It is hard to believe that two and a half years after Boris Johnson announced the first UK lockdown, and seven months after the last domestic measures ended, some care homes in Britain are still denying people access to their elderly relatives due to Covid restrictions.
Grandchildren have been banned by some homes, which put age limits on visitors. Others exclude whole families except for one relative named as “essential caregiver”, something that was dropped from government guidance in April.
Support groups the Relatives & Residents Association (R&RA), and Rights for Residents also said there were homes not allowing people to see their parents, husbands or wives in their rooms, instead insisting that the visits take place in pods outside.
And some only allow limited timed-visiting slots. About 70% of older care home residents have dementia and often find it distressing to be moved, only settling by the end of the slot.
Health and Social Care Department position
There are no nationally set direct restrictions on visiting in care homes. They expect and encourage providers to facilitate visits wherever possible, and to do so in a risk-managed way.
Visiting is an integral part of care home life. It is vitally important for maintaining the health, wellbeing and quality of life of residents. Visiting is also crucial for family and friends to maintain contact and life-long relationships with their loved ones, and to contribute to their support and care.
People living in care homes are typically more vulnerable to severe illness as a result of coronavirus (COVID-19). While vaccination is proving very effective, we are still seeing some cases of severe illness, hospitalisation and death of care home residents who have been vaccinated.
Additional measures are therefore in place to facilitate visiting while keeping care home staff and residents safe. These include:
• infection prevention and control (IPC) measures • individual risk assessments • testing arrangements • isolation on return from some high-risk activities out of the home
What does the Care Quality Commission do
As long ago as 2019 during the pandemic the CQC stated residents in care homes should be able to receive visitors if they want to. Care homes are people’s homes, and residents should be able to welcome family and friends as they did before they became a resident. Residents also have consumer rights, which help to ensure that they are treated fairly and protected if things go wrong.
It is important that people’s family and loved ones are able to help plan their care and support as much as they want them to. This sort of involvement is an essential characteristic of person-centred care. Clearly, such involvement is better enabled by family, friends and carers being able to visit relatives in their home.
What rights does a resident have to be visited by a relative or friend? Care home providers should enable a resident to see their family and friends if the resident wants to. If they do not do this, it may mean that the care provider is in breach of a number of regulations in the Health and Social Care Act 2008, against which CQC can take action. This may be a breach of the resident’s rights under Article 8 of the European Convention on Human Rights, incorporated into the Human Rights Act 1998.
The Commons joint committee on human rights in July, published a report on social care calling for ministers to legislate to give the Care Quality Commission the power to require providers to report any changes to visiting status. So far, the government has failed to respond.
Summary
Care home providers must surely recognise the anguish suffered by families who are not able to visit their loved ones. I am sure that most homes will be allowing visits along with the infection control measures recommended by the Department of Health and Social Care.
However, it may well be that those who are restricting access are concerned about residents and staff and see their actions as a means of preventing covid. But residents have rights, and the denial of visitors will surely impact on their mental health and the wellbeing of their families.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy