COVID-19: Information about Dovehaven Homes and Visits. View Here

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Dovehaven Social Visiting policy during COVID-19

This guidance applies from 17 May 2021 and replaces previous guidance on care home visiting.

Dovehaven recognises visiting is a central part of care home life. It is crucially important for maintaining the health, wellbeing, and quality of life of residents. Visiting is also vital for family and friends to maintain contact and life-long relationships with their loved ones and contribute to their support and care needs.

To ensure social visits can be achieved safely, Dovehaven have adhered to
https://www.gov.uk/government/publications/visiting-care-homes-during-coronavirus/update-on-policies-for-visiting-arrangements-in-care-homes when devising this social visiting policy.

For reference family members or friends are referred to as ‘Social Visitors’.

Visiting

  • Every care home resident will be able to nominate five visitors who will be able to enter the care home for regular visits. Each resident is permitted up to two visitors per day (if the home can accommodate this). The two visitors can visit together or separately as the resident, or they choose.
  • Visitors should be tested using rapid lateral flow tests before every visit. At the home managers discretion, Visitors CAN take the lateral flow test prior to attending the visit but must show evidence that this was done on the same day as the visit.
  • Visitors must wear the appropriate personal protective equipment (PPE) and follow all other infection control measures during visits. Visitors and residents are advised to keep physical contact to a minimum. Visitors and residents may wish to hold hands but should bear in mind that any contact increases the risk of transmission. There should not be close physical contact such as hugging.
  • Residents with the highest care needs will also be able to nominate an essential care giver (included in the five identified visitors but excluded from the daily two visitors limit). The situation described for essential care givers is considered an exceptional circumstance and should therefore continue in the event of an outbreak unless there are specific reasons not to do so. The care home and essential care giver should also agree any other relevant arrangements – for example, when and how often the visitor will come to the home, and communal areas such as staff rest areas that the visitor should not enter. The essential care giver must undertake a weekly PCR test and 2 lateral flow tests per week via the care homes arrangements for testing.
  • Garden, pod, and window visits will continue in addition to indoor visiting. In all visits – including garden and pod – visitor numbers should be limited wherever possible with 2 visitors the maximum (excluding children) at any one time.

Dovehaven will follow Public Health England (PHE) instructions regarding visits and when the home is declared in ‘outbreak’- all visits (except for End of Life visiting) will be ceased for the required timescales.

Care Homes with an Outbreak – referred to as ‘Hot Sites’.

Where a Care Home has a resident or a staff member who has tested positive for COVID-19, the home manager needs to consult with PHE and seek clarification as to whether social visits can continue.
Indoor, garden, window or pod visits would not be permitted during an outbreak until 14 days has lapsed from the last positive case within the home, unless a resident is on the end-of-life care pathway or has a nominate essential care giver.

Care Homes COVID Free – referred to as ‘Cold Sites’

Visits to residents receiving End of Life Care

If a resident is approaching the end of their life, then family/friend visits will be planned with the home manager. Time restrictions will not apply, and the visits will be led by the needs of the person and their loved ones, however there will be restrictions on the number of visitors at any one time which will be determined by the home manager.

Please see policy and procedure for facilitating visits to residents at the end of their life during COVID.

Essential care givers

Where close contact personal care from a loved one is critical for the resident’s immediate health and wellbeing, arrangements for the visitor to provide that care should be made. These ‘essential care givers’ will be supported to follow the same testing arrangements, and the same PPE and infection control arrangements, as care home staff.

Some residents may have care and support needs that mean some caring tasks cannot easily be provided by a member of staff (or not without causing substantial distress).

Examples:

  • Intimate care tasks such as help with washing and dressing where the resident becomes distressed unless it is carried out by a familiar loved one.
  • A resident’s refusal to eat unless they do so in the company of a partner or loved one may be presenting a real risk of significant physical deterioration.

Each resident’s circumstances will be different, and decisions will need to be taken in agreement between the care home, the resident, and family (and other professionals where this is helpful or necessary).

The home manager will make an individualised risk assessment for the resident which should include the risk and benefits of proposed essential care visits.

