Visiting arrangements in Care Homes

The key national guidance documents which provide advice on visiting arrangements to care homes are as follows:

• Visiting arrangements in care homes
• Summary of guidance for visitors

In line with national guidance, all visiting should be stopped if there is an outbreak in the home, unless in exceptional circumstances such as end of life visits.

An individual care home’s policy on visiting arrangements will be based on a dynamic risk assessment taking into account the individual needs of residents, risk of COVID-19 transmission, physical and other unique features of the home, and the advice of the local Director of Public Health (DPH).

Situations in which we would consider taking a more localised approach may include if local transmission rates are particularly high or if there are variants of concern circulating locally. The DPH/local public health team will inform you about this if the situation arises.

Background

The updated guidance for visiting arrangements in care homes sets out a requirement that a provider’s dynamic risk assessment should take into account advice of local Director of Public Health (DPH). 

This DPH position statement replaces the previously published position statements on care home visits. This guidance applies for the period from 17 May 2021.

This assessment covers all adult care homes in the borough. It does not cover supported accommodation or other residential settings. National guidance for visits in supported living settings is available on the GOV.UK website. 

This assessment will be kept under regular review, and any change will be communicated directly to homes. If local restrictions change, this assessment is updated as necessary. The assessment and subsequent updates will also be published on the council website.

Local data can be viewed on the council website.

General local visiting position for care homes in Islington

Care homes in Islington and the health and care services that support them have faced enormous challenges through the COVID-19 pandemic, and have had to quickly adapt to implement new infection control regimes, including PPE, social distancing measures, and the national whole home testing programme for residents and staff.

While these measures do not mean that we can become complacent, the risks from allowing visits in care homes needs to be balanced with the impact on wellbeing of residents and their families and the importance of social connections in maintaining wellbeing. 

As such, the view of the Director of Public Health is that in Islington we will align ourselves with the national guidance on visits to care homes.

 It is essential that all visits are done in a way that adheres to the important infection control precautions set out in the update on policies for visiting arrangements – available on the GOV.UK website. Care homes should discuss with families the risks and benefits of different types of visits.

When undertaking a risk assessment for certain groups of residents or individuals with particular needs, where undertaking COVID-secure visits is challenging, a tailored visiting policy is needed following the advice set out in the new national guidance. It is important that the provider communicates with family and friends regarding the care home’s visitation policy.

The Director of Public Health also supports essential visiting of external professionals where this would benefit residents' health and wellbeing. Decisions on visitation should be personalised, risk-based, and account for residents' human rights in instances where face-to-face delivery provides additional benefit than when provided remotely. Consideration should be given to undertaking support digitally or remotely to minimise infection prevention and control risks.

Please email CIPHAdmin@islington.gov.uk if you have any questions on this. Jonathan O’Sullivan, Director of Public Health for Islington (14 May 2021)