Anne's Law and Health and Social Care Standards consultations: analysis of the responses

Appendix 2: Summary of consultation events: delivering Anne's Law

Introduction

Five workshop events were held with people living in adult care homes, staff and providers to consider the proposals under Part 2 of the Anne's Law consultation in October 2021. Overall, 81 people participated in these events. The events have been recorded in note form so it is not possible to attribute different perspectives to different categories of participants but there is broad agreement across the events about the urgent need for Anne's Law. At the same time, as this is a summary of the notes taken by the Scottish Government, it is difficult to attribute weights to the views expressed. However, many of these views chime with the views stemming from the written consultation.

The structure of the events varied, but in the main considered the following issues:

• What difference should Anne's Law make?
• Who should it be for and what setting?
• Who should have the right to choose?
• How should it be enforced?
• Other comments and considerations

The implications of the lockdown and lessons for the future

There was universal agreement amongst all the events that the impact of the lockdown on residents was immense and that there is a clear and overwhelming need to treat residents as individuals. There was a strong view that people's human rights had been violated and had caused physical and emotional harm and distress. There was also a strong sense that care homes should not have the power "to lock people out" and that residents should be treated as citizens.

It was also noted that care homes operate best when the family and staff work in partnership and that excluding family has impacted on operations. It was noted that friends and relatives can help support tired and overworked staff. They should be seen as a solution and in partnership with home.

There were several references to the need for national guidelines to create consistency across the country. Several pointed to the confusion a lack of guidance created for staff and between care home managers and headquarters. Anne's Law would provide a safety net for any future pandemics - need to protect managers as well as staff. Rights should be legal rights and not left to the discretion of the care homes. There is a need to build confidence amongst care home staff and to consider how to mitigate against an outbreak if a designated visitor is the cause of an outbreak.

In two of the events, there was an expressed desire for open visiting rather than bookings and time based appointments.

It was also noted in one event that the situation should not have arisen as there is existing protective legislation and that, in the future, Power of Attorney arrangements should account for visiting rights. The importance of proportionate decision-making was also noted.

The right to choose

The majority view appeared to be that the right to choose a named visitor or visitors should lie with the resident, with some provision for those with dementia or mental health conditions, where anyone with a Power of Attorney should be able to nominate a visitor. There were some suggestions that this named person could be varied to avoid an undue burden on one family member alone. It was emphasised that the right to family life is a human right and therefore should be available to all, regardless of setting or age.

Views on next steps

Across the events, there was a view that the legislation needed to be amended as soon as possible. In one group it was thought that Anne's Law should be implemented in the same way as other emergency laws that were introduced during the pandemic. It was also mentioned that national guidance would be quicker to introduce than legislation, through the health and care standards. There should be a joined up approach with providers, care inspectorate and managers should all be on board. There was a view that it should be applied across all health and care sectors. In two of the groups, the need for access panels or visitor co-ordinators in each care home was raised. Other issues discussed included:

• More clarity around children visiting
• Training for care home staff
• Communication of Anne's Law implications to families The need for families to agree to PPE and testing and the need for reserves of PPE
• The implications of different types of infection
• Terminology is important. Should there be an Essential Contact as not everyone has a family member?
• The impact on small independent care homes
• The need for a digital standard across care settings: wifi was an issue and residents needed help with technology