COVID-19 Latest Update & Guidance for Visiting Our Homes/Independent Living Sites

Coronavirus Update 10 August 2020

GENERAL

Our priority is to keep all of our residents, visitors and staff safe during these unprecedented times; we are committed to continue to provide the best care and support for everyone.

We are working closely with the Local Authorities, Public Health England, CCGs and Government advice to ensure that any risks of COVID-19 are well managed and people are protected.

We have robust COVID-19 protocols in place, staff have received training and we have adequate supplies of quality Personal Protective Equipment.

HOMES STATUS

New Admissions:

All of our homes are open to new residents and we welcome any enquiries if you are requiring support to care for your loved one. Please contact the home directly for up to date information.

Visitors:

We understand how important it is for both residents and their loved ones to receive visits; however, all of our homes are closed to all visitors until further notice, to protect the most vulnerable and reduce the transmission of infection.

Visiting During a Pandemic

Document Date:                24 July 2020

Document Owner:             Operations

Approved By:                    Chief Executive

Date Approved:                 07 August 2020

Review Date:                     14 July 2021

Policy Statement

The policy aims to ensure safe visiting during the COVID-19 pandemic and the easement on visiting those who are shielding as a result of the sustained transmission of the Corona virus.  

The policy thus aims to minimise the risks to residents’, the employees of the Trust and to the visitors themselves, the Government has released guidance and this policy outlines out compliance with the dynamic risk assessment approach. 

Amica Care Trust’s Care Homes and services have a duty of care to protect its residents and staff from intruders and anyone who threatens their safety and security.

This policy is to be used in conjunction with the visiting and visitor’s policy.

The policy is also in line with Care Quality Commission guidance, the Department of Health and public Health England.

This policy is intended to assist decision making during the COVID-19 outbreak, which is anticipated to last for a sustained period, compared to the usual period for other infectious outbreaks. As we see other parts of our community experiencing a small degree of easement of the lockdown rules in England, it is important to recognise that for those in our care settings, there is a need to balance the continued management of COVID-19 risk, with a cautious approach to enabling the opportunity to receive visitors.

Scope

Closure of the home to visitors

In certain circumstances the management of the home may decide to close to all visitors as they have always done so in the interest of safeguarding residents; this could be due to an infectious outbreak such as:

  • Diarrhoea & or vomiting (Gastroenteritis)
  • Norovirus
  • Clostridioides Difficile (C-Diff)
  • Respiratory outbreak such as flu or chest infections
  • During any pandemic in recent times such as COVID-19
  • Discretion of management during any disaster or major event

 

During these times the home will operate a traffic light system Red, Amber or Green

  1. Green – open for visitors (essential visits only)
  2. Amber – suspected cases – managers discretion – option to close the home 
  3. Red – confirmed cases of either staff / residents / Major incident affecting the home – home closed.

At this time as a result of the global pandemic all the Trust services have been closed to visitors as residents are classified as vulnerable and have been shielding on the advice of the Government. 

In order to ensure the residents safety, it has been necessary to limit visiting to open spaces such garden visits, this has been important for the emotional well being of the residents in our care.

Human rights recognise that all people living in care settings have the right to freedom of movement and association, including the right for residents to see their families.

This policy / protocol seeks to balance the rights of an individual with the rights of the others within the care setting (residents and staff) and the duties and responsibilities of Amica care Trust.

The Trust will work within the guidance set out by the Government which states:

The decision on visiting will be based on the advice from the director of public health, as well as any additional advice or guidance from the local infection-control lead from the CCG, and the local PHE HPT.

In making their judgement the director of public health should consider as a minimum:

  1. Local testing data, including test and trace data, to form a view on the accuracy of local outbreak information including data on uptake, results and frequency of testing in the local area, as well as to form a view of community prevalence
  2. Any national oversight taking place in an area due to transmission risks

In addition, in making their decision about visiting policy, providers and the director of public health should, where possible, consider:

  1. Any testing that takes place outside of the care home, for example community or home testing. Staff must inform the care home so that the result is factored into the decision-making process to help inform the visiting policy
  2. Results from weekly testing of staff and monthly testing of residents. This data will enable the risk assessment to be well informed. Evidence of outbreaks and recovery from outbreaks should also be considered (a recovered outbreak is defined as 28 days or more since the last suspected or confirmed case reported)
  3. Local intelligence on risk factors relevant to transmission in the care home, for example a nearby concentration of locations where there is a higher potential risk of transmission (for example, food processing plants)
  4. Readiness of the care home to respond quickly when there is a confirmed or suspected COVID-19 case within the care home, to immediately return to essential visits only (for example, end of life), with no exceptions. This assessment of readiness may be based on Care Quality Commission reports, experience of a care home’s responsiveness throughout the pandemic and other local qualitative information

In this guidance, the term ‘provider’ is used to refer to providers and their care home managers. Where a decision is made by a provider to allow visiting, such visits should continue with appropriate infection-control precautions.

