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Visiting in care homes during COVID-19

Guidance for visiting care homes

The following guidance is for staff, residents and visitors of care homes. It sets out how visits should be managed now that the COVID-19 vaccination programme has been successfully delivered in care homes. This guidance is regularly reviewed to ensure it reflects changes in COVID-19 risk level to care homes in Jersey.

Allowing residents to visit loved ones is beneficial to their health and wellbeing. However, many risks remain for care home residents and staff. While the COVID-19 vaccine offers a good level of protection to the person receiving it, it does not prevent illness from COVID-19 in every case, and it is likely that it only prevents around two-thirds of the onwards spread of infection.

The emergence of new variants of COVID-19, such as Omricron, and the risk of further waves of infection, means that we must continue to exercise caution.

Care homes are responsible for ensuring that all care giving arrangements are safe with regards to COVID-19, but residents and visitors also have a role to play as they must also help to protect themselves and others.

Nearly all residents of care homes who consented to receive the COVID-19 vaccine and are medically able to receive it have now received their recommended schedule of vaccine.

Key information summary

  • it's important to ensure that residents and staff receive their booster dose of vaccine
  • there are currently no public health recommendations around limiting the number of visitors or visiting households that each resident should have
  • however, all visitors to care home residents are strongly recommended to take a lateral flow test (LFT) on the day of visiting and only visit if they do not have symptoms of COVID-19 and the LFT test is negative
  • care homes are responsible for managing visiting safely with respect to COVID-19. Some care homes may choose to maintain internal policies that allow them to do this safely and equitably in accordance with this guidance
  • visitors who are symptomatic with COVID-19 should avoid visiting care homes for 10 days. They should isolate at home and book a PCR test. If the PCR is positive they must continue to isolate for the recommended period. Any exception for compassionate or essential visits should be agreed with the care home prior to visiting on a case-by-case basis, and a decision record held. Wherever possible exceptions should not be made for visitors who are symptomatic, LFT or PCR positive
  • when care home residents leave the care home to visit relatives, it is strongly recommended that each person in contact with the resident takes an LFT beforehand and only attends if the result is negative. This is to ensure that protective measures are in place not only for individual residents, but for care homes as a whole when residents may be in contact with more people than usual
  • visitors who are informed they are as a close contact of a positive COVID-19 case should avoid visiting care homes for 10 days once identified as a close contact, and start daily LFT. If LFT negative, they should continue to do LFT on a daily basis for 10 days. Any exception for compassionate or essential visits should be agreed with the care home prior to visiting on a case-by-case basis, and a decision record held. Wherever possible exceptions should not be made for visitors who are symptomatic, LFT or PCR positive
  • extra care should be taken if children are among those visiting care home residents. See further guidance for children visiting below

Prior to visiting

Before visiting a care home:

  • all visits should be booked in advance
  • visits should be staggered and scheduled when the main cohort of staff are on duty. Mealtimes should be avoided
  • Nobody with active symptoms of COVID-19, or who has received a positive LFT or PCR test in the preceding 10 days should visit a care home. Any exception for compassionate or essential visits should be agreed with the care home prior to visiting on a case-by-case basis and a decision record held. Wherever possible exceptions should not be made for visitors who are symptomatic, LFT or PCR positive
  • visitors who are informed they are a close contact of a positive COVID-19 case should avoid visiting care homes for 10 days once identified as a close contact, and start daily LFTs
  • visitors should be advised that they should inform the care home and not attend if they become ill or are exposed to COVID-19 in the time between booking the visit and the day of the visit

On arrival and during the visit

All visitors should be aware of and follow the Public Health guidance on how to reduce the spread of COVID-19.

  • visitors should sign in on arrival and provide full contact details
  • if a visitor is a direct contact attending on compassionate or essential grounds, then the visitor's status as a direct contact should also be recorded
  • visitors should be escorted by fully vaccinated staff wherever possible
  • visitors should be guided in performing hand hygiene when they arrive and agree to use the correct hand-hygiene techniques thereafter
  • visitors should avoid spending time in areas where other residents may be present. However, if safe dedicated visiting areas have been set up by care homes these may be more appropriate
  • visitors should wear a surgical mask regardless of whether the resident or visitor is fully vaccinated. This will be provided by the care home and its disposal will be monitored
  • where masks cannot be tolerated, visors are an acceptable replacement
  • it is also recommended that residents wear PPE during visits, where this is considered acceptable by residents and their visitors. This is most important where the resident has not been fully vaccinated
  • ventilation should be maximised wherever possible where visiting is taking place, for example by opening windows and doors
  • if visiting can take place outside, where weather permits, this is always safer
  • when visiting is outside visitors and residents do not need to wear masks for the time that they are outside
  • visitor use of resident / visitor bathroom facilities should be discouraged

Children visiting care homes

Extra care should be taken where visitors are children, due to lower vaccination coverage.

