DHSC update on visiting arrangements in care homes

Topics covered: Anna Maria Lemmer, care homes, COVID-19, government, infection control

On 15 October 2020 the Department of Health and Social Care (‘DHSC’) published updated guidance in relation to visiting arrangements in care homes. The DHSC guidance, ‘Update on policies for visiting arrangements in care homes’ applies to care homes in England.

The DHSC states that care providers should follow the updated guidance to ensure that policies for visiting arrangements and decisions are based on a dynamic risk assessment and minimise risk wherever possible.

This requires consideration of:

  • the circumstances of the individual care home (for example, its employee availability, resident demographics and outbreak status)
  • its individual residents
  • its local circumstances (local epidemiological risk, presence of outbreaks in the community)

COVID Alert Level system

The updated guidance takes into account the new local COVID Alert Level system. For local areas with a high local COVID alert level (high risk or very high risk, Tier 2 and Tier 3), the guidance states that visiting should be limited to exceptional circumstances only such as end of life.

The guidance applies fully to areas with a medium local COVID alert level i.e Tier One. Where visiting is restricted due to the local COVID alert level and if, after an individual assessment of the resident’s circumstances, it is determined that in-person visitation is not appropriate, care homes should support visiting in a virtual manner.

The guidance states that for areas with a medium risk local COVID alert level (Tier 1), to limit risk, where visits to care homes do go ahead, this should be limited to a single constant visitor, per resident, wherever possible. There should be an absolute maximum of 2 constant visitors per resident (taking into account individual residents’ circumstances). This is in order to limit the overall numbers of visitors to the care home and the consequent risk of disease transmission.


Throughout the pandemic, Government guidance has changed rapidly and it is likely that the DHSC guidance on care home visiting arrangements will continue to be amended and updated to take into account local COVID alert levels.

It would be helpful if providers designate one person to be responsible for keeping up with the latest guidance, considering how to apply it to their service, updating policies and procedures in light of the guidance and communicating the updates to staff on the ground. A detailed log indicating the title of the guidance, date of publication and a summary of the main points would also be helpful.

A copy of the DHSC ‘Update on policies for visiting arrangements in care homes’ can be accessed here.



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