Designed and managed to stop the spread of infection

Like care homes all over the country, Cramond Residence has had to do its bit in the last few months to battle the challenge of the Coronavirus.

“Cramond Residence has experienced very low levels of Covid-19 infection since March,” says Director, Graeme Kelly,” but crucially it has demonstrated that professional infection control and prevention procedures have allowed infections to be contained and eradicated. Experienced management, extensive training, the building design and our small group living philosophy have all played their part and continue to do so.”

Graeme is proud to report that Cramond Residence recently got a very positive outcome from a thorough inspection that was carried out by infection control and prevention specialists from Edinburgh Health & Social Care Partnership/NHS Lothian.

“The inspectors were encouraged by the systems the Residence has in place, by our staff infection prevention training and by our staffs’ understanding and ability to demonstrate knowledge of this vital issue,” says Graeme, who adds that, “throughout this pandemic, we have felt well supported and guided by Health Protection Scotland.”

To highlight everything that Cramond Residence has in place to keep its residents as safe as possible from Covid-19 and other infections, the Residence is putting a special section on its website. This highlights the following key ways in which the Residence is designed and managed to keep infections at bay:

Small group living limits transmission

Large communal areas that are shared by all residents can lead to the fast spread of infection throughout a care home. Cramond’s design helps to solve this problem. The residence is based on nine individual homes on three storeys (most comprising just 8 bedrooms), with each home having its own private lounge, dining and snug facilities. This approach – which is known as small group living – allows residents to be cared for in small groups (using self-contained facilities) and significantly reduces the potential for infections to spread. Of course, when government guidelines have required it, we have imposed full isolation, asking residents to remain in their own bedrooms.’

Resident care focused on safety

During the Coronavirus pandemic, Cramond Residence implemented all government advice on testing and keeping residents apart from each other. And, as friends and relatives of the residence will know, the residence restricted access to essential visits only, allowing relatives to come to the residence only for the most urgent reasons and implementing strict social distancing and PPE protocols at all times. At the same time, Cramond Residence was able to keep residents in touch with their loved ones using skype and other video links. Moving forward, the Residence is abiding by all current guidance and restrictions on visiting.

En-suites help enhance infection prevention

All bedrooms in Cramond Residence are en-suite shower rooms. This removes the need for residents to share bathing and toilet facilities and makes personal infection prevention targets that much easier to achieve.

Staff cohorting reduces infection risk

Cramond Residence’s commitment to the small group living philosophy does not stop with the residents, but also extends to the staffing structure. As a result, in periods of heightened infection risk, the residence’s care and services teams adopt a system known as cohorting. This sees staff dedicated to just one of the Residence’s nine self-contained homes. This dramatically reduces the risk of infection being spread by staff movement.

1:4 care staff to resident ratio ensure excellent resource availability

Cramond Residence operates to a care staff to resident ratio of a least a minimum level of 1:4. This ensures that it has the resources to implement the highest level of infection prevention.

Negative-pressure ventilation removes germs

The Residence’s mechanical ventilation system creates a negative pressure, which means airborne germs/droplets are extracted from each bedroom (individual rooms have individual air supplies). This significantly reduces any risk of cross infection. This approach ensures there is no drift into circulation spaces thereby reducing any risk of cross infection.

Staff training and management ensures best practice

All staff are recruited and trained so that they have the expertise to comply with the strictest infection prevention measures, including patient hygiene and the use of PPE. This has meant that during the Coronavirus pandemic, all staff have followed the strictest possible hygiene, PPE and distancing protocols. This is not just true for care staff – Cramond Residence expects the highest standards from its catering and housekeeping services and its maintenance team too.

PPE and staff uniform kept on-site

One area where infection risk lurks is the incorrect use and management of personal protective equipment (PPE) and staff uniforms. For example, if staff travel to work in their uniforms they can bring in infections on the clothes. Cramond Residence follows best practice in this area and ensures that staff uniforms and shoes never leave the building. The residence provides staff with multiple uniforms which are always laundered on site in appliances that are designed to ensure that correct disinfection temperatures and wash cycles are used.

Careful planning at the heart of our approach

The management team at the residence carefully plans their response to infection and hold regular resilience meetings (currently three times a week) to ensure that they keep fully up-to-date with government guidelines, update their responses and adapt to meet each new development. Robust emergency plans have meant that, where necessary, the residence has reacted fast to isolate, test and treat any residents that showed any signs of having any infection. The Residence places a great emphasis on transparency and all relatives of residents are e-mailed regularly with updates on developments.