How a care home team made family visits possible despite pandemic

An award-winning care home team's innovations during the pandemic, including family visits with physical touching, laid the foundations for government guidance

• Success of meaningful visits team at Greenock Medical Aid Society care homes was recognised and replicated by others
• Team made sure care home residents could still have family visits – including physical touching – during the pandemic
• Data show improvements in overall well-being of residents and family members

A team who made it possible for care home residents to still have family visits – including physical touching – during the pandemic has been lauded for its achievements.

The meaningful visits team at Greenock Medical Aid Society care homes won the Nursing Older People Award at the RCN Nursing Awards 2021.

‘Holding someone’s hand is so important,’ says care home chief executive Andrea Wyllie. ‘Especially for someone with advanced dementia, it keeps people calm. Families and loved ones need to connect.’

The awards judges praised the team’s creative and innovative approach at a time when many care homes had a policy of no physical contact for visits.

‘The guidance from the government restricting visiting was trying to keep people safe, but as time went on we could see it was harming the people living in our care homes’

Andrea Wyllie, Greenock Medical Aid Society care homes chief executive

During the first COVID-19 lockdown in 2020, Ms Wyllie drew up plans for a pilot scheme on visiting using COVID-19 PCR testing and devised comprehensive risk assessments and protocols.

Its success was recognised and widely replicated by other care homes.

• RELATED: RCN Nurse Awards Winners

Enabling people to have actual contact with loved ones was the driving force behind this project, says Ms Wyllie.

‘The guidance from the government restricting visiting was trying to keep people safe, but as time went on we could see it was harming the people living in our care homes and also those who loved them.

Care home team discussed how to achieve meaningful visits involving touch

‘We were unable to give them their best life with those who mattered the most to them. Our staff cared and showed ongoing compassion but it could not be a substitute for the love of families and friends.

• RELATED: Care homes: could nurses in advanced clinical practitioner roles be key to change?

‘There used to be a session on the impact and importance of therapeutic touch during nurse training and it has never left me. Yet we had people sitting outside at a distance with the doors open talking to their friend of 70 years, or wife of decades, and it was awful. With a robust system I knew we could do something more.’

The team discussed how they could achieve meaningful visits involving touch, adopting as their motto ‘balancing rights with risk’. Ms Wyllie worked with the local health and social care partnership and drew up protocols and risk assessments.

• RELATED: COVID-19 one year on: how nurses rose to the challenge, whatever their setting

She credits the Queen’s Nurses programme run by the Queen’s Nursing Institute Scotland for giving her the confidence to keep pushing to be allowed to pilot the visits.

Having reintroduced visits in November, the team were disappointed when a further lockdown was announced for Boxing Day in 2020. They worked extra shifts to ensure every resident had a meaningful visit before it came into place and lobbied the government to allow indoor visiting as soon as possible.

The team’s data show improvements in the overall well-being of residents and family members and even an increase in the appetites of residents.

‘We saw a significant decrease in those at risk of malnutrition,’ says Ms Wyllie. ‘We saw moods lift and a feeling of life and buzz return to our care homes.

‘We also demonstrated that we could balance the rights of residents and family members in being back together with the risks that increasing footfall could bring.’

Awards judges impressed by team’s commitment to holistic care of residents

By showing how it could be done safely and successfully, the team encouraged other providers to open up and shared its risk assessments and protocols.

The RCN Nursing Awards judges were impressed by the team’s commitment to the holistic care of residents and how their brave but evidence-led approach laid the foundations for the Scottish Government’s Opening with Care guidance and paved the way for all care homes in Scotland to reintroduce meaningful indoor visits.

Chair of judges Joanne Bosanquet, who is chief executive of the Foundation of Nursing Studies, called Ms Wyllie ‘a force of nature’.

‘She overcame political and organisational challenges to maintain visiting in a care home during the pandemic by using a rights and risks model. Andrea is a real advocate for her community.’

• RELATED: COVID-19: what can we learn from our care and treatment of older people during the pandemic?

How care homes across the UK are receiving visitors

Care homes across the UK are receiving visitors, generally through a booking system and with precautions in place, such as lateral flow testing on arrival and good hand hygiene.

In Scotland, lateral flow testing is in operation and physical distancing of one metre or more is recommended, although when visiting residents in their own rooms visitors may hug or kiss loved ones. Face coverings must be worn indoors

In England, care home residents are allowed ‘named visitors’ who can enter the care home for regular visits and must produce a negative COVID-19 test on the day of their visit. Government advice is that providers should consider how to limit close contact between people in enclosed spaces and support the use of face coverings in these circumstances

In Wales, as in other areas, a negative lateral flow test is required for entry into a care home and will be taken on arrival. Visitors must wear face coverings and abide by social distancing and hand hygiene requirements

In Northern Ireland there is a booking system for visitors and ‘brief hugging’ is allowed as part of the easing of restrictions on close physical contact. Lateral flow testing is optional, but recommended. Requirements remain in place for hand hygiene and face masks.

Elaine Cole is RCNi special projects editor