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New Visitors Arrangements

1. Policy Statement
Our priority continues to be to reduce the risk of coronavirus (COVID-19) transmission within our care homes and prevent future outbreaks, to ensure the health and safety of both care workers and residents.
We recognise that lockdown has been difficult for many residents and families over the past few months and that visits are important for all those in care settings.
To limit risk, where visits do go ahead, this will be limited to a single constant visitor, per resident, wherever possible. This is to limit the overall numbers of visitors to the care home and the consequent risk of infection.
Unfortunately, due to some physical or mental health conditions, visits may not always be possible for some residents and the home manager will discuss this on an individual basis.
The care home will support NHS Test and Trace by keeping a record (including address and phone number) of all visitors.

2. Visitor Responsibilities
Prior to the visit the visitor will be issued with the visitor’s charter (Appendix 1), asked to sign and return prior to the start of the visit. Visits will not be permitted to go ahead without prior completion and return of the visitor’s charter.
All visitors must:

  • follow any guidance, procedures or protocols put in place by the care home to ensure compliance with infection prevention control.
  • be free of any COVID -19 symptoms on the day of their visit
  • not be unwell on the day of their visits
  • provide the necessary information required by the provider at the visits (e.g. honest response to screening requirements about COVID-19 risk factors)
  • comply with the infection prevention and control measures, including a temperature test, mandatory hand hygiene, the use of PPE as required and social distancing requirements, remaining in the designated visiting area
  • consent to a Lateral Flow Device (LFD) COVID -19 test immediately prior to the ‘pre-booked’ visit

Any visitor found to have not followed the conditions of visiting as set out in the policy and visitors charter will be asked to leave the premises immediately and will not be allowed any further visits to the home. These procedures are in place to ensure the safety of everyone – Residents, Staff and Visitors and must be strictly adhered to.

3. The principles of a local approach and dynamic risk assessment
The decision to allow visitors into the individual care home will be based on a dynamic risk assessment which takes into account the significant vulnerability of residents in most care homes.
NB In line with government guidance additional restrictions may be placed on visiting by the local Director of Public Health (DPH) and Director of Adult Social Services (DASS) in response to local variations including infection rates in different areas.
This approach is based on the circumstances and needs of the individual care setting including both residents and staff and the external COVID environment. The external COVID environment includes the prevalence and incidence of infection in the local community and/or outbreaks or hotspots which may increase risk of infection in visitors to care homes in the area.
This policy will be made available and/or communicated to residents and families, together with any necessary variations to arrangements due to external events.
In the event of an outbreak in the care home and/or evidence of community hotspots or outbreaks leading to a local lockdown, the care home will immediately be closed to all non-essential visitors and visits will only be permitted in exceptional circumstances such as where residents are deemed to be at End of Life.
The number of visitors will be limited to a single constant visitor per resident, wherever possible. This, for example, means the same family member visiting each time to limit the number of different individuals coming into contact. This is in order to limit the overall number of visitors to the care home and/or to the individual, and the consequent risk of infection

Subject to individual circumstances visits may take the form of:

  • designated visitors’ room
  • visits in residents own room (including exceptional End of Life visits)
  • visits in communal gardens
  • window visits
  • drive-through visits

When determining the most suitable type of visiting arrangements consideration should be given to:

  • vaccination status of resident and designated visitor(s)
  • any health and wellbeing risks arising from the needs of the cohort of residents in the home. This will include both whether their needs make them particularly vulnerable to COVID-19 and whether their needs make visits particularly important (for example, people with dementia, a learning disability or autistic people may be permitted visitors when restricting visitors could cause some of the residents to be distressed).
  • the likely practical effectiveness of social distancing measures between the visitor and the residents, having regard to the cognitive status of the resident and their communication needs
  • where the healthcare needs of the individual cannot be met by socially distant visits, whether there are sufficient infection-control measures in place to protect the residents, staff and visitors, to allow the visit to take place. This might include the provision of personal protective equipment (PPE), as provided to members of staff caring for that individual

All residents will have an individual ‘Visiting Plan’ which must then be adhered to

4. Taking visiting decisions for particular residents or groups of residents
Due to the range of individual resident needs and abilities it may be necessary for different rules to be applied to different residents or categories of resident in respect of the type of visiting arrangements allowed.
The factors relevant to decisions about particular individuals or groups of residents include the following:

