Update on the Visiting Call to Action

To date there are over 130 supporters, including some notable additional organisations including the British Institute of Human Rights, BASW, a number of MPs and many more care providers and individual relatives who have reached out having heard about the coalition. The media response has been fantastic – 208 items of coverage across press, web and broadcast media with a reach of 55 million. This is no mean feat in the week of a national lockdown and US election.

The Call seems to have landed well, bringing a wide cross section of voices with it in support of a more flexible and enabled approach to visiting in  care homes. The key messages seemed to have resonated with families and care providers alike, as well as other key stakeholders and influencers.

On Day One of Lockdown 2.0, November 5th, there is new guidance from DHSC on Visiting In Care Homes. For those who haven’t seen it – it can be found here.

There seems to have been a little progress in the government view on the importance of visiting and the increasingly difficult balancing act of managing the risk of harm COVID vs the risk of harm from isolation and lack of meaningful visits. Whilst this in no way goes far enough – it does provide something positive to work with. The guidance enshrines the expectation that care homes enable safe visiting as far as is possible, while balancing all the risks, which feels like a shift in policy intent. Whilst there is a recognition that outdoor visits are the preferred option, visits can also be enabled indoors, with a range of caveats, which is a step forward. In addition, it recognises the needs of those who cannot engage in the approaches outlined and encourages providers to work with residents and loved ones to develop a tailored approach within the principles outlined.  It also references the work on the testing of visitors, which is welcome and needs to progress at pace.

However, the guidance outlines some specific, detailed conditions for indoor visiting in care homes which will make it very difficult to actually continue to operate visiting or begin to do so. The need for substantial screens (e.g. floor to ceiling screens) poses a significant obstacle to indoor visiting in practice and  will hinder both those who are supporting visiting and those who are yet to do so.  

Of huge concern is the potential for visiting to continue to be stopped at a local level, and the ongoing risk of blanket bans. The guidance outlines ‘DPHs also have powers to issue directions to homes to close to visiting, or to take specific steps’’ The potential for very significant distress to families and loved ones from the mixed messages between national government and local directives is huge. There are examples of how visiting can continue to be enabled, even in areas of high prevalence, and it is those positive and enabling agendas that need pushing.

The coalition can continue over the coming month, using the end of November deadline, to call for a sustained focus on visiting, the introduction of the essential visitor role, indemnification of providers and a continued emphasis on getting the things in place for there to be meaningful visiting as the default position. This guidance does not go far enough, and the coalition is not deterred by the government saying it will stand until the end of national restrictions. Continued work together will show how important visiting is, how possible it is to do safely (using some of the already excellent examples) and how valued it is by stakeholders from across all bodies including residents, loved ones, providers, professionals, specialists, researchers and the wider community.

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