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Update based on Tier 4 changes -Updated 21st December

Following the Government announcement, the visitor guidance for care homes has been amended. For care homes in tier 4 (which includes Herts), visiting is only permitted:

  • End of Life visits
  • Outdoor or “shielded visits”

Lateral flow testing to allow indoor access is not permitted in Tier 4.

In terms of visiting out of the Care Home. We understand the national guidance will be updated shortly to reflect tier 4 changes as soon as this is published we will share update you.

However as residents in care homes are not part of households support bubble then under Tier 4 regulations, visits out of the care home to a family home will not be permitted.

You can view the current visitor guidance here

The Key is:

Close contact indoor visits supported by testing, which are allowed in Tiers 1-3, will not be allowed in Tier 4. We are hoping this guidance will be further updated shortly clarifying how visits in Tier 4 should be conducted.

All Care Homes, regardless of Tier (and including Tier 4) and except in the event of an active outbreak, should seek to enable:

  • Outdoor visiting and ‘screened’ visits – see section 2.3

All Care Homes in Tier 1, 2 and 3 (excluding Tier 4)– except in the event of an active outbreak – should also seek to enable:

  • indoor visits where the visitor has been tested and returned a negative result – see section 2.1

Visits in exceptional circumstances including end of life should always be enabled, in all tiers – see section 2.4

Original update from the 11th December

Please find below letter from Hertfordshire County Council regarding the updated visitor guidance and arrangements for residents visiting the family home.

Adult Care Services
Registered Managers
All Care Homes

Dear Colleagues RE: Arrangements for Family and Other Non-Essential Care Home Visits We want to thank you for your continued hard work to keep your staff and residents safe during this time. News of the confirmed vaccine gives us hope, however whilst the virus is still circulating, it is important that we continue to remain vigilant and keep people safe. We want to make visits to care home residents possible, but this can only happen if we all do everything we can to prevent the spread of infection. The government guidance released on 2 December 2020 outlined how visits can happen in the different tiers and the use of Lateral Flow Tests to allow visitors to have closer contact with their relatives. Currently, Hertfordshire has been placed into Tier 2. This means that if the home does not have an outbreak (two or more people with confirmed COVID-19), then the following visits can occur between residents and visitors:

  • outdoor visits (including window visits) – the visitor and resident must always remain 2 metres apart
  • “screened visits” – visits undertaken in a dedicated room or in an outdoor structure with a substantial screen between the resident and visitor
  • indoor visits with testing – visits undertaken indoors where lateral flow testing has been undertaken (see below).

If the home does have an outbreak, then visiting into the home must cease for 28 days. Homes may appeal for either all or some of the home (for example a wing of the home or a separate bungalow) to open before 28 days, which is outlined in our guidance document. The Government is also rolling out Lateral Flow Testing in all care homes during December. Whilst we believe this will facilitate greater contact with family members, the use of tests will not mitigate all potential risks of infection and the effectiveness of the tests is still being evaluated. Therefore, please continue to be vigilant. All visitors must continue to be screened to check for COVID-19 symptoms, wear appropriate Personal Protection Equipment (PPE) whilst in the care home, follow social distancing where possible and follow good hand hygiene. It is important that before you start using the tests that you and your team complete the national training and fully understand the guidance. If any visitors test positive using the Lateral Flow Testing or show symptoms, they need to self-isolate, please do not let them into the home and ask them to be tested through 119 or the NHS app. The Government has also released guidance for when an individual leaves the home for an overnight visit. As per Government guidance, care Homes should complete a dynamic risk assessment for these decisions. It is important that care homes have open conversations around these decisions and the family members understand the associated risk and impact around any decisions. We have produced a letter for family members, that care homes may share with them to help this conversation. Working with Hertfordshire Care Providers Association (HCPA), we have produced a number of checklists to support you in implementing the new guidance. These can be accessed via the HCPA website or through the framework document attached. You can access our local guidance at: www.hertfordshire.gov.uk/serviceupdates If you have any further questions, then please call the HCPA Provider Hub on 01707 708 108 or email assistance@hcpa.info Once again, thank you for all your tremendous work and we would like to take this opportunity to wish you the very best for the festive season.

Yours sincerely

Jim McManus – Director of Public Health Chris Badger- Interim Director of Adult Care Services

All supporting documentation:

  • For a copy of the above letter click here
  • Letter to visitors around the local visiting policy Click here
  • Letter to family members and carers around residents visiting the family home Click here
  • HCC Framework for residential care services visiting arrangements v9 Click here

National Guidance:

Support Checklists:

  • Checklist for residential care services visiting arrangements click here
  • Resident visiting family home click here
  • Care Home Lateral Flow Testing Click here

Lateral Flow National Resources:

Webinar 11th December 2020

All questions received from the provider hub and today’s webinar are being turned in to a FAQ for next week. For further support please email assistance@hcpa.info