Scottish care homes: What can I do when visiting a relative?

Care home visiting has been tightly restricted during the pandemic.

However, data released last week showed care home coronavirus deaths had fallen by 62% in the last three weeks, with the figure cited by Nicola Sturgeon as the first “hard evidence” of the vaccine’s impact.

Almost all residents have received the jab, along with 92% of care home staff.

The government says that with the extra protection in place, the greater risk to residents’ wellbeing is from a lack of family contact.

Here, we outline everything you need to know.

Are visitors required to take a Covid test?

The Scottish Government recommend that designated visitors are tested in a designated area in the care home before going to be with a resident.

All guidance and requirements for PPE and social distancing should be observed by care home staff supporting visitor testing.

Will I need to wear PPE?

People coming into the care home to see loved ones will be asked to wear a fluid-resistant surgical mask (FRSM) and these will be provided by the care home to the person visiting.

Gloves and aprons are not required as hand hygiene is sufficient to remove the Covid-19 virus.

Physical touch should also be supported when a fluid-resistant surgical mask is worn by the person visiting, as are brief hugs or embraces.

Who can visit?

Visits will be restricted to two designated visitors, visiting once a week at different times. These will need to be arranged in advance. 

Essential visits, where it is imperative to support a loved one who has deteriorated, is in distress or needs end-of-life care, will be allowed outside of the regular visiting slots.

What happens if a visitor tests positive?

If a visitor tests positive, they will be asked not to go ahead with the visit and instead to go home and self-isolate and seek a confirmatory PCR test.

The care home will wish to notify their Public Health team.

Where can visits take place?

Vistors to care homes will be allowed to go into their loved ones' rooms, a designated meeting place, gardens or short walks around the grounds.

Short trips outside the care homes in a car will also be permitted if public places are avoided.

Will contact stop again?

Meaningful contact between care home residents and their loved ones should return to being the usual practice in care homes in all but exceptional circumstances.

These circumstances are outlined in the guidance and will include, for example, when there is a Covid-19 outbreak in the care home.

What about patients who are new admissions?

The period of self-isolation should be observed so designated visitors would not normally be considered in this period.

However, essential visits should be supported, generously and sympathetically as the resident and family will be in an unfamiliar setting and contact may be needed to alleviate distress.

Can I visit my relative or friend in their room?

Residents should be supported to be with loved ones in their own room.

This is the preferred location but other person-centred alternatives, for example, a designated room for visiting, can be considered in the short term as opening up is embedded.

When will care homes have to offer daily visits?

The Scottish Government have not set arbitrary target dates.

Individual care homes need to move from two designated visitors at a pace that reflects their confidence and capacity.

Some care homes for younger adults may be able to increase opportunities for visiting more quickly than other homes as their population has a lower Covid risk profile.

Will care home residents be able to leave the care home or go out in groups?

The guidance is focused on reintroducing indoor visiting, which is the preferred and recommended approach to good quality contact with residents and loved ones.

The Scottish Government recognise that other forms of visiting are used (such as outdoors - at windows, in garden pods or marquees - or indoor, fully screened off adapted rooms), these should not be viewed as replacements to indoor visiting.

The guidance sets out an incremental, risk assessed approach to resuming meaningful contact and social connections.

As conditions improve care homes should begin to assess the opportunities for residents to safely leave the care home.

Additionally, care homes’ ongoing efforts to support residents who do not have regular designated visitors should be encouraged, but are not the focus of this guidance.

Can children visit?

Initially, children under 16 would not normally be a designated visitor for indoor visits and the guidance explains the reasons for this.

When restrictions ease and care home residents can have more visitors, children under 16 should be considered. Children should remember to follow safety advice.

Young people 16 and above can be designated visitors.

Children and young people can be part of outdoor meetings with care home residents. They should be included in group size limits.

Can visitors use the toilet in care homes?

Yes. Visitors should access dedicated toilet facilities for visitor use only.

How will visiting advice change when we’re in different Levels?

Under the Strategic Framework, each local council has a protection level. There are different restrictions for each level. From February 2021, contact between care home residents and loved ones will not usually be tied to the local level.

Travel into and out of levels 3 and 4 to see a loved one living in a care home is classed as essential travel. This travel is exempt from coronavirus travel restrictions.

Essential visits should always continue.

Garden and window visits are also likely to always be supported.

Why are care homes offering different levels of contact?

The Scottish Government recommend that all care homes begin preparations and implementation immediately to support full adoption and embedding of the guidance, accommodating up to two designated visitors per resident each week in the first
instance.

There may be a brief period while care homes need to make arrangements to resume indoor visiting safely.

Some visiting arrangements may differ based on the needs, circumstances and preferences of individual residents.

The principles of the new approach emphasises an individualised risk assessment to take account of these factors in planning visits
for people.

Part of the new approach involves strengthened support and oversight from a range of partners to help resume meaningful contact for everyone in adult care homes.

In addition, some care homes may have to pause indoor visiting on a very temporary basis – for example, if there is an outbreak, or concerns have been raised about compliance with infection prevention and control measures.