BASW England responds to guidance for visiting arrangements in care homes for the period of national restrictions

BASW England welcomes the revision of guidance for visiting arrangements in care homes issued on 5 November 2020 to ensure that care homes are supported to enable safe access and visits by families and loved ones.

The opening statement recognises the value and importance that visiting plays in maintaining people’s health and wellbeing and maintaining relationships.

This guidance, which can be viewed here, is issued as the second national lockdown comes into force in England and proposes a range of options to create COVID-19 secure care home environments and visits, including visits taking place outside and the installation of plastic screens. 

Some of these more extreme COVID-19 secure measures could be avoided with the introduction of testing for family and friends.  There is an absence of a clear commitment to regular, repeated testing for designated family carers in the guidance.

It is unclear from the guidance what constitutes a definition of an outbreak. This information should be made publicly available to ensure that all parties have a shared understanding about when it may be necessary for visits to be temporarily restricted on this basis. 

BASW England has previously expressed concern about the lack of transparency of decision-making processes, particularly in relation to blanket bans on family visiting. This guidance has a focus on local provider and regional decision making, with the Director of Public Health playing a significant role in giving advice to providers about visits including to close visiting.

Social workers are mentioned briefly in the guidance, the guidance states: "Social workers can assist with individual risk assessments, for visits, and can advise on decision-making where the person in question lacks capacity to make the decision themselves."

Social workers do so much more and are pivotal in promoting strengths based human rights models of good practice. Social workers undertake a variety of statutory and non-statutory functions on behalf of Public Bodies. Recognition of the importance of safe access to care and health settings for social workers as professional visitors is essential.

The involvement of social workers in assessing risk and making decisions about visits is mentioned as it was in the previous guidance however, does not go far enough in recognising the essential role and unique contribution social workers bring in relation to the following:

• Knowledge and application of key legal frameworks: MCA, DOLS, Care Act
• Ensuring the person’s views and wishes are central to decision making about visits
• Supporting providers to thoroughly explore rights and risks alongside all other factors that need to be considered in bespoke visiting arrangements
• Promotion of the least restrictive option

In line with our campaign for social workers to be recognised as Professional Visitors BASW England calls for:

• Testing for designated family members and social workers as key essential professional visitors
• Safe access and promotion of human rights must take priority and we must learn from the devastating impact of the first lockdown
• Additional funding to support provider services to create COVID-19-secure environments to enable family members to visit
• National and local monitoring and reporting process for any blanket no visiting decisions
• Virtual technology cannot replace human in person interaction, we urge providers at a local level to promote visits safely

Maris Stratulis, National Director at BASW England said: “We need to balance legislative and personal human rights, the impact of people residing in care and health settings not seeing a loved one and dynamic-person centred risk assessments. Families matter and social workers play a pivotal role as essential professional visitors.

“BASW England commends the incredible love, support and care provided by families, paid and unpaid carers and social workers pre and during COVID-19. We must work collaboratively to ensure the rights and voices of those in care homes and health settings are represented and heard.”

BASW is campaigning for social workers to be tested and given safe access to promote rights #TestSafeAccessPromoteRights. Join our campaign and ensure your voice is heard.

Leading campaigners criticise new measures

The measures proposed have been met with strong criticism by leading campaigners:

Kate Lee, Chief Executive Officer at Alzheimer’s Society, said: “The prison style screens the government proposes – with people speaking through phones – are frankly ridiculous when you consider someone with advanced dementia can often be bed-bound and struggling to speak.”

Paul Edwards, Director of Clinical Services at Dementia UK, said the guidance “falls very far short of what we, and families, have been calling for.”

“Suggesting that people communicate through phones and full-length screens is not only impractical for many care homes but fails to consider the particular needs and challenges faced by people with dementia,” he added.

The costs of implementing measures suggested to create COVID-19 safe environments are to be met by providers. There is no commitment for additional money, excluding the Infection Control Fund (IFC) to cover the costs associated with purchasing screens or visiting pods.

The guidance refers to funding made available previously through the ICF, however this fund is also expected to cover any other additional costs (e.g. enhanced staffing). Also concerning is the length of time it will take for structural measures such as screens and pods to be put in place and the availability of such measures if it is even considered appropriate or possible to install these.