  • Essential care givers will be required to take a rapid lateral flow test before every visit except in the circumstances below. This must include a minimum of 2 tests a week: one rapid lateral flow test on the same day as the PCR test, and one rapid lateral flow test 3 to 4 days later. If the visitor is visiting less than twice a week, they will need to plan with the care home to carry out the twice weekly testing. These rapid lateral flow tests must be done on site and visitors cannot self-test at home as yet, however further guidance will be published on testing at home at a later date
  • The essential care giver must take a weekly PCR test and share the result with the home. Care homes should use their existing PCR stocks to test these visitors, and these should be registered as ‘staff’ tests using the care home unique organisation number (UON) and be returned via courier with other staff tests.
  • Be subject to additional testing in line with care home staff should the care home be engaged in rapid response daily testing or outbreak testing.
  • People that have had a positive COVID-19 PCR test within the last 90 days of will not be required to undertake testing until this timeframe has lapsed.
  • Essential visitors must use the same PPE as members of the care home staff and must follow appropriate guidance for using it after being shown how to correctly don and doff on a video or by a staff member.
  • Essential care givers will be required to maintain 2 metre social distancing from all other residents and staff and IPC measures.
  • It is important that these visitors agree with the care home what tasks they will and will not be undertaking, and that all involved are confident that the visitor has the skills to perform those tasks safely. This will need to be written down and tasks agreed between the home manager and essential care giver.

Indoor Visits (permitted from 08th March 2021)

  • An individual care plan will be devised with each resident and detail which category of guidance needs to be followed. The care plan will include the views and wishes of the resident / service user as to whether they wish to have contact and whom with at this time.
  • For those residents who lack mental capacity to make this decision, a best interest process should be followed (If there is a lasting power of attorney for health, welfare and treatment then please resort to this and seek guidance and support from your Social Services Authority).
  • A booking system will be in place which will be determined by the home manager and communicated to visitors. This will allow lateral flow testing at the care home (if home managers preference), space between visitors to be maintained, and cleaning to occur between visits.
  • Guidance indicates residents will have a two-person limit on the number of
    indoor visits each day (excluding the essential caregiver), but this remains at the home manager’s discretion as to whether the care home can facilitate two visitors daily for each resident.
  • The visit will be time limited and communicated by the home manager but will consider how far relatives may have travelled and the needs / wellness of the resident.
  • Visitors will be asked to complete a risk assessment and confirm that they have not been in contact with a suspected or confirmed case of COVID-19 or had symptoms themselves within the past 10 days. (They will not be allowed to enter the premises if they have.)
  • Visitors will need to show evidence of a lateral flow test prior to the indoor visit being facilitated. If the home manager prefers, they can continue to insist all lateral flow tests are performed at the care home and require the visitor attend the home half an hour prior to the scheduled visit to undertake the test before the visit can be facilitated.
  • Information detailing the practicalities of administering tests and registering. results can be found in https://www.gov.uk/government/publications/coronavirus-covid-19-lateral- flow-testing-of-visitors-in-care-homes
  • The home test site will be set up as one of the following two types:
    • Indoor (most likely). For ASC visitors, the assumption is that the testing would take place within the care home, in a room that:
      • Ideally the flooring is easy to clean, preferably not carpet
      • the testing area should be easy to clean and sterilise
      • all surfaces should be de-cluttered of equipment that is not
        required to run the testing
      • Sufficient room for storage
    • Outdoor
      • The home manager will be required to undertake a risk assessment of the area selected before taking a decision to proceed with rolling out LFD testing.
      • Visitors will be asked to attend the home 30 minutes prior to their scheduled visit time to enable lateral flow testing to be performed. Visitors should not leave the care home grounds whilst waiting for their test results.
      • People that have had a positive COVID-19 PCR test within the last 90 days of their scheduled visit will not be required to undertake a lateral flow test. Please bring the PCR result at each visit to verify this and timeframe lapsed.
      • Visitors will be required to wear full PPE (which will be provided by the home) in line with required guidance https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-domiciliary-care
      • Visitors will not be able to pass residents gifts during the visit (these can be left with a member of staff to be sanitised).

All window and COVID-secure pod visits will be facilitated with the strictest infection control measures and precautions

The following will apply:

