Visiting Policy during the ongoing COVID-19 pandemic
Our priority during the COVID-19 pandemic is the safety of our service users and staff. This policy is based on guidance for Registered Care Home settings. Principles around testing, PPE and infection control apply to all our care settings. Policies relating to named visitors and vaccination status of visitors does not apply in our supported living settings.
We believe that maintaining family and social connections is fundamental to the wellbeing of our service users and will work with our stakeholders to find the right balance between the benefits of visiting and the risk of infection transmission.
Some restrictions have been introduced from 15th December 21 in response to concerns about the Omicron variant. Care home residents can now nominate 3 named visitors for indoor visits. Care home residents who have had both vaccinations can also leave the home for low risks visits without the need to isolate, however they will be required to undertake lateral flow tests for 10 days following the visit. Our approach to visits in and out of our homes from this date is as follows:
- We will continue to offer and facilitate ‘virtual’ visits for anyone who prefers this method of keeping in touch. If a face-to-face visit is preferred but there are concerns about the risks of transmission outdoor/garden visits can be arranged. If social distancing (2m) can be maintained a mask does not need to be worn. We will ask that a lateral flow test is undertaken prior to the visit.
- Indoor visits will always be permitted for essential maintenance, health and medical care and in exceptional circumstances such as end of life care. In addition to these arrangements service users can nominate 3 named visitors for regular indoor visits. Completion of a Covid-19 rapid test showing a negative result will be required before visitors are permitted inside the care location. Named visitors will need to take this test on the same day their visit is planned. The requirement for these tests will include professionals who are not part of a regular NHS testing programme. These professionals will usually be tested on arrival, however as more than one test is not required in a day, we are able to accept proof of a negative result undertaken at another location on the same day. Medical and health professionals will not require a rapid test if they are already included in a weekly NHS testing programme. We will however be required to see evidence of a negative result within the last 72 hours. Paramedics are tested regularly and in emergency visits such as 999 responses, we will not ask to see proof of the negative result as this could delay emergency treatment required. CQC inspectors are part of a regular testing programme and are required to complete LFT tests on days of visits to care homes. We will expect to see evidence of the negative test from the inspector on arrival.
- Service users can nominate an essential care giver, but we anticipate this is only likely to be needed in a small number of cases and have not identified anyone for whom this arrangement is currently required, however we recognise that individual needs change and this may need to be discussed and agreed with the service user, family and home manager. Please talk to us if you would like any more information about essential care givers.
For any home that is in ‘Outbreak’ status- i.e., two members of staff or a service user has tested positive within 14 days of each other or is experiencing Covid-19 symptoms, we are required to stop all visiting (except for in exceptional circumstances such as end of life). During the period of any outbreak the only type of visits we will be able to facilitate are virtual visits. Out of home visits will also cease as all movement in and out the home should be minimised. Where there is one confirmed or suspected case of Covid-19 at any location it is also likely that we will close the home to visitors. The local Health Protection Team will inform us how long the outbreak restrictions need to be in place.
All visits to homes will be subject to the following measures:
- Visits will be subject to pre-visit checks which will include temperature checks and screening questions for symptoms.
It is not a condition of visiting that family or friends should have been vaccinated. However, it is strongly recommended that all visitors take up the opportunity to be vaccinated and have their booster and flu vaccination when they are invited to do so through the national programme. Managers may ask to see evidence of this when determining risk assessments for individual service users.
- We will require, except in emergencies, to see evidence of both Covid-19 vaccinations (or evidence of exemption) for all visiting professionals.
- Visitors will be required to wear appropriate PPE and follow infection control measures. They will be provided with PPE and advised of these requirements by staff.
- Social distancing (2m) must always be practiced during visits. Visitors will only have contact with the person they are visiting. Government guidance acknowledges that visitors and residents may wish to hold hands but also explains that physical contact increases the risk of transmission. We ask that visitors do not take unnecessary risks and keep physical contact to a minimum. Close physical contact such as hugging is best avoided.
- Visitors must not visit the care home if they are unwell or if they or any other member of their household have any symptoms of coronavirus. If visitors have been identified as a close contact of someone with Covid-19 in the last 10 days, they should not attend the home.
- Indoor visits will be limited to 3 named visitors. To continue to manage visits safely we will continue to adopt the following principles: a maximum number of visitors at any one time, this will vary at each location according to the needs of service users and the layout of the home. Other friends and family can visit outdoors, but we will continue to limit the number of people visiting outdoors. It is possible for children to visit; however, we would ask friends and family to consider this carefully and discuss this with the home manager. Unless below pre-school age children will be counted toward the maximum number of visitors and will be required to adhere to the same infection prevention measures as adult visitors. This will include wearing PPE, testing and social distancing.
- Visits will be pre-arranged and will last for a pre-agreed amount of time. These arrangements are in place to ensure we can regulate the number of visits taking place and clean equipment such as tables and chairs between visits.
- During outdoor visits, visitors will not be permitted inside the care setting. Visitors will be unable to move through the care setting to access the visiting area. Each home will designate an outside area and visitors must remain in this area throughout the visit. Facilities such as toilets will not be available to visitor. We are currently unable to provide visitors with drinks or refreshments.
