What is the current guidance on visiting care homes?
The government’s guidance on visiting care homes changed on 17 May 2021. Allowing visitors into care homes is crucial for maintaining the quality of life of residents and also allowing family and friends to maintain contact with their loved ones. Welcoming visitors back into care homes will inevitably bring with it the risk of COVID-19 transmission. However, these risks should be balanced against the importance of visiting for care home residents and their families.
It is not a pre-condition that individuals or residents should be vaccinated before visits take place, however it is recommended that all visitors and residents should take up the opportunity to be vaccinated when they are invited to do so.
General visiting guidance
Every care home resident can nominate up to 5 named visitors who will be able to enter the care home for regular visits. These individuals can visit together or separately as preferred, and excludes babies and preschool-aged children so long as this does not breach national restrictions on indoor gatherings. Residents can have no more than 2 visitors at a time or over the course of one day.
The care home will ask each resident who they would like their named visitors to be. However, if the resident lacks the capacity to decide who they would like their named visitors to be, the care home will speak with their family and friends so they can decide what to do between them.
The named visitors should be tested using rapid lateral flow tests on the day of every visit and produce a negative COVID-19 test prior to their visit. Visitors will need to wear a surgical mask for the duration of these visits. The care home may also provide other items of PPE, such as disposable gloves or a plastic apron. Visitors should also bear in mind that any physical contact such as hugging or holding hands should be avoided and social distancing maintained when walking through the home.
Essential care giver
Residents with higher care needs can choose to nominate an essential care giver who may visit the home to attend to essential care needs. This is because some residents may have needs that cannot easily be provided by care home staff. Therefore, the government is advising that care homes should offer the essential care giver scheme, however it will not be necessary for everyone.
Essential care givers will be included in the total of 5 named visitors, but are excluded from the 2-person limit per day and will be able to visit more often to provide essential care. Essential care givers will be subject to the same testing and PPE arrangements as care home staff.
Many residents will have other people who would like to visit outside of their 5 named visitors. These visits will have to occur in a different way, and can take place outdoors, including at a window. Additional family or friends can also visit residents in special ‘visiting pods’ if the care home has one, or in a room with a screen between themselves and the resident.
The guidance also includes ways visitors can help to reduce the risk of transmission during a visit. This includes washing hands frequently, avoiding public transport if possible and reducing contact with other people by not socialising, in order to minimise the risk of unknowingly picking up the virus. Most importantly, visitors must remember to observe social distancing at all times and use whatever PPE the care home requires.
In the event of an outbreak, all movements in and out of the care home should be minimised as far as possible and limited to exceptional circumstances only, such as to visit a friend or a relative at the end of their life. These restrictions should continue until the outbreak is confirmed as over, which will be at least 14 days after the last case was identified in a resident or member of staff in the home.
The starting point in the government’s guidance is that visiting must be supported wherever and whenever it is possible and safe to do so. However, sometimes there will be good reasons, such as an outbreak of COVID-19 in the care home, as to why the home cannot offer the visiting that individuals would like. If an individual believes the care home is not following visiting guidance, they should raise the matter with the care home. If this is not satisfactory, an individual can also contact the Care Quality Commission (CQC), who are responsible for inspecting the safety and quality of care provided in care homes, and they will consider if they need to investigate.
The guidance for supported living was updated on 22 April 2021, and once again recognises that maintaining opportunities for visiting and spending time together is critical for the health and wellbeing of people being supported. In addition, for many people, there are important reasons for having in-person visits, as not doing so may be difficult to understand and lead to distress.
Individuals living in supported living settings live in their own homes and therefore they should be treated as such. This means they, and their visitors, need to follow the same national restrictions as other members of the public, including following each step in the government’s roadmap around social contact. The roadmap does provide some flexibilities which may apply to people in certain supported living, such as exemptions for some indoor gatherings and in relation to forming support bubbles.
In relation to those with impaired decision-making capacity, any visiting arrangements should be made in agreement with the person being supported. If an individual is assessed as not having capacity in relation to this decision, the provider should work within the appropriate MCA framework to establish whether the arrangements are in the person’s best interests.