Care home visits to resume

Routine indoor visiting of care home residents by relatives, friends and carers will be able to resume from early March with care providers supporting residents to have up to two designated visitors each and one visit a week for each visitor.

With a wide range of protections now in place against COVID-19 for care home residents, it is has been decided meaningful contact should be made easier for the wellbeing of residents and their loved ones. The most recent of these protections is the COVID vaccine with more than 99.9% of older care home residents and 92% of staff now vaccinated with first dose. Additionally, the national picture of coronavirus outbreaks in care homes is improving.  NRS data shows that deaths from coronavirus in care homes have fallen by 62% in the last three weeks and the balance is now in favour of allowing contact to resume.

Guidelines to be published on Wednesday 24 February will support care providers to resume visiting for up to two designated visitors per resident. Every time someone goes into a care home it is a COVID  risk. But we are acutely conscious that continued restriction of contact for residents with relatives can contribute to  loneliness and isolation and worsening physical and mental health. With the range of protections in place against COVID, the bigger risk now is the continued separation of residents from loved ones.

Visitors will need to wear face coverings and any PPE requested by the care home, and are strongly encouraged to take a COVID test on-site. While visiting may sometimes still be restricted, for example in the event of an outbreak at a care home, the expectation will now be that homes will facilitate regular weekly contact as long as certain safety conditions are met. We will then work to continue to gradually increase the frequency and duration of contact.

Health Secretary Jeanne Freeman said: “The decisions regarding restrictions on visiting for care home residents have been some of the most difficult we have faced and I have the greatest sympathy for those who have been unable to see relatives and loved ones in person for so long.

“Care home staff have worked tirelessly throughout the pandemic to support continued contact between residents and their loved ones but these restrictions have been hugely challenging for them, as well as for care home staff and colleagues.

“We deeply regret the deaths and other harm caused by coronavirus in our care homes, but we also recognise the harm caused to the wellbeing of residents and families as a result of an inability to see those they love.

“We must remain vigilant about the risks but with multiple layers of protection now in place the balance is in favour of allowing visits.  Everyone, including visitors, has a responsibility to ensure that visits take place as safely as possible by continuing to follow safety advice.

“The additional protection in place includes infection prevention and control measures (IPC); personal protective equipment (PPE) in care homes and testing of staff and visiting professionals to care homes, which have developed processes and protocols for safer indoor visiting to take place.

“The guidance we are publishing sets out an expectation that providers will put in place arrangements to enable regular visits to resume from early March and from the discussions I have had with providers, I now expect all care homes to have embraced this guidance by mid-March.”

Cathie Russell of Care Home Relatives Scotland said: “We look forward to working with care home providers, public health and oversight teams to ensure that the new guidance allows residents to enjoy meaningful contact with their closest relatives and friends once more. It has been a very difficult year. The deepest ties of love are important and we can never thrive without them.”

Donald MacAskill, chief executive of Scottish Care, said: “The COVID pandemic has presented frontline care home staff and managers with many challenges but undoubtedly the hardest has been keeping residents apart from family and friends. 

“We have now reached a very different place and with a range of COVID-19 protections in place, including vaccination and testing, combined with the use of PPE and IPC, we are at a stage where we can re-introduce safer indoor visiting to Scotland’s care homes. This day has been long-awaited and we understand that it will be an emotional time for many. 

“Scottish Care is committed to supporting staff and managers, residents and family, to make sure that these guidelines succeed in their aim of reconnecting individuals.

"We commit to working together to overcome any challenges and difficulties we might face and to support those who may still be anxious and fearful, so that together we can ensure that a painful period of separation can be replaced by greater togetherness.” 

Gabe Docherty, on behalf of Scottish Directors of Public Health, said:

“There’s not been a day when these very human considerations haven’t weighed on the minds of my colleagues and I as we’ve endeavoured to safely negotiate all the challenges COVID has presented.

“It is always been the focus of Directors of Public Health to reinstate visiting as soon as there was evidence that the risks of doing so were greatly reduced. So I warmly welcome and wholeheartedly endorse the approach – and all that it means for care home residents, their families and  Care Home staff.”

Councillor Stuart Currie, Health and Social Care Spokesman for the Convention of Scottish Local Authorities, said: “Local Government welcomes the forthcoming guidance on resuming meaningful contact for care home residents and recognises the impact that restrictions have had on residents, their families and friends and care home staff. 

"This guidance supports all parts of the system to ensure that meaningful contact is undertaken safely with a number of safety and protection measures in place.“

Background:

Initially care homes will be asked to introduce to meaningful contact by supporting up to two designated visitors per resident, once per week.

Essential visits – in cases where there is distress, urgency or a need to prevent decline - should continue to be supported by all care homes compassionately and generously under this guidance.

Initially, children under the age of 16 should only be classed as a designated visitor for indoor contact under exceptional circumstance, however outdoor visits for children under 16 are still encouraged.

The nine levels of protection to mitigate the risks of resuming visiting are:

• Effective Infection Prevention Control in each care home as standard practice at all times
• Appropriate PPE and training on donning and doffing in a safe way and a safe place
• Testing for all residents entering or returning to a care home
• Three times weekly testing for all staff
• Testing for all professional and other staff entering a care home
• Testing for family visitors
• PPE for family visitors
• Vaccination of residents and staff
• Public health and primary care support and guidance if symptoms or  a positive case develops in a resident or staff member

COVID in care homes

NRS figures, show a 62% reduction in the number of COVID deaths which have taken place in care homes in the last three weeks. The proportion of COVID deaths taking place in care homes, fell from 34% at the start of the year, to 14% last week. Care homes now account for a smaller proportion of COVID deaths last week, than at any time since March of last year.

The Scottish Government has extended financial and practical support for the provision of personal protective equipment and care home testing until June 2021 and this is regularly reviewed. Scottish Government also provides financial support to care homes through the sustainability fund for adult social care providers, for reasonable staff and non-staff costs to support safe visiting, as well as additional training and support on infection prevention control as well as the appropriate use of PPE and of testing.