Visiting and Visitors in Care Homes (Scotland) Policy

Policy Statement

This policy sets out the values, principles and procedures underpinning {{org_field_name}}’s approach to receiving visitors to the home. It applies to everyone visiting the home on any business and to all staff in their treatment of visitors. It provides guidance for residents on what they can expect when they have visitors or make arrangements to have them.

The policy is written in line with the national health and social care standards set out in My Support, My Life, particularly statements made under Standard 5: “I experience a high-quality environment if the organisation provides the premises”.

It also helps to answer key question 5: “How well is our care and support planned?” of the Quality Framework for Care Homes for Older People, particularly 5.2: “Carers and family members are encouraged to be involved in delivering care and support”.

The home’s aims are on the one hand to promote an open ethos whereby all legitimate visitors are made welcome and comfortable during their visit and are treated with courtesy and respect, and on the other to recognise that the home has a duty of care to protect its residents and staff from intruders and anyone who threatens their safety and security.

The home’s visiting policy thus aims to minimise the risks to residents’ safety and security, while enabling them to receive as visitors and guests people of their own choosing, which includes children, at times that are mutually convenient to them. There is a separate policy concerned with the Protecting Children Visiting or Living in Care Homes for Adults (Scotland), which should be referred to as necessary.

Covid-19: “Visiting and Staying Connected”

Normal open access visiting arrangements had to be curtailed during the Covid-19 pandemic and specific policies put in place to prevent and control the spread of infection, which resulted in restrictions to visits to and from the home being imposed and conditions attached to the visiting.

{{org_field_name}} has now modified its policy in line with the current Public Health Scotland and Care Inspectorate guidance.

{{org_field_name}} is aware of and will comply with the two new Health and Social Care standards for “visiting and staying connected”, which have been added to “Be Included” in My Support, My Life as 5.16 and 5.17 under “I experience a high quality environment if the organisation provides the premises”.

The first applies to periods when visiting could be restricted because of an outbreak of infectious illness in {{org_field_name}}.

The second applies at all times but would be specifically reinforced under restrictive conditions.

The standards were introduced in March 2022 with guidance from the Care Inspectorate, ie the following.

“5.16. If I am an adult living in a care home and restrictions to routine visiting are needed to prevent infection, I can nominate a relatives/friends (and substitutes) to visit me. My nominated relatives/friends will be supported by {{org_field_name}} 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.

5.17. If I am an adult living in a care home, I can nominate a relatives/friends (and substitutes), who will be supported by {{org_field_name}} to be directly involved in providing my day-to-day care and support if that is what I want.”

{{org_field_name}} will always ensure that every resident is aware of their right to nominate visitors who could by agreement be involved in a person’s care and who would continue to be involved in the event of an emergency that could result in visiting restrictions being imposed.

{{org_field_name}} recognises and will work in partnership with any appointed welfare attorney or guardian to decide who could be a nominated visitor and the nature of their involvement in the person’s care.

{{org_field_name}} will keep records of its nominated visitors and include their involvement in the personal plan and in the person’s care arrangements.

It will always seek the consent of the resident to all arrangements or in the event of a person being unable to give their consent, it will seek the consent of the person acting legally for the resident.

{{org_field_name}} is aware that named visiting is not the same as “essential visiting”, which is a right of any resident who is receiving end-of-life care regardless of any outbreak occurring in {{org_field_name}}.

Definitions

A visitor is defined as someone who does not live or normally work on the premises as a paid staff member or accredited volunteer and who comes to the home for a short period of time in order to see residents or staff.

For the purposes of this policy visitors include people who:

deliver, provide or supply goods and services that have been bought or commissioned by the home, staff or residents, including repairs and maintenance
provide professional services to residents such as GPs, community nurses, pharmacists, occupational therapists, physiotherapists, ministers of religion, social workers, advocates, hairdressers, opticians, etc
visit residents on a personal or social basis regularly or occasionally, eg relatives, friends and others who come to see an individual resident
come to the home to see staff members for any reason
visit the home on a professional or business basis, eg external managers, inspectors and other personnel from the employing organisation or similar who may not be coming specifically to see individual residents, but who may have some contact with them depending on the nature and purpose of their visit.

Residents’ Visitors and Visiting Arrangements

Residents may receive visitors at any times that are acceptable and reasonable to them and no general restrictions are imposed. There may be occasions when a resident finds it difficult or inconvenient to receive a visitor, eg because of ill health or current circumstances. However, any such decisions to refuse or defer access will be determined by those individual circumstances and the wishes of the resident will always remain paramount.

