Updated guidance on care home visiting

We expect and encourage providers to facilitate visits wherever possible, and to do so in a risk-managed way.

Visiting is an integral part of care home life. It is vitally important for maintaining the health, wellbeing and quality of life of residents. Visiting is also crucial for family and friends to maintain contact and life-long relationships with their loved ones, and to contribute to their support and care.

People living in care homes are typically more vulnerable to severe illness as a result of coronavirus (COVID-19). While vaccination is proving very effective, we are still seeing some cases of severe illness, hospitalisation and death of care home residents who have been vaccinated. Caution is advised as we learn more about real-world vaccine effectiveness and disease severity of the Omicron variant of COVID-19.

Additional measures are therefore in place to facilitate visiting while keeping care home staff and residents safe. These include:

• limiting the number of visitors who can visit regularly
• infection prevention and control (IPC) measures
• individual risk assessments
• testing arrangements
• isolation on return from some high-risk activities out of the home

This guidance is based on regularly reviewed clinical advice.

This guidance covers:

• visits that should happen in all circumstances
• safe visiting practices
• when different visiting arrangements are needed
• sources of information and support

The key things to know about care home visiting are:

• every care home resident can nominate up to 3 visitors who will be able to enter the care home for regular visits (this number does not include essential care givers or preschool age children)
• visitors should make arrangements with care homes in advance of the visit, so that care providers can manage the number of people attending at any one time to ensure safe visiting practices can be maintained taking into account the size and layout of the care home
• the duration of visits should not be limited if safe visiting practices can be maintained
• visits should take place in a room most practical and comfortable for the resident (for example, residents with dementia may be more comfortable in their own room with familiar belongings)
• visitors should receive a negative lateral flow test result and report it on the day of their visit, either by conducting the test at home or when they arrive at the care home – essential care givers need to follow the additional testing arrangements outlined below
• every care home resident should be supported to have an identified essential care giver (in addition to their named visitors) who may visit the home to offer companionship or help with care needs – essential care givers should be able to visit inside the care home even during periods of outbreak affecting the care home
• during an outbreak, care providers should also continue to offer visits in well-ventilated spaces with substantial screens, visiting pods or from behind windows – rooms should be left to ventilate with external doors and windows open between uses wherever possible, while aiming to maintain a comfortable temperature for residents and visitors
• subject to a risk assessment by the health protection team (HPT), outbreak controls may be in place for up to 28 days following the last positive case especially as we learn more about real-world vaccine effectiveness and disease severity of the Omicron variant
• physical contact should be enabled to help health and wellbeing, as long as IPC measures are in place, such as visiting in a ventilated space, using appropriate personal protective equipment (PPE) for the visit, and hand washing before and after holding hands – gloves are not needed for handholding and stringent adherence to hand washing is advised
• residents should be supported to undertake visits out of the care home as appropriate:
  • residents who have received at least 2 doses of the vaccine, or are exempt from vaccination, should not have to isolate following most visits out of the care home if they follow the correct testing regime
  • residents who have not received at least 2 doses of the vaccine, and are not exempt from vaccination, should isolate for 14 days following a visit out
• all residents should isolate following an emergency stay in hospital, if they test positive for COVID-19 or following a visit that has been deemed high-risk following an individual risk assessment by the care home
• vaccination is one of our best defences to combat infection. The COVID-19 vaccine significantly reduces the transmission of infection, particularly after 2 or more doses. It is strongly recommended that residents and visitors receive 2 doses of the COVID-19 vaccine, plus their booster especially in light of the emergence of the Omicron variant. The data shows that booster doses are required to provide higher levels of protection against symptomatic infection. If eligible, visitors should also get their flu jab when it is offered to them
• visitors should not enter the care home if they are feeling unwell, even if they have tested negative for COVID-19 and are fully vaccinated and have received their booster. Transmissible viruses such as flu, respiratory syncytial virus (RSV) and norovirus can be just as dangerous to care home residents as COVID-19. If visitors have any symptoms that suggest other transmissible viruses and infections, such as cough, high temperature, diarrhoea or vomiting, they should avoid the care home until at least 5 days after they feel better
• visitors who are not legally required to self-isolate are advised against visiting the care home (for 10 days) if they have been identified as a close contact of someone with COVID-19, unless absolutely necessary, even if they have been fully vaccinated. Where visits do occur, visitors should have received a negative PCR test result prior to their visit, and a negative lateral flow test result earlier in the day of their visit
• anyone who is fully vaccinated, and has been identified as a close contact of a confirmed case of the Omicron variant of COVID-19, does not need to self-isolate if they receive a negative PCR test result and take daily rapid lateral fow tests until 10 days after their last exposure to the positive case

Read more of this update from the Department of Health & Social Care here