- The Trust
- Our Homes
- Independent Living
Updated 23 July 2021
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.
Document Owner: Operations
Approved By: Operations Manager
Date Approved: 22 July 2021
Review Date: 30 November 2021
The policy aims to ensure safe visiting during the COVID-19 pandemic and the easement on visiting those who are vulnerableas a result of the sustained transmission of the Coronavirus.
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 and the COVID-19 Testing 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 the removal of 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, the prevalence of this is highlighted again with another new strain of the COVID-19 virus and the known enhanced spread of the virus.
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:
During these times the home will operate a traffic light system Red, Amber or Green
As a result of the global pandemic all the Trust services have previously been closed to all visitors as residents are classified as extremely 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 as garden visits at these times when the homes were unable to accommodate indoor visits, these visits have 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 and guidance 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.
Role of providers and directors of public health (DPH) in providing a dynamic risk assessment
The priority is making sure those in care homes receive the care and support they need. This includes making sure that residents are not put at avoidable risk of contracting COVID-19, which can have such a devastating impact if it spreads through a care home, infecting vulnerable residents and potentially care staff.
Therefore, for visits to happen, the provider needs to assess and balance the risk of local prevalence and the ability of the care home to manage the visit safely. This dynamic risk assessment must formally take into account the advice of the local DPH. The DPH may choose to provide this through a dedicated care home outbreak management team or group, often in partnership with local social care commissioners.
The role of the DPH includes formally leading efforts to suppress and manage outbreaks, and the local outbreak plan (overseen by the DPH) includes care homes. DPHs also have powers to issue directions to homes to close to visiting, or to take further specific steps.
Care homes must also take into account the significant vulnerability of residents in most care homes, as well as compliance with obligations under the Equality Act 2010 and the Human Rights Act 1998, as applicable.
The care home’s visiting policy is made available and communicated to residents and families, together with any necessary variations to arrangements due to external events.
In the event of an outbreak in a care home, the home will rapidly move to stop visiting (except in exceptional circumstances such as end of life) to protect vulnerable residents, staff and visitors. There may be local policy and outbreak management arrangements, which will be important to follow. These restrictions may continue until such time as it is understood that the outbreak has been brought under control and the care home has recovered – at this point visiting may be restarted but with the usual infection prevention and control measures and any enhancements required due to any risks identified following the recent outbreak.
In making their judgement the director of public health should consider as a minimum:
In addition, in making their decision about visiting policy, providers and the director of public health should, where possible, consider:
In order to enable visits to happen safely, it is vital that the DPH has a live view of the local conditions. The Capacity Tracker is a timely and rich source of information that will help inform the DPH’s advice on visits. Completing the Capacity Tracker daily will help provide assurance and early warning if there were to be an outbreak, as well as helping to provide confidence on regular reporting and that any new cases would be rapidly reported to the local PHE Health Protection Team.
Visits should always take place with appropriate infection-control precautions.
The Trust’s services have engaged in a variety of visiting options which have included:
Care home visiting should be supported and enabled wherever it is possible to do so safely –supported by this guidance and within an environment that is set up to manage risks. All visitors also have an important role to play –helping to keep their loved ones, other residents and staff safe by carefully following the policies described in the guidance and the practical arrangements that care homes put in place, such as internal risk assessment and infection prevention and control protocols. Local system leaders such as the directors of public health (DPH) and directors of adult social services (DASS) also have a key role in this partnership to support visiting.
In the face of new variants of the virus, we need to remain alert to ensure we protect those most at risk in care homes while ensuring indoor visits can go ahead.
Vaccination is one of our best defences to combat infection. It significantly reduces the transmission of the virus, particularly following 2 doses. It is strongly recommended that all visitors and residents take the opportunity to be vaccinated before conducting visits.
Each care home is unique in its physical environment and facilities, and the needs and wishes of their residents. As such, care home managers are best placed to develop their own policies to ensure that the visits described in the guidance are provided in the best way for individual residents, their loved ones, and care home staff.