Residents have the right to receive visitors in the privacy of their own room and for the purpose of the visits to remain private. Where it is inconvenient or uncomfortable to use the resident’s own room, eg because of numbers, the home will arrange for a more suitable venue in accordance with the resident’s wishes.

Staff should make enquiries on the nature and purpose of any visits only where the resident is evidently vulnerable to harm or injury or there is evidence that the resident may have been subject to some form of abuse as a result of a visit or the actions of a visitor.

Normally, the home will get to know who a resident has or wishes to have as a visitor, so there will be no reason to enquire into the nature and purpose of the visit. Where a resident receives a visit from an apparent stranger or at an unusual or irregular time, it is appropriate to ask the resident first whether they wish to receive the visitor.

In coming across strangers, it may be appropriate and reasonable for staff to enquire about the identity of the person and the nature and purpose of the visit, especially if the resident is uncertain or confused by it. For example, this might happen in the cases of visitors who are cold-calling for commercial purposes.

In connection with their personal plan, residents are asked by the appropriate person who they are likely to have as bona fide visitors and any people who they would find unacceptable or who they would wish to be consulted over first before receiving them. This information, with the resident’s consent, is recorded on the personal plan and provides some general guidance to staff under circumstances where they are uncertain about a visitor’s credentials or credibility. However, the cardinal rule is to always consult the resident or their representatives whenever in doubt.

Infection Prevention and Control Measures

While the risks of Covid-19 transmission remain, {{org_field_name}} will continue to have in place the recommended infection prevention and control measures to reduce risks to residents and {{org_field_name}} from experiencing further outbreaks. These are in line with the recommendations made in the current Public Health Scotland’s Covid 19: Guidance for Care Home Settings (Older Adults).

{{org_field_name}}’s policies can be summarised as follows.

{{org_field_name}} asks visitors to keep checking with the home’s staff that it is safe to visit or continue visiting. This will help {{org_field_name}} in the event of it having to restrict visiting because of a new outbreak of Covid-19 or other infectious illnesses.
{{org_field_name}} asks prospective visitors to avoid visiting if they have any of the recognised symptoms for Covid-19 or those for other infectious illnesses, including influenza and even heavy common colds.
{{org_field_name}} asks all visitors to follow basic Covid-19 and general infection prevention and control procedures while in the home, ie:
– keep as far as possible a safe physical distances between people who they meet around the home, which should be a minimum of 1m and do not hold close conversations with people
– continue to wear face coverings when moving through and around the communal areas of {{org_field_name}} when there are large numbers of people around
– observe good hand hygiene as directed by any notices using {{org_field_name}}’s equipment and facilities.
Prospective visitors with Covid-19 symptoms in the last five to seven days should clearly not visit until they are satisfied that it is safe for them to visit.
{{org_field_name}} will ensure that there is good ventilation throughout the premises and particularly in any dedicated visiting areas being used.
{{org_field_name}} asks visitors who continue to provide some degree of personal care to the person they are visiting and are visiting to wear suitable PPE while carrying out any care tasks as would a paid care staff member.
{{org_field_name}} will continue its policy of supporting people who need to visit flexibly on compassionate grounds, such as when a resident is terminally ill and receiving end-of-life care.

Out of Home Visiting

There are now no restrictions to care home residents making visits outside of {{org_field_name}} for a set purpose for a short or longer period, which could include the following:

to go or to be taken to visit family members or friends
to stay with family and friends for one or more nights
to go away on holiday
to have a period in hospital
to go shopping
to visit a café or restaurant
to attend a sporting event or place of entertainment
to attend or take part in a local community event
to go to a place of work or education.

However, where there are evident risks of community transmission of Covid-19 or any other infectious illness, {{org_field_name}} considers that out of home visits should take place in a risk-managed way that considers the risks to the person and other people from subsequent exposure to infection.

{{org_field_name}} will support out of home visiting by balancing the benefits to its residents against the risks of being exposed to Covid-19 and their consequences to the person and other residents.

Risk Factors to Consider in Planning Outings

{{org_field_name}} plans its visits or outings, including communal outings, by considering:

the purpose and nature of the outing or visit
if it involves being indoors (higher risk) and/or outdoors (lower risk)
if it involves use of private (lower risk) or public transport (higher risk)
if it involves mingling with people whose exposure risk is not known (higher risk)
if it involves an emergency visit or overnight stay in hospital (considered higher risk)
how much support the person will need from staff or others to make the visit
how far the current conventions about physical distancing, wearing of face coverings and hand hygiene will be adhered to (risks will increase with non-adherence)
if there are less risky alternatives to achieving the same purpose as the outing or out of home visit
the amount of time available to plan the outing or visit and to take all the precautions necessary to make it safe
the vaccination status of residents and the people they are visiting
the availability of rapid antigen testing, which can be carried out before and after the visit or outing, where this is indicated by the risk assessment
levels of infection in the community.

