a plastic apron. The home had two reception rooms but not every person used these communal areas, preferring to remain in their own bedroom. The people who liked to spend their day in the lounge were well spaced apart.

The care team continued to support people with activities of their choosing. Some people preferred to remain in their own bedroom whilst others just liked to watch the television or use the garden to have a cigarette. There was evidence of recent arts and crafts work displayed regarding 'stay home, stay safe'.

At the time of this inspection the home had three vacant rooms and were admitting one person later in the day. The registered manager told us they were being admitted from their own home where they lived alone, they had a negative COVID-19 result and were to be isolated in their bedroom for a 14-day period. When one person had previously had a hospital stay, they had not been accepted back into Granada House until a negative result was received, and they were then isolated. The registered manager said if there was an outbreak of COVID-19 in their home, people would have to be isolated in their rooms. The premises are not such that an area could be zoned off to look after infected people.

We looked around the home. All areas of the home were clean, tidy and homely. The service employed one cleaner, but care staff also covered cleaning shifts. Extra hours have been allocated each month to ensure communal areas had a really thorough deep-clean. The registered manager has put together a cleaning checklist for each person's bedroom. Extra touchpoint cleaning (door handles, furniture and toilets/bathrooms) was carried out twice during the day, and again by the night staff. The registered manager and senior care staff monitored work practice and completed competency assessment forms, checking on staff compliance with wearing PPE and the cleanliness of all areas of the home.

The service had plentiful supplies of PPE. Face shields and arm covers were available should the need arise. We saw this being used correctly.

Infection prevention and control training was part of the provider's mandatory training programme, but extra training had been delivered. All staff had received instruction on how to complete the LFT device training as they tested themselves at home. They had also received hand hygiene and donning and doffing of PPE training. The registered manager and the senior care assistant had received training from a specialist regarding the use of PPE and then had cascaded this to the staff team.

The provider had updated their infection prevention and control policies; these were in line with Public Health England, CQC and the Department of Health and Social Care. They had a business contingency plan and a staff sickness contingency plan. The registered manager had regular contact with the local authority COVID team and was in constant contact with the provider who did not live locally.

The five questions we ask about services and what we found