Care home managers should feel empowered to exercise their judgement when developing practical arrangements or advice to put this guidance into practice so that visiting can take place smoothly and comfortably for everyone in the care home.
The individual resident, their views, their mental capacity, their needs and wellbeing should be taken into account when decisions about visiting are made, recognising that the care home will need to consider the wellbeing of other residents as well.
These decisions should involve the resident, their family and friends and the provider and other relevant professionals such as social workers or clinicians where appropriate. Throughout the guidance the use the phrase ‘family and friends’. This is intended to be a wide-ranging and inclusive term to describe the network of people around the resident who may wish to visit, or whom the resident may wish to meet.
All visits have and will continue to have the to follow the visiting code/guidelines
The Trust continues to adopt the current Government guidance, which is based on the following principles:
It will continue with its policy of:
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.
If at any time visitors break the visiting protocol, they may be asked to leave, and a meeting arranged with the management of the home.
The health and wellbeing risks arising from the needs of our residents will be taken into 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.
The Trust recognises that its visiting policy and arrangements will be very much subject to local circumstances and will have to be adjusted to meet any changes in these. These changes include:
Any arrangements made by the home will apply only when safe to do so, with the approval of the local Public Health authority and on the basis its “dynamic risk assessment”.
Its decisions will continue to be based on balancing the benefits to its residents (and reducing harm because of lack of visits) against the risks of increasing COVID-19 infections and their consequences to a vulnerable group of people.
The home recognises that decisions to allow visiting and under what circumstances will be made in line with local intelligence from testing on the community and of residents and staff, transmission risks in the local community and other information provided by the home, for example, through its Capacity Tracker updating.
Day of Testing:
All visiting professionals who are not regularly tested through another route, should be tested on every visit in the same manner as visitors via the LFD test, this is if they have not tested at home, the care home has the right to ask for evidence of a negative test.
Under the present circumstances, the home recognises that all visits will have to be pre-booked and with limited availability some order of priority might need to be established.
It will base its priorities on the following.
The home will ensure that the visiting arrangements will be planned, including times, frequency, and duration, and agreed in consultation with residents and their families and with professionals involved in a person’s welfare.
Visitors will need to be tested or provide evidence that a test has been undertaken on the same day outside of the home on entry, every time they visit the care home, regardless of the date of their previous visit
The Trusts homes will follow Government guidance in respect of enabling visits to be conducted safety and successfully, including supporting visitors on how to prepare for a visit, including where testing is being carried out.
The Trusts homes accepts that the arrangements for each set of visits will vary and need to be highly individualised.
When visiting our care homes as an agreed “named visitors” we will still ask you to:
We are confident that with these precautions in place we will be able to keep our residents safe.
The home will update this visiting policy in the light of further developments and the easing of restrictions as the risk decrease. It will, however, return to a tightening- up if there are further cases of COVID-19 in the home or evidence of increased risk from community transmission that has been identified by local Public Health.
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.
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.
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.
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 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.
Care homes should support NHS Test and Trace by keeping a record of current and previous residents, visitors and staff. As per General Data Protection Regulation (GDPR) requirements, these records can be destroyed after 21 days.
Spending time out of the care home has always been an important part of life for many people living in residential care, and residents leave their care home for a range of reasons. These might include to attend work or education, attend medical appointments and to spend time with friends and family.
For some residents, regular visits out may have been assessed as being a necessary part of their care plan, such as accessing care and support at day services, participating in community groups and volunteering. This might include regular planned overnight visits to the nominated family home.
We recognise how important this is for residents’ health and wellbeing, their ability to remain at the heart of family and social networks, and, in some cases, to deliver the objectives of their care plan.
However, spending time with others outside the care home will increase the risk of exposure to COVID-19 for the resident and potentially to other residents and staff on their return. This is the case even as we see community infection rates dropping and vaccine coverage increasing.
There are certain types of activity where the risks are inherently higher and will mean that the resident should self-isolate on their return (to the care home). This is to ensure that, in the event they have unknowingly become infected while out of the home, they minimise the chances of passing that infection on to other residents and staff. These activities are:
This remains under review, and it is the governments ambition that guidance on the need for self-isolation following overnight stays in hospital will be amended as soon as the data and evidence show it is safe.
