Introduction

Visiting over the winter months

This policy is subject to change and will be reviewed in line with current Government Guidelines. This policy outlines the procedures in place to ease and reduce the visiting restrictions in place for our residents in our Care Homes at South Coast Nursing Homes Ltd. The Safety of the people in our care, our staff and the people who use our services is paramount. We will always follow the current guidelines set out by the Government for delivering Care in Care homes during this COVID-19 pandemic which are reviewed on a regular basis and are subject to change. We endeavour to take into account not only the Health but the mental well-being of the people in our care and the impact any quarantine and shielding measures that are placed upon them for their safety. We are also mindful of balancing their Human Rights and their right to Equality when putting Safeguarding measures in place. Where possible we will fully inform residents and visitors so they can make their own choices and decisions but also taking into account the Health and Safety of everyone in the work place to adhere to the Health and Safety at Work Act of 1974.

Designated visitors

Visiting to be restricted to 4 designated visitors per resident and a maximum of 2 visitors per visit. If the resident does not have a family member this could be designated friends or LPA’s. These will be the only people who can visit this person until restrictions are lifted further. The designated visitors must give the home full details such as name, address, and contact details which will be kept in a register by the home.

This has been reduced as the visits have changed to occur inside the building. Previously they were facilitated outside but with the change in weather we can only accommodate smaller numbers inside.

Rationale:

To be able to control the possible transmission of the virus to our residents and to be able to trace and track cases more effectively while adhering to the Government 3 step Guidelines for lifting Lockdown.

Risk Assessment:

  • Anyone coming into the home is at risk of carrying the COVID-19 Virus to our staff, residents and others.
  • Anyone coming into the home is at risk of contracting COVID-19 from the people who live or work here as we cannot guarantee that the home is free from infection.
  • Regular routine testing of staff and residents will be carried out, as per Government Guidelines to enable the continual monitoring and enable appropriate infection prevention measures to be put into place to reduce the risk of transmission.
  • Minimising the number of visitors will enable us to monitor and reduce the exposure to staff, residents and visitors.
  • Having a detailed register of contacts will enable us to trace visitors to inform them if any new cases of infection have put them at risk

Information about symptoms

The designated visitor must be willing if necessary, to inform the home of any symptoms or positive results for themselves or any close contacts. (They do not have to disclose Personal Data of others (GDPR).

Rationale:

This is in line with the New Government Test and Trace initiative to control the virus and ease Lockdown in the UK. In order for us to take appropriate actions to effectively isolate and test individuals in a timely response to the possibility of transmission of infection to our residents and staff.

Risk Assessment:

  • To enable us to put the necessary infection prevention and control measures in place to reduce the spread of the virus.
  • Any resident who has been visited by someone who has contracted the virus, will be isolated for 14 days.

Visitors information about Health risks

The visitor must be fully informed in writing about the risk to their own health of entering the care home and the risk to the individual they are visiting from exposure to the virus.

Rationale:

Duty of care under the Health and Safety at Work Act 1974 for other people in the workplace.

Risk Assessment:

  • A letter will be sent to all relatives and LPA’s to explain the risk of visiting our care homes and to advise them to continue not to make non-essential visits and to continue to use other methods of communication set up for the purpose of making contact with the residents in our care which help to reduce the risk of exposure to the virus.
  • Visitors will be reminded of the risks when they are screened before entering the premises
  • Visitors will sign in the visitors’ book and undertake screening of their health status prior to being allowed entry to the premises.
  • Visitors to be fully informed of the risk to their own Health and Safety and the Health and Safety of others in the work place including the person they are visiting, in order for them to make a decision to expose themselves and others to the risk of exposure to COVID-19.
  • The home will put measures in place to reduce this risk as far as practically possible but the risk cannot be eliminated.

Residents information about Health risks

Residents are particularly vulnerable; the Government Guidelines on Shielding should remain in place unless the resident has made an informed choice to take the risk of exposure. This decision and risk assessment must be agreed by them and documented.

Residents must be fully informed of the risk to their own Health and the health of the other residents and staff if they receive visitors.