Types of visiting

The Trusts services have engaged in a variety of visiting options which have included:   

  1. Window visits:  ground floor window access for both residents and their visitors and the relevant social distancing and PPE measures have been observed
  2. Garden visits: Relevant PPE measures and social distancing have been used, and these visits have been pre-booked to ensure distancing is observed
  3. Designated areas within a care setting where settings allow for this: depending on the physical layout of the care setting, we have enabled visits to an identified location inside our services reserved for this purpose
  4. In-room visits: These visits have been implemented as appropriate, in line with national guidance 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.

All visits have and will continue to have the to follow the visiting code / guidelines

  1. Book visits in advance for a specific day and time, visits will be for one hour only – this must be adhered to; visitors are expected to also give their up to date contact details  
  2. Check in with the care service on the day prior to their visit, to ensure the situation in the service has not changed
  3. Be free of any COVID-19 symptoms on the day of their visit
  4. Must be well on the day of their visits
  5. Provide the necessary information required by the service at the visits (e.g. honest response to screening requirements about COVID-19 risk factors)
  6. 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
  7. Ensure they visit with a face covering / face mask
  8. Ensure that any gifts brought to give to the individual they are visiting can be sanitised, in line with relevant infection prevention and control (IPC) guidance
  9. Wherever possible, visitors should a try to walk or travel by car and avoid public transport when visiting the home, in line with the latest government advice on travel during COVID-19.

Additional measures

Each service will risk assess their environment to be able to accommodate visiting in areas of the home, each service will also take the following measures.

  1. Where an area is available staff will facilitate the visit, this will be to ensure the area has been disinfected before and after the visit
  2. Staff will ensure the visitor has washed their hands / used the alcohol hand gel when they arrive and leave the area.
  3. Each service will have a bookings diary and this must be completed by the home administrator / the homes management team only, this is to ensure the following:

 

  1. Visiting is restricted to a maximum of one hour this will also be limited to the numbers of visitors to a single constant visitor per resident. 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. Any adaption to this would be discussed with the senior management of the Trust and circumstances considered for approval measuring the risk factors, home managers will complete an Ethical decision tool in collaboration with the senior management team. Garden visits for other family members may still be permitted depending on the current risk rating  
  2. Only 3 visitors per day and at least 2 hours apart to ensure touch points have been disinfected again
  3. Visitors temperatures are taken and questions asked about their general health
  4. If refreshments are offered / required an allocation of disposable crockery will be supplied and disposed of in the provided pedal waste bin
  5. The visitor should have access to their own face covering and will not be permitted to visit without this
  6. Where it is appropriate and the resident understands it’s use, a shield screen will be used during the visit
  7. Any items brought into the home will be placed in a designated area to be sanitized by the staff team  
  8. The visitor will restrain from any physical contact and uphold social distancing rules.

Where a visitor appears unwell / has a temperature the home / service will request the visitor leave and re book their visit.

If the “R” rate increases the home / service will cease visiting and remain closed, this could also be a local increase in the “R” rating and may not apply to all the Trust services.  

The health and wellbeing risks arising from the needs of our residents will be taken in to consideration. 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 living with dementia, may be permitted visitors when restricting visitors could cause some of the residents to be distressed) each resident will have a care plan detailing visiting information / requirements and a risk assessment. 

Ability to suspend visiting

In the event of any suspected or actual outbreak of COVID-19, or a suspected or known case of COVID-19 within the home / service, visitor restrictions may need to be immediately implemented which suspend some of these enabling approaches and will include exclusion of any non–essential visitors. (this includes any contractors visiting the home)

This will be implemented in a transparent manner with open and clear communication to residents and relevant family members; this could mean that a visitor will be turned away if a suspected case has come to light during the time it has taken them to travel to the home.

