Initiative boosts cleanliness and safety for residents

A team of nurses who created tools that help the independent care sector prevent infections and reduce hospital admissions has been named runner up in the infection prevention category of the Nursing Standard Nurse Awards 2015

A team of nurses who created tools that help the independent care sector prevent infections and reduce hospital admissions has been named runner up in the infection prevention category of the Nursing Standard Nurse Awards 2015.

Check to Protect, which enhances the skills and knowledge of staff in care homes, has been taken up by almost half the 300 adult social care providers in Shropshire.

Infection prevention and control lead nurse for Shropshire, Telford and Wrekin clinical commissioning groups (CCGs) Tanya Kidson explains: ‘There are lots of supportive initiatives and tools around for NHS organisations to monitor practices and maintain consistency, but not so much for the independent care sector – which still has to meet Care Quality Commission (CQC) requirements.’

Infection prevention and control lead nurse Tanya Kidson (right) and colleague Jill Hassall using their Check to Protect tool with staff at Alexandra House Residential Home, Ludlow. Picture credit: Neil O’Connor


Ms Kidson and her colleague Jill Hassall examined how the infection prevention and control team could work with nursing and residential homes to ensure that residents and clients enjoyed the best care and that providers met commissioning and CQC requirements.

Development and piloting

‘The tools provide the sector with a means to evidence that every resident/client is receiving the right care, at the right time in a safe environment,’ says Ms Kidson.

It was important to develop tools that the sector was happy to use, she explains, so they invited infection prevention and control link nurses from across Shropshire and Telford to come together and participate in working groups to develop ‘useful’ resources.

The information gathered, coupled with the nurses’ specialist knowledge, enabled the team to produce a set of assessment tools built around priority areas. They include hand hygiene, oral hygiene, waste disposal, enteral feeding and equipment cleaning.


As each tool was developed, volunteers from the working group piloted them for six to eight weeks in their work area. Feedback was also obtained from service managers, staff and residents/clients, with the results taken on board and the tools refined.

Assessor prompts are provided for each of the tools to ensure assessments are consistent, so Ms Kidson’s team delivered training sessions for designated staff. ‘We spend time in the home to help skill those who will carry it forward,’ she says.

They promoted the tools further through the infection prevention and control link nurse group and visits to care homes. ‘Using the infection prevention and control link nurses has been a tremendous success,’ says Ms Kidson. ‘We can’t get to over 300 providers so we rely on them to act as a resource and role model in the area. We have an active link nurse group which meets regularly in various locations across the county.’

Raising awareness

The team also worked closely with Shropshire Partners in Care, a not-for-profit member organisation for the independent care sector, to promote and raise awareness of the initiative.

The input of the sector has been vital to the initiative’s success. ‘It has been invaluable in creating a sense of ownership which in turn has encouraged take up by providers – almost half of care homes have implemented it,’ says Ms Kidson.

The Check to Protect tools have been used for the past three years at Alexander House in Ludlow, a 22-bed residential care home for people aged over 80. Its residents are people with dementia, physical disabilities and sensory and visual impairment.


Manager Sue Grehan says: ‘All the Check to Protect tools are user-friendly and easy for employees to understand. Implementing them has improved the standard of infection control within the home and staff are also more vigilant in spotting any infection issues so that they can be addressed.’

Countywide, the tools have also been credited with helping to reduce the length of diarrhoea and vomiting outbreaks as a result of norovirus. A review of all diarrhoea and vomiting outbreaks reported to date in 2014/15 has found that most have been contained within a period of eight days compared with 15 in previous years.

They have also helped cut hospital admissions when norovirus has been circulating in the community. To date in 2014/15 no residents from care homes have been admitted to hospital due to diarrhoea and vomiting, dehydration or associated urinary tract infections.

Infection control

Chief nurse of Shropshire CCG Linda Izquierdo says: ‘Care homes in the independent sector are responsible for some of the most vulnerable people in society. It is vitally important staff practise infection prevention and control procedures to the highest standard. Any shortfall can lead to hospital admission and subsequently affect NHS services.

‘Check to Protect has taken a partnership approach to clinical and care processes to improve cleanliness and safety for patients in the independent sector. Early signs are promising, and are a credit to Tanya and the team’s hard work and enthusiasm.’

The judges were also impressed. They praised the widespread effect of Check to Protect and Ms Kidson’s leadership.

Building blocks

Chief nurse at North Hampshire CCG Jan Baptiste-Grant says: ‘The building blocks laid by Check to Protect bode well for the future – the initiative has strengthened the relationship between Ms Kidson’s team and the independent care sector.

‘Creating an environment in which independent sector nurses could have their voices heard has built trust and confidence,’ says Ms Kidson. ‘That trust has created something special in Shropshire and the sector’s enthusiasm for this has been truly inspirational.’

Elaine Cole is deputy editor, Nursing Standard



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