Rationale:

To ensure fully informed consent has been obtained and all risks have been identified to enable a decision.

To ensure we continue to give full protection to the most vulnerable individuals in our care.

We continue to safeguard them from harm while we are respecting their own choices and decisions, accepting that they have a right to make unwise and eccentric decisions under the Mental Capacity Act of 2005.

We also acknowledge that residents have a right to a private and family life – Article 8 of the Human Rights Act 1998.

Risk Assessment:

  • The manager will discuss the risk with the resident and document the risk assessment on Nourish.

Best Interest Decision making

For residents who lack capacity to make an informed decision a Best Interest Decision will be put in place and fully documented.

Rationale:

To safeguard and to ensure the residents rights have been protected under the Mental Capacity Act 2005 and the least restrictive option for the individual has been put in place.

Risk Assessment:

  • The manager will discuss this decision with the LPA for Health and Welfare, the family and anyone else directly involved in the decision.
  • The decision will be documented by the Manager using the Mental Capacity Assessment folder on Nourish.

Visiting by appointment only

Visiting will be by appointment only and at the discretion of the management. The management reserve the right to cancel the planned visit at any time if circumstances with the resident or the home change, without prior notice if necessary although every effort will be taken to inform the visitor before their arrival.

Where an outbreak occurs in any home visiting will be stopped as per guidance from Public Health England.

Visiting will resume 28 days from the date the last person tests positive.

To enable as many people to see their relative as possible we have tried to coordinate visiting at most homes over the weekend as well as during the week.

Rationale:

To ensure we can react to the changing needs of the residents and put the necessary procedures in place to protect our residents and staff.

Risk Assessment:

  • Visits will be restricted to 30 mins and between the hours of 10am – 12pm and 2pm – 4.30pm. Visits will be scheduled on the hour i.e. 10 – 10.30. 11-11.30 to facilitate the cleaning and sanitising of the visiting area and furniture etc. in between visits. This may be subject to change depending on availability of the home and their family liaison staff.
  • Visits will be by appointment only by a designated person which will normally be the Administrator.

Assisting residents to access visits

Every home now has their own designated space for allowing visitors inside the building. Each home also has a specific risk assessment for these visits. Please see separate document. Where possible visits should be held outside but if the weather does not permit visits can be held in these designated areas.

This is different to palliative care visits which has separate guidance.

Rationale:

To ensure compliance with the Government 3 step Guidelines for lifting lockdown. To reduce exposure of the virus to our residents, visitors and staff.

Risk Assessment:

  • Visits will only be in the designated space within the building or a residents’ room if agreed with manager, as will be the case if someone is palliative.
  • If the resident is unable to access the designated area alternative arrangements must be made to enable their visits with minimal risk to all involved.
  • Visitors must remain in the designated area at all times.
  • Designated staff will monitor the visits by making regular safety and comfort checks to the area as a point of contact for the resident and visitor.
  • A 1-2-meter distance must be maintained at all times by the visitors and resident.
  • Visitors will be responsible for the resident while they are in their company.
  • Within the building all visitors must wear masks.

Designated visitor coordinators

Member/s of staff per shift will be designated to coordinate visits and assist residents who are not independent to prepare for and access their visit.

Risk Assessment:

  • Members of staff will be identified and allocated to be responsible for coordinating the visits and preparing the residents. They will assist the resident into the designated area and then escort the visitor to the designated visiting area.
  • The care staff will assist the resident to get ready by offering personal care and making sure they have had fluids and an opportunity to use the toilet facilities before the visit. This will be documented on the appropriate Nourish interactions.
  • The care staff if necessary, will assist the resident to be hoisted into an appropriate transportation chair or Altitude type chair prior to the appointment time to ensure the visiting time is not impeded.

Visiting for residents unable to access outside areas

Visiting for residents who are palliative/end of life is different in every case. Each case must be discussed and agreed with the manager of the home to allow for the safest and most appropriate visiting for that person and their family.

Considerations must be made with the level of risk involved for the resident, their family/friends and staff.
A separate risk assessment must be undertaken specifically for each case and shared with the relevant people.

