Updated Covid-19 guidance for visiting care homes is “confusing” and “encourages blanket bans on visits” in areas under the highest alert levels, a charity has argued.
John’s Campaign said the latest guidance for England from the Department of Health and Social Care (DHSC), published on Thursday, does not go far enough in helping relatives visit care home residents during the pandemic.
The guidance, which supersedes previous versions, applies fully to areas in the “medium” level of the Government’s new three tier Covid-19 alert system.
It states: “As the rate of community transmission has reduced, care homes can now develop a policy for limited visits.”
We find this guidance totally cynical as it tries to deflect our legal challenge and appalling in its potential effect across the country Will write more later Please take note of this @NursingTimes https://t.co/wuImm9G2CF https://t.co/S1PedtWTpC
— John's Campaign (@JohnCampaign) October 16, 2020
Decisions on visiting policies should be made by local directors of public health, together with care homes, and in light of their legal obligations such as those under the Equality Act 2010 and Human Rights Act 1998, the guidance explains.
Visiting policies require consideration of the individual circumstances of a care home, its residents and the local epidemiological risk or presence of outbreaks.
Providers should undertake “individualised risk assessments” to assess the rights and needs of each resident, the guidance states.
This includes taking into account the potential wellbeing benefits from visits, particularly for residents with dementia, a learning disability or autism.
To reduce risk visits should be limited to a single constant visitor per resident, where possible, with an “absolute maximum” of two constant visitors per resident.
But for local areas with a “high” local Covid-19 alert level, described as “high risk” or “very high risk”, the guidance says “visiting should be limited to exceptional circumstances only such as end of life”.
It adds: “Where visiting is restricted due to the local Covid alert level and if, after an individual assessment of the resident’s circumstances, it is determined that in-person visitation is not appropriate, care homes should support visiting in a virtual manner.”
John’s Campaign, led by Julia Jones and Nicci Gerrard, welcomed the introduction of individualised assessments in “medium” alert areas but expressed disappointment this didn’t extend further.
The pair said: “The new guidance fails to offer real improvement for the hundreds of thousands of people who have had no meaningful contact with their loved ones for over seven months now, and the continuing imposition of outright bans in many parts of the country is harmful and wrong and we will continue to challenge it.”
They also expressed concern that the guidance only says that care homes “can” draw up policies for limited visits rather than “must”.
Their charity, which campaigns for people with dementia to be supported by family carers, was set up after Ms Gerrard’s father, Dr John Gerrard, deteriorated during an imposed separation from his family, dying in 2014.
Last month, the charity said it was seeking a judicial review of the DHSC’s July care home guidance, which said visits could resume in specific care homes in England once local directors of public health and local authorities decide it is safe to do so.
But charities argued passing responsibility to local decision-makers was likely to result in little change in visiting access unless the point was “clearly made and enforced by the Government”.
John’s campaign said it had held back from pursuing the judicial review while updated guidance was developed, but now vowed to “fight on”.
The charity previously said it believes closest family members are not an “optional extra” but integral to residents’ wellbeing, and that the Government has failed to take into account individuals’ human rights.
Its founders claimed that while some care homes are making decisions based on individuals’ needs, the founders say others “lack the confidence which clear Government direction would give”.
Tessa Gregory, a partner at the Leigh Day law firm, said it was “absolutely crucial” that individualised risk assessments were “carried out everywhere in order to allow care homes to strike an appropriate balance between infection control and the need to ensure vulnerable individuals have access to family contact and care.”
She added: “It is time for the Government to recognise that for many of those living with dementia meaningful contact with their family is as essential to their survival as infection control.
“The updated guidance is confusing for care home providers and encourages blanket bans on visits and that simply does not reflect the obligations under the Human Rights Act and Equality Act to take individualised approaches.”