All other visits out of the care home that are not assessed as high risk should be supported without the need to isolate on return to the care home, subject to an individual risk assessment. Where applicable, attention should also be given to any additional local guidance provided by the local director of public health (DPH) and director of adult social services (DASS).
All precautions relating to COVID-19 (including social distancing and those set out below) should be followed while out of the care home. Where residents are visiting a location with an existing testing regime – for example a workplace, day care centre or education setting – they should participate in the relevant testing regime for that organisation where possible.
Our Care homes will always support visits out in exceptional circumstances, such as to visit a friend or relative at the end of their life.
Providers are best placed to define their overall policy for how outward visits are supported in the care home, in a way that takes into account the assessed needs of their residents and what is possible within the facilities and resources of the care home.
The make-up of the care home community should be a key determinant of local arrangements for supporting outward visits. This is because residents are likely to have a range of needs, long-term conditions and other clinical vulnerabilities and levels of mobility.
Providers should consider both the benefits and potential risks involved in a visit out of the care home, in order to recommend measures to mitigate risks before, during and after the visit. Consideration should be given to the risk to other residents (who may be particularly vulnerable) and staff.
The local DPH and DASS both have an important role in supporting care homes to ensure outward visiting can happen safely. This support should assume that outward visiting should be possible unless there is evidence which suggests a more restrictive approach should be taken.
In particular, the DPH and DASS should not recommend an approach across the whole of the local authority area that does not recognise variation between different areas with the local authority, and which does not take account of the different circumstances in individual homes and the need for any specific COVID-related infection control measures at a given time.
No visit out of a care home during a pandemic is without risk, but there are steps we can take to reduce those risks. Care homes will discuss and agree arrangements with residents, residents’ named visitors, or their essential care provider in advance.
Decisions about an individual resident’s visits out of a care home should be taken with the resident’s assessed needs and circumstances considered. The care home will balance the benefits of visits out of the care home against a consideration of the risks to others in the home, where necessary.
It is important that the resident and their family are involved in discussions throughout this process. If undertaking a visit out is not possible because of the risk to the individual and other residents and staff, care home managers will communicate the reasons for this decision clearly to the resident and their family.
Individual risk assessments should take into account:
Where a care home is situated in a local community with high, or rapidly rising, levels of infection, and/or where there is evidence of variants of concern or variants under investigation, care home managers should seek additional local advice from their local authority DPH.
Regard will also be given to the ethical framework for adult social care, and the wellbeing duty in section 1 of the Care Act 2014, and all decisions should be taken in light of general legal obligations, such as those under the Equality Act 2010 and Human Rights Act 1998, as applicable.
To support safe visits out of care homes and to minimise the risk of transmission of infection to care home residents and other people they live with in the care home, the following measures are advised and should be considered for all visits out of care homes:
residents may be (but are not required to be) accompanied by:
Where residents are visiting a location with an existing testing regime, for example a workplace, day care centre or education setting, they should participate in the relevant testing regime for that organisation where possible.
Others involved in the visit should take steps leading up to the visit to minimise the risk to the care home resident and others in the care home, recognising that introducing COVID-19 to a care home puts all those who live and work there at risk. This includes receiving a negative test and following good infection control practice including social distancing, hand hygiene, wearing face coverings and avoiding crowded places.
Vaccination is one of our best defences to combat infection risk. It significantly reduces the transmission of the virus, particularly following 2 doses.
It is strongly recommended that all visitors and residents take the opportunity to be vaccinated before conducting visits.
In the event of an outbreak, all movements out of a setting should be minimised as far as possible.
These restrictions should continue until the outbreak is confirmed as over, which will be at least 14 days after the last laboratory confirmed or clinically suspected cases were identified in a resident or member of staff in the home.
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 give consent provided by the services and this is a true and honest reflection.
Each of the Trust’s services will keep a visitor log in line with the Track and trace initiative.