The Grange Nursing Home

The Grange Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided.

We found the following examples of good practice.

• Visits were by appointment and staggered to minimise visitor numbers. A designated visiting pod had been purchased to enable socially distanced visits to take place. Marquees in the garden had also been utilised to support socially distanced visits for people. All visitors had to fill in a track and trace form, their temperature had to be taken and each were given a PPE pack that they had to wear. This included a visor, an apron, and a pair of gloves which they were required to put on immediately after washing their hands. • People had been consulted and involved in deciding how visits could best be supported. People had declined the option offered to turn one of their communal rooms into a dedicated visiting room and the provider had listened to this feedback. People told us how valued they felt to have been consulted and included in this decision making. • The provider utilised their 'family liaison officers' to facilitate alternative forms of maintaining social contact and to ensure people had access to meaningful engagement and activities, such as video calls and one-to-one activities.

• There was prominent signage and instructions to explain what people should do to ensure safety. Plastic or glass barriers were used to help prevent infection but did not restrict people's access and mobility. Where room sizes limited the ability for people to social distance, the provider had clearly identified maximum occupancy levels to support people safely when they were choosing which rooms to enter. • The provider had installed a handwashing facility outside their main entrance that all visitors, including staff, used on entering and leaving the home. In addition, an infectious waste bin had been provided at the front of the building for the correct disposal of all PPE by visitors. • Cleaning staff had cleaning schedules, which they were required to complete which included evidence that high touch areas were regularly cleaned. For example, light switches, keyboards, door handles and telephones. In addition, the provider had infested in a 'fogging' machine to enable regular effective deep cleaning within minimal impact on people. • The provider ensured that current guidance was shared in a timely way with the service. When the guidance was updated, the risk parameters were reviewed, and changes made. This reduced any potential risk of infection.

• Contingency plans were in place to manage ongoing or future outbreaks or other events effectively. The provider collected data and regular reports from the service. This information was analysed and used to inform future incident management and support learning. • The provider had upskilled and cross-trained staff in various roles to ensure adequate cover was provided in different roles should they have experienced any shortages of staff. • An overall risk assessment has been done to categorise the risks and which staff fall into which category. To individualise the risk, they have been graded from low to high using green, orange, and red colour coding. Each risk specified whom it affected more but if all staff were at risk it specified all staff. Each risk came with its own action plan on what the provider had done and what they could do to help minimise and prevent risks. The NHS guidance was used to help to categorise the risks. • The registered manager had arranged for a pharmacist to visit the service to offer all staff the opportunity to have the flu vaccination.

Further information is in the detailed findings below.

The five questions we ask about services and what we found