Care Provider Visitor Guidance

Changes to visiting in care homes – From 04/04/2022

As part of the new guidance to care homes, Hertfordshire County Council has reviewed their visitor policy that has been in place since July 2020 as part of the national guidance on visiting in care homes. The new guidance states that “There should not normally be any restrictions to visits into or out of the care home.”

As a result of the above, the local “visitor appeal” process has been withdrawn from 8th April 2022.

If a care home is in an outbreak all types of visits can continue. The care home should undertake a risk assessment to help them assess that they can manage visits to the home safely. The risk assessment may identify changes that need to be made to visiting while the outbreak is ongoing.

This dynamic risk assessment should consider relevant factors relating to the rights and wellbeing of the residents. Any risk assessment should follow the CQC regulatory framework around providing person centred care. It may also be appropriate or necessary for providers to apply different rules for different residents or categories of resident, based on an assessment of risk of contracting COVID-19 in relation to such residents, as well as the potential benefits of visits to them.

The risk assessment should also consider factors relating to the layout, facilities and other issues around the care home – to help determine: 

  • where visiting will happen – the rooms or outdoor spaces in which visiting will happen, where and how visitors might be received on arrival at the home to ensure mixing is limited between visitors, staff or residents 
  • the precautions that will be taken to prevent infection during visits (including  PPE  use, hand washing, maximising ventilation) 

Care home managers should share the risk assessments underpinning visiting policies with residents or their families, to help explain the decisions they have made, and their visiting policy. Sharing completed assessments with families may assist in emphasising the need for cooperation between families, residents and care home staff. 

Please remember – If a resident is isolating in the care home, then they can have one named visitor. In all cases, end of life visiting should also be supported

Testing for visitors

Type of visitor Testing requirements

All type of visitors who are providing personal care (definition below)

 

A negative lateral flow test prior to entering the home, unless exempt for medical reasons or visiting someone who is at the end of their life. The test should be provided by the care home

 

If the visitor attends once or twice a week, they should only test on that day. If they visit more than twice a week, they should test a maximum of twice weekly, 3 to 4 days apart.

 

The testing can be undertaken at the person’s own home

 

Proof of negative result can be sent by email or text to report the result, a date stamped photo of the test cartridge, or any other proof. Care homes do not need to retain records of proof.

 

Visitors should also continue to follow infection, prevention and control measures

All type of visitors not providing personal care Visitors do not need to undertake a LFT before entering the home. Visitors should continue to follow infection, prevention and control measures
Professional visitors – e.g. front line facing NHS, CQC and adult care services staff

Twice weekly tested through their own organisation. The professional should provide evidence of a negative rapid lateral flow test within 72 hours. This may be an email or text from reporting the result, a date stamped photo of the test cartridge, or any other proof.

 

For emergency visits, where it’s not appropriate due to the speed of the response required, proof is not required but all other IPC measures should be followed

 

If the individual has not been tested within 72 hours (or is unable to provide proof) and it is not possible to test prior to entry, the care home will need to make a risk-based decision regarding whether to permit entry, taking into account the reason for and urgency of the visit.

 

 

Provider care is defined as “The regulated activity of personal care consists of the provision of personal care for people who are unable to provide it for themselves, because of old age, illness or disability, and which is provided to them in the place where those people are living at the time when the care is provided. As an example, this includes personal care provided by a domiciliary care agency. It also includes Shared Lives schemes. Personal care includes assistance with washing, dressing, and other personal needs including continence and assistance with eating and drinking”

Further examples of what constitutes personal care may also include but is not limited to:

  • Bathing and showering, including bed-baths
  • Applying lotions and creams as required
  • Dressing and getting ready for bed
  • Oral hygiene
  • Applying make-up, and hair care
  • Support with shaving
  • Foot care, especially if you are diabetic need to be extra vigilant with your feet
  • Helping you to the toilet, including using a commode or bed pan
  • Changing continence pads, along with cleaning intimate areas
  • Support moving position in bed, to stretch and prevent bed sores
  • Changing or maintaining a stoma or catheter bag, or other form of clinical intervention

 

Visitors should not enter the care home if they are feeling unwell, even if they have tested negative for COVID-19, are fully vaccinated and have received their booster. Transmissible viruses such as flu, respiratory syncytial virus (RSV) and norovirus can be just as dangerous to care home residents as COVID-19. If visitors have any symptoms that suggest other transmissible viruses and infections, such as cough, high temperature, diarrhoea or vomiting, they should avoid the care home until at least 5 days after they feel better. Care homes to encourage all visitors to wear a face mask when visiting.

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