Chiltern Grange Care Home

Chiltern Grange Care Home can accommodate 75 people across three separate floors, each of which have separate adapted facilities. One of the floors specialises in providing care to people living with dementia. At the time of the inspection there were 54 people living in the home.

We found the following examples of good practice.

Visitors had their temperature taken and were asked about their health to identify signs of infection. On arrival, there was clear signage and visitors were encouraged to wash their hands and wear appropriate personal protective equipment (PPE). During periods when local and national guidance permitted visiting, relatives used an electronic system to book visiting slots. We observed safe arrangements for visits, including the use of substantial screens between the resident and visitors, designed to reduce the risk of viral transmission.

The home was registered to regularly test staff and people using the service for COVID-19 infection. Some people using the service could not consent to COVID-19 swab testing. Where staff believed a person was unable to give informed consent, the service had undertaken a mental capacity assessment and recorded best interests decision making.

Safe admission processes were in place when people arrived from the community or a hospital setting. This included testing for COVID-19 and a period of isolation on arrival, to minimise the risk to existing residents.

The service had a detailed infection control policy and a business continuity plan in place. Audits took place to monitor infection prevention and control across the service. The home environment was kept in a clean and hygienic condition throughout. During our site visit, we observed regular cleaning taking place. This included the frequent sanitisation of areas which could pose a higher risk of cross infection, such as door handles and surfaces.

We observed staff wearing appropriate PPE, and found the home had a good stock of face masks, aprons, gloves and eye protection. PPE stock levels were closely monitored. Staff had received training in infection prevention and control, including regular demonstrations in the correct use of PPE. We identified where improvements could be made to PPE donning and doffing areas, to ensure all areas included hand sanitiser, apron dispensers and appropriate signage. The service responded to our feedback immediately to confirm they had taken appropriate action.

The home had experienced a recent outbreak of COVID-19 infection and was required to isolate individuals

with suspected symptoms of infection. This presented challenges, as some people living with dementia were independently mobile and required close supervision to prevent them from having contact with people who did not have symptoms. The service had already reflected on their response to the outbreak and shared a detailed action plan following our site visit. This demonstrated how future outbreaks could be effectively managed, including improved isolation protocols and the safe management of waste.

The five questions we ask about services and what we found