The Department of Health and Social Care (“DHSC”) has now published updated guidance on visiting arrangements for care homes. Understandably, this has been one of the toughest, most sensitive issues challenges created by the COVID-19 pandemic. For both residents and relatives, not being able to see one another due to the restrictions on visiting in care homes has been emotionally tough and has inevitably put a strain on the mental health and wellbeing of residents within care homes and their loved ones alike.
The DHSC has now published guidance stating that care providers should ensure that visiting arrangements and decisions are based on “a dynamic risk assessment and minimise risk wherever possible”. This requires consideration of the circumstances of an individual care home (i.e. employee availability/resident demographics/outbreak status) and its local circumstances (i.e. local epidemiological risk/presence of outbreaks in the community).
The guidance sets out five points for care homes in England, namely:
- The principles of a local approach and dynamic risk assessment – this includes following advice from the local director of public health and responding quickly when there is an outbreak in the home or local lockdowns are imposed.
- Advice for providers when establishing their visiting policy – this includes considering a number of factors when completing your risk assessment, such as limiting the numbers of visitors to a single constant visitor and ensuring sufficient infection control measures are in place.
- Advice for providers when taking visiting decisions for particular residents or groups of residents – where a care home’s visiting policy allows for different rules to be applied to different residents or categories of resident, then further visiting decisions will be needed. The policy should explain why there is a different approach applied to individuals or groups.
- Infection-control precautions – visiting policies should set out the precautions that will be taken with regards to infection control during visits. Providers must ensure that these are communicated in a clear and accessible way to residents and their families.
- Communicating with family and others about the visiting policy and visiting decisions – advice for residents and families should be set out in the visiting policy of the care home and shared with them.
The DHSC has said that “the process of considering visitors should be led by the relevant local director of public health, who should give a regular professional assessment of whether visiting is likely to be appropriate within their local authority, taking into account the wider risk environment.” The local director of public health will assess the suitability of visiting guidance for their area. This will take into account relevant infection and growth rates.
The visiting guidance is welcome as we start to move towards an easing of the lockdown restrictions and towards a “new post-COVID normal”. Providers, for some weeks now, had been anxious of the requirement to balance the mental health and wellbeing of their residents, particularly those living with dementia, alongside the consideration of infection control. The update to the rules is a positive step forward for reuniting residents and relatives who have spent many weeks apart.
However, despite the positives, the DHSC guidance is long, extensive, prescriptive (yet not exhaustive) and could very well lead to some uncertainties and grey areas. We have already seen situations which the guidance does not specifically address. This is not an easy time for providers, who are in the very difficult position of trying to balance the safety of their residents along with the need for contact between residents and relatives.
The guidance is based on local considerations and advice from local directors of public health so it is likely we will see some variations in visiting arrangements and what is permitted, around the country, to reflect local risks. The DHSC has stated that the guidance will be updated as the risks posed by coronavirus continues to change. The guidance states that stakeholders (healthcare professionals, family members, providers, volunteers etc) should ensure that they are regularly checking the most recent version of the guidance for any updates or changes.
If you require any assistance with drafting an updated visiting policy, assistance with understanding the updated guidance or dealing with any disputes which may arise, we can help. Please do not hesitate to contact one of our specialist healthcare solicitors at email@example.com or call 01202 786135.