  • the benefits to a person’s wellbeing by having a particular visitor
  • the extent of the harm that will be experienced by the resident from a lack of visitation or whether the individual is at the end of their life
  • whether residents or staff or visitors are in the extremely clinically vulnerable group (in line with latest government guidance on shielding)
  • if not regarded as a person requiring support to shield, whether the resident’s state of physical health is such that they may be more seriously affected if they develop COVID-19
  • the provisions and needs outlined in the person’s care plan
  • the availability of staff to enable safe visiting practices

5. Visiting Guidelines
*These guidelines apply to all visitors and all types of visits

  • No visiting will be permitted if you are displaying any COVID-19 symptoms (or anyone in your household or ‘bubble’ is displaying symptoms or tested positive within the last 14 days)
  • Visits will be between 10am – 12 noon and 2pm – 5pm Monday to Friday only, strictly on a ‘first come, first served’ appointment basis
  • Visit will last for no longer than 20 minutes.
  • Visitors must PRE-book a time slot with the home. Visiting outside this slot will not be permitted.
  • Visitors will be limited to a single constant visitor per resident, wherever possible. This, for example, means the same family member visiting each time to limit the number of different individuals coming into contact
  • Visits will be limited to a maximum of once a week for each resident
  • At this time, we will not be permitting visitors under 18 years-of-age.
  • No drinks will be offered or use of the home’s facilities including the toilet during the visit.
  • Prior to the visit the visitor will be issued with the visitor’s charter, asked to sign and return prior to the start of the visit.
  • Visitors must check in with the care home on the day prior to their visit, just in case the situation in the care home has changed.
  • Visitors must have a Lateral Flow Device (LFD) COVID -19 test immediately prior to the start of the visit
  • In order for the LFD test to go ahead visitors are requested to arrive 45 minutes prior to their allocated visiting time to allow for the test results to be processed
  • In the event of a positive LFD test the visit will not be allowed to go ahead, the visitor will be asked to immediately take a confirmatory PCR test on site and advised they must isolate and go home immediately, avoiding public transport and wearing a mask.
  • As each time slot is pre-booked late arrival may lead to the visit being shortened or not able to go ahead.
  • Visitors are required to wash their hands for 20 seconds and / or use hand sanitiser on entering and leaving the home.
  • Social distancing principles must be applied – they must be a physical distance of two metres (six feet) from residents and staff
  • Visitors should keep personal interaction with the resident to a minimum, for example avoid skin-to-skin contact (handshake, hug) and follow the latest social-distancing advice including wearing of required PPE for as much of the visit as possible
  • Visitors should have no contact with other residents and minimal contact with care home staff
  • Visitors are not permitted to hold conversations with staff at the time of the visit (this can be arranged over the phone following an in-person visit).
  • Visitors are asked not to bring any of their own personal items with them and not to share any personal items such as mobile phones
  • Visitors who wish to bring in a gift will need to ‘hand in’ for a member of staff to handle, nothing is to be given direct to the Resident.
  • Any items that visitors wish to bring with them on their visit, such as a gift will need to be something that can be easily cleaned by the care home to prevent cross contamination. For example, it is not permissible to bring flowers but a box of chocolates that could be sanitised with wipes is allowed
  • All visitors MUST bring and wear a suitable face covering
  • All visitors MUST wear PPE appropriate to the need of their visit. If a visitor is making close personal contact with a resident they may need to wear PPE which goes beyond a face covering.
  • A dedicated member of staff will be provided to facilitate these visits and ensure protocol is followed

It is not possible to enable visits by children at present, given the current guidance and PPE and social distancing measures.
Visits between residents and their visitors must operate fully in line with the latest infection prevention and control guidance including provisions relating to the use of designated areas for visits and the use of social distancing practices, good hand hygiene, use of PPE for visitors and residents.
Visitors are encouraged to walk to the home or use their own transport and avoid public transport where possible. Visitors who are especially vulnerable and require assistance to get to the care home should speak with the home manager who can provide information of organisations which can offer advice on safe travel arrangements if required

6. Type of Visit
This will be agreed with residents and visitors following the individual risk assessment in line with the visitor plan. Varying levels of staff supervision may be required dependent on individual circumstances.

