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Is it beyond our ability to get to grips with care homes visiting policy?

As we come to the end of another traumatic week in the COVID saga we see the political drama being played out in Westminster, while in care homes residents are being denied face to face contact with their loved ones.

While the country is in the critical phase of lockdown with infection transmission and deaths rising at an alarming rate. The government is at loggerheads as a result of sacking its head of communications and the appointment of a new head of staff. At the other end of this unbelievable level of restriction is a picture captured in the Daily Mail of a lady kneeling on a pavement with outreached arms seeking to comfort her husband in the courtyard of a care home. It beggar’s belief.

There is a great deal of anguish and concern about the latest government guidance on visitors to care homes and domiciliary care policies and procedures which is coming from all quarters.

Latest government guidance on visitors to care homes.

The guidance includes:

  1. The home should have an arrangement to enable booking/appointments for visitors – ad hoc visits should not be enabled.

  2. visiting spaces must be used by only one resident and visiting party at a time, and between visits there must be appropriate cleaning and an appropriate time interval.

  3. visits should happen in the open air wherever possible, recognising that for many residents and indeed visitors this will not be appropriate in the winter (this might include under a cover such as an awning, gazebo, open-sided marquee etc):

  4. the visitor and resident must remain at least 2 metres apart at all times

  5. the visit can take place at a window

  6. some providers have used temporary outdoor structures – sometimes referred to as ‘visiting pods – which are enclosed to some degree but are still outside the main building of the home. These can be used. 

  7. where this is not possible, a dedicated room such as a conservatory (i.e. wherever possible, a room that can be entered directly from outside) can be used

  8. in both of these cases, providers must ensure that:

the visiting space is used by only one resident and visiting party at a time, and is subject to regular enhanced cleaning between each visit

  1. consider the use of speakers, or assisted hearing devices (both personal and environmental) where these will aid communication. This will also avoid the need to raise voices and therefore transmission risk

  2. there is a substantial (e.g floor to ceiling) screen between the resident and visitor – designed to reduce the risk of viral transmission

  3. consider the use of speakers, or assisted hearing devices (both personal and environmental) where these will aid communication. This will also avoid the need to raise voices and therefore transmission risk.

What strikes you when you read this list is how inhuman and restrictive it all is.

Concern about lack of face to face contact

There is a great deal of anguish and concern about the latest government guidance on visitors to care homes and the restriction on human contact. Dr Max Pemberton says, “When fear of a virus such as COVID-19 is allowed to devastate the lives of vulnerable people in such a way surely it is the proof that we have lost all perspective of the situation. It is a shameful indictment of how Britain views its care home residents, and we have no choice but to find an alternative that allows them to have face to face contact when they need it. We need to recognise that maintaining relationships is fundamental to human nature”.

Balancing of risk

One’s heart goes out to care providers as they are required to follow government guidance. On the one hand and balance the risk of the virus to individual residents who are being visited, with the potential transmission to other residents and staff.

Effects of non-face to face contact

There is growing evidence that COVID is not the only killer in care homes. Lack of face to face contact is having a serious effect on resident’s health and wellbeing and is leading to an increase in resident deaths.

Summary

We must find an alternative system that enables residents and their families to have face to face contact. The current guidance bears the hallmarks of this governments approach to tackling the virus, and the only answer on the table is restriction.  In France for example there are no such restrictions on visitors to care homes If we do not seek an alternative, as Age UK and a significant number of doctors are now suggesting, residents will cease to have the will to live.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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