Clinical update

Guidance on visiting care homes during COVID-19

DHSC guidance states that providers should enable indoor visits where the visitor has been tested and is negative, along with outdoor and screened visits

DHSC guidance states that providers should enable indoor visits where the visitor has been tested and is negative, along with outdoor and screened visits

Essential information

Allowing visits to care homes is important in maintaining the health, well-being and quality of life of residents, but inevitably it brings a risk of infection with COVID-19. At various points during the pandemic care homes have been closed to all outside visitors, often for lengthy periods.

Across the UK, around 420,000 people live in care homes, according to figures published in 2017 by the National Care Forum.

What’s new?

The Department

DHSC guidance states that providers should enable indoor visits where the visitor has been tested and is negative, along with outdoor and screened visits

Robust infection prevention and control procedures are crucial during care home visits.
Robust infection prevention and control procedures are crucial during care home visits.
Picture: iStock

Essential information

Allowing visits to care homes is important in maintaining the health, well-being and quality of life of residents, but inevitably it brings a risk of infection with COVID-19. At various points during the pandemic care homes have been closed to all outside visitors, often for lengthy periods.

Across the UK, around 420,000 people live in care homes, according to figures published in 2017 by the National Care Forum.

What’s new?

The Department of Health and Social Care has published new guidance on visiting care homes during COVID-19 in England.

This says that regardless of which tier the care home is in – unless there is an active COVID-19 outbreak – providers should enable all indoor visits where the visitor has been tested and is negative, alongside outdoor and screened visits.

In addition, visits in exceptional circumstances, including end of life, should always be enabled.

Key recommendations

The guidance looks in detail at developing a policy for visiting a care home and ensuring safe visiting.

Each care home is responsible for setting its own visiting policy, on the basis of a dynamic risk assessment that takes into account the needs of individual residents and the advice of the local director of public health, the document states.

Visits should be booked in advance rather than take place ad hoc. Every visitor must return a negative test before each visit, but they should also be made aware that testing does not completely remove the risk of infection associated with visiting.

Robust infection prevention and control procedures are crucial, ensuring visitors follow social distancing, practise hand hygiene and wear personal protective equipment (PPE).

Lateral flow devices are being provided for COVID-19 testing, with care homes registered by the Care Quality Commission receiving enough to test two visitors for each resident twice a week. Results should be available quickly, allowing visitors to take a test on arrival.

Care home managers can set up their own testing areas with clinical guidance. They should have enough space to allow visitors to maintain social distancing before, during and after the test, including a waiting area and a one-way system.

Outdoor and screened visits can be made available to visitors who have not been tested, allowing the opportunity for more visitors and greater frequency.

How you can help your patient

Nursing staff can communicate the requirements of the new guidance to visitors, explain its purpose and ensure they understand the risks and their role in managing them, with the aim of keeping loved ones safe.

Staff should also clearly explain what is expected of visitors in terms of social distancing, hand hygiene, PPE, physical contact and what happens in the event of a positive test.

Visitors can be given tips on how to prepare for their visit, including how to communicate while wearing a face covering.

Expert comment

Liz Jones, policy director at the National Care ForumLiz Jones is policy director at the National Care Forum

‘In the previous tiers before the recent lockdown, lots of the guidance was very restrictive and did not recognise the risk of harm from residents’ continued isolation.

‘The National Care Forum has been supporting the call for more visiting, with a statement signed in November by a coalition of organisations and individuals, brought together by the forum.

‘We feel it’s positive that the government has moved from its original position, with a default that enables visiting. The commitment to rapid testing for visitors is also a good thing.

‘Care homes will be pleased about this combination of a change of approach plus extra testing tools. But the elephant in the room is the resources involved in administering the tests, including the amount of extra time it will take.

‘There is also a lack of clarity about a care home’s responsibilities towards any visitors who test positive.’


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