Opening up care homes and supported housing
Care homes and supported living: Learning and sharing following the COVID-19 lockdown
Opening up care homes and supported housing includes both facilitating visitors coming into the home and also those living in a home or supporting living environment being supported to safely go out.
Whilst the UK continues to experience changes to restrictions and areas move in and out of different Tiers, care homes have been starting to open up to visitors and supporting people to go out safely.
Prior to the publication of the Government guidance, SCIE held two virtual meetups with care homes and supported living managers to discuss issues around opening up care homes. Providers were at different stages and were balancing a range of considerations.
Care homes and supported living managers recognised the importance of opening up care settings for:
- wellbeing (emotional, cognitive and physical) – of both those living in the care setting and their families
- supporting care – highlighting that family members can be an active part of the care team
- independence – opening up care setting allows those living in them to go out.
The first practice example below contains a general overview of the different methods being implemented to support visits. The second example is a detailed overview of indoor visits using a visitor pod. The third is an example of how visits outside the home could be risk assessed and supported, making it clear that visits could only be facilitated where certain conditions could be met.
There has been limited guidance and resources on this topic to date, with the Government publishing Visiting care homes during coronavirus. There remain some significant gaps, including guidance specific to supported living and guidance on supporting visits out of the home. These are both being considered by DHSC.
Opening up care settings has been a high priority but area of concern for many providers. This is an area that has been highlighted as important for sector learning and peer support. Please do contribute examples you have, including what has or has not worked well. Please contact us.
Different approaches to supporting visits
Managers have reported using a range of approaches to support visitors in care settings, most of which were currently outdoors and weather dependent:
- Patio areas with glass fencing
- Garden visits with social distancing
- Using visitors’ pods. Splitting a room with Perspex screen and using a hands-free intercom system.
- Room being used is purpose built or directly accessible from outside
- ‘Window visits’ (visitor is outside)
There was set of common considerations for supporting visits and these were:
- Appointment systems, limited number of visits, set times for visits, visits for a limited amount of time (such as 30 mins)
- Making sure staff are available to support visits and to ‘keep an eye’
- No toilet visits or refreshments provided to visitors (they can bring their own refreshments though)
- The use of a mixture of face-to-face and virtual/online visits to meet different needs
There are a range of approaches care homes can use to support COVID-safe visits, all of which require planning and resources; in terms of changing the physical environment and staff being available to support visits.
Visitor pods for indoors visiting in care homes
The Royal Masonic Benevolent Institution (RMBI) Care Co was able to restart care homes visits by installing COVID-secure visitor pods. The newly created partitioned spaces have an airtight glass screen. The residents and care staff enter from a door within the care home and are separated by the glass from the visitors who enter and exit directly from outside the home.
The pods have an intercom system to allow everyone to speak easily with one another. Both sides of the pod are deep cleaned between each visit.
It means the world to our residents to be able to have their loved ones visit and chat to them.
We’re all looking forward to the day when they can hug each other, but until then, we hope that our new secure pod will make it a bit easier for our residents and their families.Beverley Roberts, Home Manager at Prince Michael of Kent Court in Watford.
Care homes may have to be creative to set up safe indoor spaces to make sure both residents and visitors feel comfortable during visits. The layout of the home and resources available may influence what is possible.
Planning for visits outside supported living to the family home
Achieve together is a provider of support for people with learning disabilities, autism and associated complex needs. In dialogue with families it has created a risk-consideration tool to consider the potential for the young adults they support to spend time with their families, indoors at the family home.
- A flow chart where 14 criteria need to be met to allow a visit to be supported. Considerations include capacity, transport, restricting other visitors in the family home, social distancing, PPE if necessary, cleaning, actions to be taken when returning to supported living, testing and the need to change or cancel plans at short notice if risks change. Any visit and the actions put in place need to be agreed by all parties as well as the funding authority.
- A form with details as to how risk will be managed for each individual visit and for each area of risk identified.
- A contact plan for the young adults and their families so that everyone understands their role. This plan includes the responsibilities of both the young adult and their family.
Planning for visits outside of supported living and care homes is a process involving the providers, person being supported and families with understanding their role and responsibilities. This example could provide a good template for planning visits to family homes.
Guides and resources
Update on policies for visiting arrangements in care homes Department of Health and Social Care) Open
Care Setting: Care homes
Audience: Care home managers, commissioners and providers
This updated guidance sets out:
- the principles of a local approach and dynamic risk assessment
- advice for providers when establishing their visiting policy
- advice for providers when taking visiting decisions for particular residents or groups of residents
- infection-control precautions
- communicating with family and others about the visiting policy and visiting decisions.
Visitors’ protocol – CPA briefing for care providers (Care Provider Alliance) Open
Region: England but with relevance to other regions
Care setting: Care homes for older adults (including dementia). Of relevance to care settings for people of working age (including physical, sensory or learning disabilities)
Audience: Care home managers, commissioners and providers
Format: Webpages; downloadable pdf
Protocol developed in consultation with Carers UK, John’s Campaign and the Relatives & Residents Association. The protocol sets out a dynamic risk-based approach to facilitating visits and includes and includes different types of visits, policies and procedures and rights and responsibilities for both care providers and visitors.