Impact of Level 4 on care home visiting
Aligned to Level 4 visiting guidelines the Scottish Government recommends that visiting now reduce. We realise that this reduction will be difficult for many, however this is recommended for preventative, protective purposes. In parallel, national prioritisation of care home residents and staff for the COVID-19 vaccine remains in place. Our focus on vaccinating everyone living and working in adult care homes as soon as possible means that we are aiming for these additional restrictions to be as time limited as possible Under Level 4, care home visiting is advised as follows, at a frequency agreed between the care home and visitors:
- indoors: essential visits only
- outdoors: visits to the care home to see loved ones via garden or window visits, arranged with care home in advance. As a result of the additional risk posed by the
new variant, garden visits should now be limited to one visitor and visits by children and young people should be suspended.
It is important that essential visits continue to be supported. Essential visits include circumstances where it is clear that the person’s health and wellbeing is changing for the worse, where visiting may help with communication difficulties, to ease significant personal stress or other pressing circumstances, including approaching end of life. In relation to visits outwith the care home, for under 65s - previous advice recommended that these visits could be supported, following a risk assessment, and as long as individuals were tested and isolated on return. This continues to be the advice up to and including Christmas Day, and for areas that remain in Level 3. In view of the emerging situation of this new and more virulent variant of virus, we now advise that such visits should not be supported, from 26th December onwards and while Level 4 is in place.
Examples of essential visits include:
- End of life care - where a resident has a decline and it is confirmed with medical staff that the situation is irreversible. The family might be allowed some flexibility to attend in the days leading up to the resident’s death.
- Deterioration – where for instance a resident declines in mood or cognition, appetite or mobility and the cause of the decline has been shown not to be COVID-19 and where an interaction with a key loved one might be felt to help improve mood or cognition.
- A COVID positive resident is seriously unwell and potentially declining. Family and friends should be able to attend as in other end of life care situations and the home must be careful to ensure that IPC and PPE precautions are being closely followed. Physical distancing remains the recommendation, where possible although we recognise that this will be valuable at times, in cases of distress.