New guidance on visiting arrangements in Care Homes

The Department of Health and Social Care has published new guidance on visiting arrangements in care homes.

The guidance sets out:

  • the principles of a local approach and dynamic risk assessment
  • advice for providers when establishing their visiting policy
  • advice for providers when taking visiting decisions for particular residents or groups of residents
  • infection control precautions
  • advice regarding communicating with family and others about the visiting policy and visiting decisions

Guidance for supported living settings is in development, and guidance for visits out of a care home, for example to a family home, is being considered and an update from the Government is expected soon.

Providers’ visiting policy

Providers will need to pay close attention to this guidance when producing visiting policies. Furthermore, the guidance is set to be updated soon to factor in supported living settings and visits out of a care home, for example to a family home.

First and foremost the visiting policy should allow only one designated visitor per resident who is able to make repeat visits. That means, in accordance with the guidance, different members of the same families will not be able to pay visits even at different times. It is said that this is to limit the overall number of visitors to the care home and the consequent risk of infection.

Among other recommendations, according to the guidance:

  • Visitors will not be allowed to enter residents’ rooms unless they are dying, but will be able to visit in designated areas of a home such as a conservatory or in gardens.
  • Providers should consider putting in place practical measures to mitigate any risks arising from visits, such as visits in communal gardens, window visits and/or drive-through visits
  • Providers should encourage all visitors to wear a face covering and to wash their hands thoroughly before and after putting it on and taking it off.
  • Visitors should also wear appropriate further PPE depending on the need of their visit, including gloves and aprons.
  • Providers should have an arrangement to enable bookings or appointments for visitors – ad hoc visits should not be permitted.
  • Providers are encouraged to support NHS Test and Trace by keeping a temporary record, including address and phone number, of current and previous residents, staff and visitors as well as keeping track of visitor numbers and staff.

The guidance reminds Providers to consider the legal, decision-making framework offered by the Mental Capacity Act 2005(MCA), individually for each of these residents, providing links to Government published advice on caring for residents without relevant mental capacity, and on the MCA and Deprivation of Liberty Safeguards (DoLS), during the pandemic.

The care home’s visiting policy should be made available and/or communicated to residents and families, together with any necessary variations to arrangements due to external events. Local Directors of Public Health will lead assessments on visiting within their local authority. They will be expected to take a measured, risk-assessed approach, considering the situation in specific care homes as well as the community context, including any local outbreaks. Public Health Officials will also have the power to stop visits at short notice if there are concerns they are high risk.

The sector’s response

The Care Provider Alliance (CPA) welcomes this “overdue guidance”. The CPA has highlighted that it has been calling for Government guidance for many weeks and released its own visitors protocol last month in its absence.

Vic Rayner, Executive Director of the National Care Forum also commented on the delay in the publication of this guidance stating that, “The Secretary of State for Health and Social Care promised in early July that the government would publish guidance on reopening care homes to families and friends within a matter of days”. She emphasises that the delay has caused “unnecessary anguish to many”.

“Safety is paramount, but it is also absolutely true that people need people, and as we reopen homes to visitors, we must make sure that we put in place all the measures needed for now and the future, so that we never again get into the position where families and friends are kept apart.”

Professor Martin Green OBE, Chief Executive of Care England, says: “This guidance should have been with care providers last month. We are at a loss to understand why the Department of Health and Social Care cannot act quickly in a crisis or why it is deaf to the comments and input from the sector”.

“…we need to look beyond outdoor visits and recognise that these new conditions may be with us for quite some time. The failure to acknowledge this nuance underscores the lack of governmental understanding of the complexities present within the adult social care sector”.

Care England is concerned that the guidance does not address a range of issues including:

  • Visits out of a care home
  • Supported living
  • Insufficient information about Local Outbreak Boards
  • Volunteers
  • Support staff ratios
  • Information around how a dynamic risk assessment may affect the frequency of visits.

To read the full guidance and keep up to date on future updates visit https://www.gov.uk/government/publications/visiting-care-homes-during-coronavirus.