- Each of our homes will have a risk assessment outlining the arrangements for indoor visiting. Each location is unique, and the risk assessment will take account of the needs of the service users living there, the layout of the home and the needs of the staff working at that location. Not all our homes have a room that we are able to designate for visiting and managers at each location will consider where visiting will happen whilst taking account of the need to mitigate risks for other people in the home. Visiting may be able to take place in a service users own room, but we will need to make arrangements to ensure there is no contact with other service users when passing through the communal parts of the home.
- Managers will assess whether supervision is required during the visit. The duration of visits will be determined by a range of factors and managers will decide how long visits can last according to individual circumstances. Visitors contact with staff should be minimal and in instances where staff supervision is required visits will need to be limited.
- If visitors are bringing gifts, they must ensure that they can be sanitised. For example, a box of chocolates that can be wiped down.
- Staff and service users will need to wash their hands thoroughly before and after a visit takes place.
- Visitors should sanitise/wash their hands-on arrival and departure.
- We will keep a log of visitors.
Additional information regarding rapid tests
- A lateral flow test with a negative result will be required for all family/friends on the same day of every visit. We are able to facilitate your test on arrival, however this process requires a considerable number of extra resources and not all our locations have a room suitable to undertake the tests. For this reason, our preference is for visitors to test at home or by attending a community test centre site provided by Warwickshire County Council. The home kits can be provided by us or collected from a local pharmacy. Tests undertaken at home must be registered and you will require a UON number from us to do this. We can provide instructions for completing and registering tests and will support you to do this the first few times if required.
- Visitors who have had Covid-19, have completed their isolation period and are not showing any new signs of the virus, will be exempt from testing for 90 days. We will need to see proof of the visitor’s positive result.
- Visitors will need to complete a consent form before every rapid test if we are completing this for you.
- If a visitor tests positive, they will be required to return home immediately, if not already there, and must avoid use of public transport. A PCR test will need to be completed on your return home. If you have completed the rapid test at one of our homes or offices, we will provide you with a PCR test to take with you.
Out of home visits
Providing service users have had both vaccinations lower risk visits out of the care home no longer require the need for self-isolation on the service users return to home, however there are additional testing requirements, and the service users will have to undertake daily lateral flow tests for 10 days. This means that service users can be supported to spend time outdoors, go to work, take part in education or training and go to a day centre or a place of worship. This might also include regular planned overnight visits to a nominated family home, however those who go out regularly may need to complete lateral flow tests every day. In order to manage this process staff will complete and record the tests on a LOG sheet, however providing the result is negative the test will not be registered. Services users will usually be accompanied by a support worker or one of their named visitors. They may go alone if they are able to do this.
Risk assessments will be completed for out of home visits and will take account of the vaccination status of the service users, visitors and staff, the mode of transport the service user intends to take, where the service user intends to go and the activities, they will take part in during the out of home visit. The assessment will also take account of local levels of infection and variants of concern in the community. Any visit determined to be high risk will continue to require a 14-day period of isolation on return. All unplanned overnight stays in hospital are determined to be high risk.
Routine appointments such as dental or doctors’ visits and walks in the community where service users do not have close contact with other people, will not be considered a ‘visit out’ that would require extra testing or isolation.
All out of home visits increase transmission risks and are subject to the following precautions:
- service users may meet other people. They should avoid visiting people they do not usually spend time with regularly and should maintain social distance from anyone who is not one of their named visitors, essential care providers, or care staff and, wherever possible, should avoid close physical contact with those who are supporting their visit to minimize the risk of infection.
- named visitors accompanying service users on out of home visits will need to follow the testing guidance for rapid tests as described earlier in this policy as a minimum.
- additional testing will be required for overnight stays to family homes. Named visitors and the service user should complete a rapid test prior to their departure for the overnight stay and again before returning to the home. If overnight stays are taking place on a regular basis the service user and named visitors will be encouraged to complete weekly PCR tests. All tests should be registered to the homes UON number.
- If the service user will meet anyone other than their named visitor during an indoor visit, that person should also undertake a rapid test on the day of the visit.
- anyone involved in supporting visits should recognise the risk that introducing Covid-19 to a home has for everyone living and working there. Prior to out of home visits, particularly those taking place at a family home it is expected that suitable precautions will be taken to minimise risks. This will include informing us and cancelling the visit if you are unwell, wearing face coverings, avoiding crowded places, practicing social distancing and good hand hygiene.
- managers should discuss arrangements with service users, their named visitors, or their essential care provider, in advance.
- service users should avoid crowded places and where possible should undertake outdoor activities rather than indoor as this remains a safer option.
- visits to indoor spaces should normally be avoided (except, for example, for the use of toilet facilities), unless they are for work, education, medical appointments or where an individual assessment has determined the activity is necessary to maintaining an individual’s health and wellbeing.
- visits should not involve the use of public transport.
- service users and those they are visiting should, if possible, have both their vaccinations and a booster.