Keeping care home residents safe

Case study summary

Key learnings from a nurse-led COVID-safe and COVID-free care home environment:

  • Building the capacity of the core nursing and support team has been vital to resident outcomes and staff wellbeing.
  • Training and support to develop skills across the nursing and support teams has underpinned the resilience of care in the home, taking pressure off community services and reducing admissions.
  • Leadership and support for the team to deliver the highest standard of care.

Background to learning

Mais House is a small care home in coastal Bexhill for residents with a military service connection. This case study explores how the homes nursing team maintained a COVID-safe and COVID-free environment for all staff, residents and visiting family members throughout the first wave of the pandemic – despite community rates of COVID-19 staying high within its local area during this time.

Learning and advice to be shared

Throughout the pandemic infection prevention and control measures have been vital to the approach to care. The Mais House nursing team proactively implemented PPE guidance, including testing staff daily and residents weekly and ‘cohorting’ staff and residents into ‘Mais ready’ teams.

To minimise transmission, the team worked hard to recruit and maintain additional staffing capacity. By recruiting and retaining new starters locally, the home was able to build resilience and avoid reliance on temporary staff.  These additional staff members ensured that there was a strong core workforce providing the best of care to home residents. The balance of registered nurses and support staff underpinned staff wellbeing and enabled the home to remain COVID-19- free and secure throughout both the first and second wave of the pandemic.

This strong core workforce also enabled nursing teams and colleagues to innovate, developing new ways of working to care for residents and to further build resilience. Across the team, new skills, protocols and systems were developed in partnership with wider community teams. This allowed the home to provide key services in-house and strengthened the knowledge and skills of the home’s staff in long term condition management.

The team succeeded in ensuring the continuation of training to build the skills of existing staff whilst simultaneously ensuring training for new colleagues to deliver in their new roles. Examples of this are:

  • adding diabetes education and training for the nursing team and diabetes and blood pressure training for health care assistants.
  • supporting residents who might otherwise not be comfortable accessing routine primary care, for example, providing anti-coagulation training amongst nursing staff (contributing to reduction of resident hospital visits by 90%).
  • working in partnership with local specialist teams and developing the skill set around continence care for example training and support for the care team to use the home’s new bladder scanning equipment.

All the team at Mais house are proud – during a pandemic – to have maintained everyday care whilst strengthening and developing their skills across a range of conditions to expand the care offered in the home. These advanced and strengthened skill sets make the home more resilient, takes pressure off community services and reduce admissions. For example, the team has been able to manage care for residents nearing the end of their life and avoid hospital admissions over the last 12 months.

Would it be beneficial to retain this change?

The proactive, coordinated and collaborative new ways of working adopted by Mais House continues to support them with their aims to keep the home COVID free whilst also ensuring the best possible outcomes for their residents. Nursing teams view these new ways of working positively. The team have felt secure with the adoption of new skills/equipment during the pandemic and have felt confident as part of a multidisciplinary team with community nurses, specialist services and primary care colleagues.

As community care is built-up through the long-term plan there are increasing opportunities to work across boundaries to support complex care already being delivered by nurses in care homes.

The case study is by Susan Barnes, Registered Nursing and Care Manager, The Royal British Legion Mais House Bexhill-On-Sea.  To find out more or to connect with Susan, email england.1professionalvoice@nhs.net