6a. Designated Visitors Room
A designated visitor’s room is provided in each care home and is the preferred choice wherever possible. The visitor’s room is only used by one resident and their visitor at a time and is subject to regular enhanced cleaning. A glass barrier is provided, and visitors can only access the room from the outside of the building, to prevent cross infection and reduce the risk of transmission.
Staff will complete the ‘Visitors Room Checklist’ immediately prior to and following each visit. This must be returned to the office upon completion and stored safely for future inspection.

6b. Visits in Resident’s own rooms
These visits may continue to be facilitated as appropriate, in line with national and local IPC guidance, including in relation to essential / end of life visits to ensure the person can die with dignity and comfort, taking into account their physical, emotional, social and spiritual support needs.
The visitor should go there directly upon arrival and leave immediately after. The visitor must confine themselves to the resident’s room and not engage with any other person including staff members
Visitors to residents’ rooms may be required to wear additional PPE as necessary and must avoid any direct physical contact.

6c. Garden Visits
Where available, a separate entrance to the garden is to be used

  • Where available, a separate entrance to the garden is to be used
  • In the event of the visitor having to access the garden through the home, the full Coronavirus Risk Assessment process must be completed.
  • The home must physically mark out distance measures minimum 2 metres apart
  • A chair for visitors must be provided and this needs to be cleaned after each visit
  • Where possible a covered area will be provided e.g. garden gazebo

Staff will complete the ‘Garden Visit Checklist’ immediately prior to and following each visit. This must be returned to the office upon completion and stored safely for future inspection.

6d. Window Visits
In some homes window visits may be the most appropriate form of visiting for residents accommodated in ground floor rooms. The relevant social distancing and PPE measures will still need to be observed.

6e. Drive Through Visits
These are facilitated visits in the car parks of homes. Again, any relevant social distancing and PPE measures will still need to be observed.

7. Exceptional Circumstances
In exceptional circumstances, a very small number of people may have great difficulty in accepting staff or visitors wearing masks or face coverings. The severity, intensity and/or frequency of the behaviours of concern may place them, visitors, or the supporting staff at risk of harm. A comprehensive risk assessment for each of these people identifying the specific risks for them and others should be undertaken for the person’s care, and this same risk assessment should be applied for people visiting the person. If face visors or clear face coverings are available, they can be considered as part of the risk assessment. Under no circumstances should this assessment be applied to a whole care setting.
Where face coverings are required visitors should be advised to:

  • speak loudly and clearly
  • maintain eye contact
  • not wear hats or anything else that might conceal their face further
  • wear clothing or their hair in a way that a resident would more likely recognise

Staff should provide reassurance to visitors, including that some people with dementia might struggle at first to remember or recognise them. Where possible, staff should try and prepare the resident for a visit, perhaps by looking at photographs of the person who is due to visit, and talking to them about their relationship

8. Visitor Screening
All visitors will be screened for symptoms of COVID 19 before being allowed to enter the care home / visitors room / garden visiting area, including temperature check, completion of a Coronavirus Risk Assessment and Lateral Flow Device COVID -19 test. This includes external professionals, local authority/NHS staff, statutory inspectors, and contractors.
No-one who is currently experiencing, or first experienced, coronavirus symptoms in the last 10 days, will be allowed to enter the premises, nor anyone who is a household contact of a case or who has been advised to self-isolate by NHS Test and Trace.
The home reserves the right to refuse entry to anyone who is assessed as a potential infection control risk.

9. Outbreaks of COVID -19
Family and friends should be advised that if there is a declared outbreak in a care home then the visiting guidance will need to be immediately restricted for a period of time until the care home has been assessed to be in recovery.
If there is a restriction to visitors in place, alternative ways of communicating between residents and their families and friends should be discussed and offered. The care home should also provide regular updates to residents’ loved ones on their mental and physical health, how they are coping and identify any additional ways they might be better supported, including any cultural or religious needs.

10. Visitors Charter
All visitors are expected to abide by the Visitors Charter prior to and during any visit. All visitors must:

  • follow any guidance, procedures or protocols put in place by the care home to ensure compliance with infection prevention control.
  • be free of any COVID -19 symptoms on the day of their visit
  • not be unwell on the day of their visits
  • take a Lateral Flow Device (LFD) COVID -19 test immediately prior to the start of the visit
  • provide the necessary information required by the provider at the visits (e.g. honest response to screening requirements about COVID-19 risk factors)
  • comply with the infection prevention and control measures, including a temperature test, mandatory hand hygiene, the use of PPE as required and social distancing requirements, remaining in the designated visiting area