  • An individual care plan will be devised with each resident and detail which category of guidance needs to be followed. The care plan will include the views and wishes of the resident / service user as to whether they wish to have contact and whom with at this time.
  • For those residents who lack mental capacity to make this decision, a best interest process should be followed (If there is a lasting power of attorney for health, welfare and treatment then please resort to this and seek guidance and support from your Social Services Authority).
  • There is no limit to the number of different households that can visit one resident at different times. However, there will be a limit on the number of visits that each resident will be allocated each week to ensure that all residents can receive social visits equally.
  • Mixed households can visit a resident at the same time if they have formed a support bubble and/or they are adhering to indoor mixing guidance which currently indicates six people indoors or up to two different households.
  • The visiting space is only small and not always well ventilated so can only be used at any one time by two people (excluding children under 4 in this number).
  • The home manager will determine how many visits can be facilitated for each resident in their home ensuring that each resident is provided equal opportunity to receive visits.
  • The home manager will determine the times in which visits can be facilitated.
  • All visits will be prearranged and scheduled with the Home Manager.
  • Visits will not be facilitated without a scheduled appointment.
  • There will be set visiting times for each home which will be determined by the
    home manager. At Dovehaven, we promote protected mealtimes, so it is at
    the home managers discretion if visits are facilitated at these times.
  • A social visitor’s risk assessment will be completed prior to any visit being
    facilitated.
  • The duration of each visit will be determined by the home manager and take
    into consideration the requirement to clean the pod between scheduled
    visits.
  • The touch point cleaning schedule will be completed between window and
    COVID-secure pod visits.
  • Social visitors will not be permitted to enter the home to access outside
    space, therefore all visiting areas will be in direct accessible outdoor areas or facilitated in a COVID-secure pod that is accessible without the social visitor entering the home.
  • In the COVID-secure pod, the social visitor and resident are in separate rooms with a window partition and intercom system to support communication.
  • Hand sanitizer will need to be used at point of entry in the COVID-secure pod and hand sanitizer at point of exit.
  • Social Visitors are not permitted to bring any food or gifts etc. into the home without the specific agreement of the care home in advance of the visit.
  • Toilet and other facilities within the care home will not be available to visitors.
  • Refreshments will not be provided and are not permitted to be brought on to the premises during the visit.

Children

  • the 5 named visitors may include an essential care giver (where they have one) but excludes babies and preschool-aged children (if this does not breach national restrictions on indoor gatherings)

Any children visiting (apart from babies and very young children) should also be counted towards the maximum number allowed for the visit. In general, a child under the age of 4 need not be counted. As is the case with visitors of all ages, there should be no close physical contact between babies or young children and the residents they are visiting.

Children aged 11 and over should wear the same PPE as adult visitors. Children under the age of 3 should not wear masks, for safety reasons.

We do not currently recommend that children under the age of 11 participate in regular asymptomatic testing.

Children must be accompanied by a responsible adult and will not be able to access other areas in the care home apart from the designated visiting area.

Visitors and family members have an important role to play – helping to keep their loved ones safe by carefully following the policy, and the practical arrangements the care home has put in place to maintain everyone’s safety.

The home manager will determine whether lateral flow tests are performed at the care home on the day of the visit or whether the home manager enables the visitor to complete this prior to attending the visit. The home manager also reserves the right to request a further lateral flow test is performed on site if they request this.

If a visitor refuses to comply with lateral flow tests, the visit will not go ahead. The home manager will be required to inform the regional manager and action taken which could result in the visitor being stopped from visiting the care home in future if their actions are perceived to put both residents and staff at risk.

Protect and prevent.

Visitors will not be permitted to visit either indoors, pod, garden, or window if any of the following apply:

  • They do not have a scheduled appointment.
  • The lateral flow test indicates a positive result for Covid-19.
  • The visitor is unable to show evidence of a lateral flow test that day (if agreed
    by the home manager to occur prior to the visit) and there is insufficient time
    to perform a test on site that day to facilitate the visit.
  • The visitor has a temperature of 37.5 or above.
  • The visitor has a new, dry persistent cough.
  • Flu like symptoms.
  • Loss of taste or smell.
  • Been in contact with someone who is COVID positive or symptoms of COVID
    within the last 14 days. If yes, they should be self-isolating as a family member
    or as a contact advised to do so by NHS Test and Trace?
  • Have they tested positive for COVID-19 in the past 10 days? (Note: if that
    positive test were from a LFD and was followed by a negative PCR test, that
    would not preclude the visitor coming in.)
  • have returned from an overseas visit recently and should still be in the
    quarantine period?
  • If there is any verbal or physical abuse to the resident, or care home staff,
    Dovehaven will take a dim view on this behaviour and will stop all visits to the home.

All social visitors will be asked to complete a risk assessment on the day of their visit, prior to the visit being facilitated.

If the answer is yes to any of the above, the visit will not be facilitated.

If there are any questions, please be advised these can be directed to:
askcovid@dovehavencarehomes.co.uk

We will continue to review the COVID social visitors’ guidance weekly and update as changes in Government guidelines are announced.