Rights and responsibilities

This policy includes the rights and responsibilities for both Amica Care Trust and visitors which put the welfare and wellbeing of residents/ people receiving care at the heart of the approach when developing this visiting policy.

Rights

Amica Care Trust has the right to

Visitors have the right to

Mitigate risk of infection by refusing entry to their home to anyone, or requesting that a person leave the premises, for any justifiable reason consistent with this policy / protocol.

Access care homes in accordance with the entry requirements set out in the visiting policy of the care setting.

Consider increased visitor restrictions when an outbreak (including non-COVID-19) occurs within the home, or declared outbreak / clusters have occurred within the home's local area or if there are other extraordinary circumstances that require it, and usage of such circumstances will be closely monitored.

Be notified by timely and regular updates and information about what is happening in the home, in relation to visiting and local COVID-19 prevalence and transmission risk.

 

Be provided and supported with additional ways to connect such as video conference or telephone calls in addition to a limited number of in-person visits.

     

    Responsibilities

    Amica Care Trust has the responsibility to

    Visitors have the responsibility to

    Provide a clear policy and information on how they will facilitate visitors, using a dynamic risk-based approach, and make this publicly available as needed.

    Follow the home's visiting policy and Visitor Code, including booking in advance.

    Provide clear information about how the visit will work and the infection and prevention control measures that must be followed.

    Not to visit when unwell or displaying any signs of a cold/flu, respiratory or COVID-19 symptoms.

    Appropriately support staff in order to facilitate visits including written processes and procedures.

    Respond truthfully to COVID-19 screening questions asked by the home's staff and to sign the checklist / visitor.

    Treat all visitors with respect and courtesy, and to provide clear instructions about the visiting policy

    Treat all staff with respect and courtesy, and to follow their instructions on the visitor policy.

    Proactive communication with residents and families where an outbreak occurs, and the impact on the visiting policy.

    Follow visiting requirements including, infection and prevention control measures such as washing hands, use of visiting windows, remaining designated areas and social distancing requirements – as directed by the care home staff – and that failure to do so may affect the future ability to visit.

     

    The Trust will have the right to change and adapt this policy in line with Government guidance at any time.

    Visitors have the right to express their concerns through the Amica Care Trust complaints and concerns policy.

    The Trust will not accept liability for any illnesses the visitor may contract following a visit to its services including COVID-19 as a global pandemic.

    Amica Care Trust services will request that visitors complete the questionnaire and risk assessments provided by the services and this is a true and honest reflection. (Appendix 1)

    Each of the Trust’s service will keep a visitor log in line with the Track and trace initiative. 

    Visitors confirmation of being safe to visit

    To ensure that it is safe to visit our care home during the coronavirus crisis we would ask that you read and sign the following disclaimer, which amounts to a “Visitor’s Code”.

    1. I confirm that at the time of my planned visit I have not been told to self-isolate on the grounds that I:
    2. I not developed any Covid-19 symptoms
    3. I confirm I have not been feeling unwell recently
    4. I have not had recent onset of a new continuous cough
    5. I have not noticed a loss of, or change in, normal sense of taste or smell.
    6. I have not been in contact with someone who has had symptoms of Covid-19 or who was a known risk of having this due to an exposure themselves or has been confirmed as having Covid-19. (and I have not been contacted by the track and trace service to isolate)
    7. I have not returned from abroad in the last fourteen days or a local area known to have a high “R” rating (or has been in lockdown)

    I can confirm that I am not suffering from related symptoms of Covid-19 such as infectious cough, sneezing, high temperature, chestiness, or a similar “flu” like infection that could be passed on during my visit and which would increase people’s risk of contracting Covid-19 or another infection that would increase their risk of being adversely affected if they did acquire Covid-19. I will also agree to any additional checks required by the home to reduce the risk of my spreading any infection.

    When visiting, I will ensure that I comply with the current Government guidance regarding physical distancing and numbers if part of a “social bubble”. I will also follow the care home’s policy on visiting as it applies to the current situation and follow all good hygiene practices that are used in the home to prevent any spread of infection, including the sanitisation of any gifts brought for the person being visited.

     

    Data protection

    I understand that all information contained here will be subject to the home’s data protection policy and kept in line with that, ie for no longer than it is needed.

    Signed:________________________________________Date_________________

     

    Name: ___________________________________________________________________

     

    Name of Resident visiting:

    ________________________________________________

     

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