When children visit care homes they should:

  • only visit a residents' private room rather than spending time in any communal areas
  • wear masks
  • perform stringent hand and respiratory hygiene throughout the visit
  • if possible undertake LFT before visiting

Care homes where there is a confirmed active case of COVID-19

Resident

If a care home resident has a confirmed case of COVID-19 all visits should be suspended until the Government of Jersey's Infection Control Team advises that it is safe to continue visits. This is to protect residents, visitors and staff and assessed on an individual basis.

Whilst visiting is suspended, visits on compassionate grounds should be assessed on a case-by-case basis in discussion with Infection Control staff, and a risk assessment should be undertaken.

If a visitor develops symptoms while they are in a care home, then precautions should be taken to ensure they leave the premises without coming into close contact with any other residents or staff.

Visiting in Jersey Hospice Care

It is vital that the Jersey Hospice is protected from COVID-19 as it is an essential and unique centre of respite and palliative care in Jersey. However, flexibility must be afforded to those in end-of-life circumstances and as much freedom given to see loved ones, as is safe to do so, during this critical time.

Jersey Hospice Care will assess and determine visiting on a case-by-case basis, in accordance with the unique needs of Islanders receiving this care. This should be with consideration to the wider care homes visiting guidance, to ensure that visiting is safe where it is permitted.

Factors that may be considered include:

  • circumstances of the individual in care
  • length of time and purpose of stay

For example, for those patients in care for a short duration before returning home, it may be appropriate to restrict visiting altogether, or to 1 named visitor, unless an emergency end of life situation arises during the stay. This will help protect the Hospice as a whole from COVID-9 transmission, while having a relatively low impact on the patient in care. However, for those in Hospice who are at end-of-life stages and/or are in care for a longer duration, more liberal visiting will likely be needed, with more named visitors permitted. All visits to the Hospice should still be safely managed with respect to the wider visiting in care homes guidance wherever possible.

Visitors taking residents out of the care home

Trips outside of the care home grounds may continue. If residents are spending time with others for gatherings, all members (including hosts) are strongly encouraged to take LFTs ahead of the event with a vulnerable individual from a care home. This is in keeping with the advice to all Islanders of the importance of knowing their covid status to protect others. Whilst vaccination offers good protection from severe disease, it does not fully prevent the spread of COVID-19 to others in every case.

All care home residents, whether they are vaccinated or unvaccinated, should follow public health guidance if taking trips outside the care home, as trips out may introduce risk of infection to other residents.

The following is recommended for all residents and their family or loved ones when taking trips out:

  • physical distancing should be maintained wherever possible with anyone other than visitors or their household members
  • although not always possible to keep physical distance between residents and visitors, this should be attempted in all situations where it is possible
  • wear a face mask whenever possible. This is especially vital when:
    • physical distancing of 2 metres cannot be maintained, for example when travelling by car
    • when indoors, including someone’s home
  • any surfaces that more than one person touches, such as a door handle, should be sanitised. For example, if travelling in a private car, car surfaces should be wiped down before travel with disinfectant wipes
  • residents should be guided to use 60-70% alcohol hand-sanitiser frequently where regular handwashing is not possible
  • avoid use of public transport wherever possible and where this does not negatively impact on the health and wellbeing of residents
  • spend time outside wherever possible. Do not mix with anyone, other than visitors or their household members in indoor environments
  • tell the care home if any risk of exposure to COVID-19 occurs

An Activity Risk Guide highlighting factors that make an activity higher or lower risk is available.

A lower risk trip could involve, for example, going for a drive or walk with named visitors, or visiting the named visitors’ home when no one else is present.

Guidance for professionals visiting care homes to provide a service

Professionals or external support staff who need to visit the care home should be made aware of the need for; a pre-visit screening call, symptom checking, determination of known exposure to COVID -19 (including if recently identified as a direct contact); use of correct hand-hygiene techniques; requirements to wear appropriate PPE and compliance with Infection Control and public health guidance.

Group activities run by external professionals and others play a vital role in supporting residents' wellbeing, but these should only take place if carried out in line with physical distancing guidance and other public health advice. If there is a confirmed active case of COVID-19 in a care home, these visits may be suspended, depending on the nature of the visit.

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