Every effort will continue to be made to ensure visitors can spend quality time with their loved ones at these difficult times. These appointments can be made with the manager of the home.

Rationale:

To reduce the risk of transmission of the virus within the home to residents, staff and visitors and to ensure we are following the Health and Safety at Work Act 197 and the Current Government 3 step Guidelines for lifting Lockdown.

Risk Assessment:

  • Visits inside of the home are restricted to those who are End of Life or deteriorating.
  • It is mandatory for visitors to wear gloves, aprons and a surgical mask for the duration of their visit.
  • They must stay in the room with the door closed at all times
  • These visits will be arranged with the manager of the home
  • *Visiting time may be reduced if the resident is positive to COVID-19 to minimise the risk of transmission to the visitors
  • If inside please try and ventilate rooms with fresh air by having windows open.

Visitor screening

All visitors will be fully screened on arrival and will be escorted on and off the premises by designated members of staff.

Rationale:

To monitor the health status of anyone entering the home, to reduce the risk of transmission of the virus to residents, staff and visitors to the home in line with current Infection Prevention and Control measures to prevent the spread of COVID- 19 in Care homes and to be able to track and Trace cases effectively.

Risk Assessment:

  • Visitors will wait at the front door to be escorted to their resident.
  • The following measures will be carried out by the designated staff who have been allocated to coordinate the visiting:
  • All visitors to the home will have their temperature recorded and any symptoms listed prior to entering the premises.
  • A set of Health Screening questions will be asked and answered fully before being allowed entry to the premises.
  • Visitors may be refused entry if they have any symptoms or have been in contact with anyone else with symptoms or who have tested positive in the past 14 days or if they have had any symptoms in the past 7 days
  • All visitors will be asked to wear a mask.

Infection control measures for visitors

Visitors must comply with the Infection control measures in place for their own safety and the safety of others.

Rationale:

To reduce the risk of transmission of the virus to residents, staff and visitors to the home in line with current Infection Prevention and Control measures to prevent the spread of COVID-19 in Care homes. To adhere to the Health and SAFETY AT Work Act 1974

Risk Assessment:

  • Visitors will sanitise or wash their hands on entering the premises.
  • They will be offered a disposable face mask to wear during their visit. These will be provided by the home.
  • Visitors will NOT be able to access any other areas of the home and they will not be provided with food or drink during their visit
  • Visitors are advised to bring a bottle of water for their own use. Visitors must not bring food or drink in for the residents to share during the visit to reduce the risk of cross contamination and contact.
  • Visitors are asked to avoid using toilet facilities where possible to reduce the risk of cross infection.
  • Sanitising stations will be set up at the entrance for visitors to sanitise their hands and dispose of their masks before leaving.

Visitors under 12

Visitors under 12 are permitted.  All visitors who are currently at secondary school, college, or university are requested to communicate with relatives via skype at this heightened time of cases increasing within this age group.

Rationale:

Currently cases within this age group are rising in the community with little ill effect in the majority of individuals. This may not be the case should the transmission gets passed onto people who are frail. This will be reviewed as soon as possible

Risk Assessment:

  • All visitors under the age of 12 must wear a face covering. This should be their own face covering as we cannot provide smaller face covering to accommodate younger people.
  • We would ask all people under the age of 12 to stay with the relatives who have brought them into the home and that they respect our guidance.
  • Visitors under the age of 12 should also maintain social distancing where possible when visiting.
  • We would discourage anyone currently attending secondary school, college or university from visiting whilst the number in this group are rising often asymptomatically as we currently feel this is a high risk group.

Comments, concerns or complaints

Visitors will not be allowed to engage directly with the manager or staff directly during their visit, other than with the designated staff coordinators. They will be advised to follow the whistleblowing or Complaints procedure and to ring the manager direct to discuss any matters of concern.

Rationale:

To reduce contact with others and to reduce transmission to residents and staff in line with Infection prevention and control measures for COVID-19. In line with Adult safeguarding and Whistleblowing procedures and the Complaints procedure.

Risk Assessment:

  • If visitors have any concerns or wish to speak to someone about their relative, they will be advised to do this directly after the visit via the telephone.
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