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Joanne Strain: Care homes should only restrict family visits as a last resort

We work in the residents' home, they don't live in our workplace, says the head of nursing at Four Seasons Health Care.
Joanne Strain

Unjustified banning of relatives who complain is rare, says the head of nursing at Four Seasons Health Care

Recent media reports have highlighted instances in which care homes have banned relatives who complained about the quality of care their loved one received. The controversy broke at the beginning of November after the BBCs Victoria Derbyshire show reported that a Somerset care home had prevented a man from visiting his 93-year-old father.

The Care Quality Commission (CQC) has announced that it will publish guidelines to clarify visitor and family rights in relation to care homes. This guidance will set standards regarding how family members can express concerns.

Care homes should always recognise and value relationships with residents families. At Four Seasons Health Care our ethos has always been that care staff work

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Unjustified ‘banning’ of relatives who complain is rare, says the head of nursing at Four Seasons Health Care

Recent media reports have highlighted instances in which care homes have ‘banned’ relatives who complained about the quality of care their loved one received. The controversy broke at the beginning of November after the BBC’s Victoria Derbyshire show reported that a Somerset care home had prevented a man from visiting his 93-year-old father.


Care homes should recognise and value relationships with residents’ families. Picture: iStock

The Care Quality Commission (CQC) has announced that it will publish guidelines to clarify visitor and family rights in relation to care homes. This guidance will set standards regarding how family members can express concerns.

Care homes should always recognise and value relationships with residents’ families. At Four Seasons Health Care our ethos has always been that care staff work in the residents’ home, not that the residents live in our workplace. 

Shared goals

A key component of this vision in practice is recognising that the experience of each resident is unique. It is our residents and their family members that are the true experts in their care, and only through collaboration, shared decision-making and mutual goal setting can our residents flourish and live well.

An important, but often overlooked, aspect of this ethos is feedback from residents and relatives, either praising a service or providing constructive criticism, sometimes in the form of a complaint. Both processes are equally important: praise gives care home staff confidence that they are doing a good job; complaints help to improve the service and should be listened to and acted on.

We have developed a system that captures live feedback via tablet computers, which can be used by residents, relatives and visiting professionals. This system gives us visibility across the organisation and allows us to respond to feedback quickly.

Complex decisions

Any decision that leads to a relative being ‘banned’ from seeing their family member in a care home should be made with multi-agency involvement. This is because, aside from the potential to violate human rights and breach a model of relationship-centred care, such a decision can cause life-altering distress. 

There are rare occasions when it may be appropriate for care homes to impose supervised visiting or visiting sanctions. The rationale for such a decision might relate to safeguarding for the resident. This should be a last resort and only in response to complex issues that have been discussed and agreed with multidisciplinary team members.

I welcome CQC involvement in the matter and think greater visibility of these issues is extremely timely. But I strongly caution against the perception that it is common practice for care homes to routinely ban relatives of residents who complain.

From my 20 years of working in care homes and alongside colleagues across hundreds of care homes in the UK, I know this simply isn’t the case.

About the author

 Joanne Strain is head of nursing at Four Seasons Health Care

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