11 June: The UK’s lockdown has now spanned across four months. When the Prime Minister instructed the nation on 23 March “you must stay at home”, many care homes had already closed their doors to visitors. Anticipating the destruction the virus could cause in such settings, many homes changed their policies much earlier, restricting visits from family and friends. As difficult as this was for family members, they of course wanted their relative in care to be safe and to help prevent the risk of infection to their relative and others, including staff.
The emotional toll of months of separation has been immense. The R&RA Helpline has heard from callers anxious that their relative with dementia will be distressed about their sudden loss of contact, distraught as they watch their relative’s physical and mental health deteriorate through the video screen, heartbroken that they ‘lost’ the last weeks and months of their relatives lives.
As restrictions are lifted across England, this has given people living in care and their families a glimmer of hope. Government guidance now allows a physically distant visit outdoors with up to six people from different households. Outdoor visits are allowed even for the most vulnerable people in the ‘shielded’ group, although they are advised to only meet one other person outside their household. This triggered a wave of calls to the R&RA Helpline from people desperate to see their relative. Some callers were met with resistance from their relative’s care home, who clearly hadn’t been consulted or informed about how the changes apply to those they care for.
Government guidance specific to visiting in care homes was written at the beginning of April and hasn’t changed. It states “family and friends should be advised not to visit care homes, except next of kin in exceptional situations such as end of life.” For weeks now this guidance has contained a note saying it is being reviewed following the publication of the adult social care action plan on 15 April, but there is still no timetable or indication of what will change. There is an urgent need for government agencies to work together to produce joined up, consistent, up-to-date guidance for care providers to ensure those on the front-line of this pandemic have the support they need to protect the rights of older people.
In contrast, guidance suspending visits in hospitals was updated on 8 April to allow visitors for patients with a mental health issue such as dementia, to prevent distress. The national suspension on visiting in hospitals has since been lifted.
We urge the Government to produce a clear strategy for unlocking care homes. It should provide guidance to care homes on how they might start to relax restrictions on visiting. As a matter of urgency, the strategy should set out where action is needed to protect people whose human rights are at risk. For example, older people whose physical or mental health has seriously deteriorated due to lack of familiar support from relatives for crucial care tasks like eating, or where emotional support is needed to relieve distress or anxiety. An individualised approach will be needed, carrying out risk and needs assessments to identify where visits are necessary to protect the person’s rights.
This will need to be carefully administered by care providers and processes will have to be in place to manage any risk of infection, including stringent hygiene measures, regular spot checks for COVID-19, testing of regular visitors, and PPE. The strategy should set out a timetable for delivery of vital support from Government on both regular testing and adequate supplies PPE for staff, residents and visitors, and could set out expectations for a phased lifting of restrictions as this support is achieved.
The Government should consult and work closely with people using care services, their families/carers, provider organisations, local authorities and charities representing those receiving care to produce this strategy. This will help to ensure the strategy has the support of the sector and those it seeks to protect.
This would provide much needed hope to the thousands of families separated by the virus. The same energies being put into opening up schools, shops, pubs, prisons, and air travel should be put into opening up our care homes. The ‘travel corridor’ many families are desperate for lead not to Portugal but to their relative’s care home. Older people receiving care shouldn’t be left behind once again in this crisis.