The Care Inspectorate sends our best wishes to all those working in services across the country over the festive season and our sincere thanks for your continuing commitment during this time.

We know this is an extremely busy time for care homes and want to remind services of the importance of visiting throughout this period.

Meaningful contact with families and friends is fundamental to health and wellbeing, and is a key human right.

As we are now well into the winter months, many care home services are experiencing increased outbreaks of infections.

All services must ensure that even during an outbreak, people are supported to stay connected, in person, with those who are important to them, when this is what people want.

Services must also ensure that any temporary changes in visiting arrangements are clearly communicated to families and friends, with the expected end date, and updated as appropriate.

The Health and Social Care Standards set out the clear expectation that everyone who lives in a care home will always have the right to see and get support from loved ones, including during outbreak situations when some restrictions may be needed to limit the spread of infection. The two new standards introduced last year set out what people experiencing care should expect:

  • If I am an adult living in a care home and restrictions to routine visiting are needed to prevent infection, I can nominate relatives/friends (and substitutes) to visit me.  My nominated relatives/friends will be supported by the care home to see me in person day-to-day and to be directly involved in providing my care and support if that is what I want 
  • If I am an adult living in a care home, I can nominate relatives/friends (and substitutes), who will be supported by the care home to be directly involved in providing my day-to-day care and support if that is what I want

Open with Care guidance

Where there is an outbreak within the home, as advised by the local Health Protection Team (HPT), residents should continue to be supported to stay connected with people important to them by default through their named visitors. The following outlines the current guidance for visiting, outings, and activities in adult care homes during an outbreak:

  • residents can now identify up to three named visitors, and one named visitor can visit the resident in their private room each day
  • named visitors may also be able to spend time with a resident who is self-isolating because of being Covid-positive. This should be discussed in advance of the visit with the care home who will take advice from the local health protection team following their risk assessment
  • flexibility will need to be applied, for example where support is needed by one named person to visit e.g. an elderly spouse or due to other individual circumstances*
  • it should be possible to change named visitors to take account of family circumstances
  • regardless of outbreak status, essential visiting should continue to be supported. This is in addition to named visitors and is not restricted by numbers, frequency or length of time spent with the resident**
  • if the resident is well enough, unless they are Covid-19 positive, have Covid-19 symptoms, or symptoms of another infection, they can continue to go on outings from the care home in line with the support needs within their care plan.
  • However, in some circumstances the care home, following advice from their local health protection team, may recommend that residents do not leave the home for a short period of time, while the outbreak is ongoing
  • during an outbreak, visits from clinical and social care professionals will be prioritised due to the essential nature of support for resident health and wellbeing. Advice will be provided by the Health Protection Team.

* Public Health Scotland has advised that in exceptional circumstances, two named persons can visit at one time if support is needed by one of them, for example, an elderly spouse or due to other individual circumstances.

** Essential visits must be supported for end of life or stress/distress.

The guidance states any restrictions must be for the shortest time and be regularly reviewed.

The Care Inspectorate recently produced a webinar and accompanying factsheet, which discuss further some of the factors around supporting meaningful connection during an outbreak situation.

If you require any support over the festive period regarding outbreaks and management of these, please contact your local health protection teams (HPTs).  Please note that the contact details for HPTs (including out of hours) available here are only for care home managers – not for relatives of care home residents.