When a resident returns from a visit or period away from {{org_field_name}} it will check any risks of infection and put appropriate proportionate measures in place to control any assessed risks.

Contingency Visiting Arrangements During Outbreaks of Covid-19 and other Infectious Illnesses

{{org_field_name}} understands that an outbreak is defined as two or more confirmed cases of Covid-19 or clinically suspected cases of Covid-19, or of another notifiable infectious disease, among people in the same setting, with the onset of symptoms within 14 days.

With any outbreak of an infectious disease, {{org_field_name}} will notify its local Health Protection Team and seek advice on the precise measures to take, which will depend on the nature and severity of the outbreak.

{{org_field_name}} recognises that an outbreak could require changes to its usual visiting arrangements. In the event of an outbreak in {{org_field_name}}, it will allow residents to receive their “named visitors”, who could also be directly involved in their care.

{{org_field_name}} requires its visitors to follow the home’s outbreak management and infection control procedures when visiting.

In organising any arrangements, {{org_field_name}} will carry out a risk assessment of the impact of the outbreak and of the feasibility of alternative visiting arrangements, which will not increase the infection risks. {{org_field_name}} understands that it might need the advice of the local Health Protection Team and Local Authority to carry out the risk assessment and to act on its outcomes.

{{org_field_name}} understands that if the outbreak appears contained the outbreak control restrictions will be lifted unless the HPT advises otherwise. This should mean that outbreak measures will only be in place for the minimum period required before normal visiting arrangements can resume.

Staff visitors

Staff are not expected to receive visitors while they are working or to be interrupted in the course of their duties by social calls. However, it is acceptable to have people who they know as family members or socially to call to leave messages or have some brief contact. This is quite consistent with the open ethos that the home is trying to promote. The same principle applies to staff receiving telephone calls, which are acceptable for information exchange, but not general conversational purposes.

Procedures for Receiving Visitors

The home has a single port of entry policy so that all visitors (as defined above) report on arrival to [the receptionist/the person in charge/an available staff member], who will ask them their name and who they wish to see and direct them accordingly.

All visitors who enter the premises other than those who are simply delivering or dropping off items such as the mail or supplies, must sign the visitors’ book. This will record time of arrival, time of departure, any car registration number if parked on the premises and the main contact person. This ensures that the home is able to account for everyone in the building at all times, which is important in the event of any emergency evacuation of the building.

The signing of the visitor’s book on arrival and departure signifies that the visitor has agreed to the facts of their presence in the building being known and that they are aware of the necessity on the grounds of fire safety and security.

Confidentiality and Data Protection

To comply with current data protection requirements which require the confidential treatment of all personal data, the visitor can be assured that the information they provide will not be disclosed to third parties or be kept longer than necessary. (Best practice guidance suggests 12 months or 24 months maximum.)

This is done by careful screening/“blacking” of all existing information in the visitor’s book/daily removal of previous entries, eg using a ring back diary/a data protective electronic method (there are different options to protect the visitor’s personal data).

All visitors will thus in effect have a “responsible person”, who can be a resident or staff member, and who will be able to account for the nature and purpose of the visit and visitor’s whereabouts.

As part of its general approach to customer service, staff are expected to treat every visitor courteously and to make them feel welcome and comfortable. Where visitors have to wait to see the person they have come to see, they should be offered a comfortable seat and refreshments as available.

Where staff encounter someone they do not know or who seems lost or uncomfortable in the building, it is appropriate to ask them politely whether they need help and who they are there to see.

Adult and Child Protection

{{org_field_name}} applies its adult and child protection polices and procedures in respect of any visitor who could cause harm to a resident they are visiting or other residents.
{{org_field_name}} is also mindful of its legal responsibilities for the health and safety of its staff and will not accept visitors’ rude and aggressive behaviour towards them.
{{org_field_name}} has separate policies to deal with any such incidents. See Antisocial Behaviour Policy.

Training

Staff receive training to implement the home’s policies on visiting and visitors so that {{org_field_name}} can achieve all My Support, My Life standards.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next Review Date: {{next_review_date}}

SCH271. Visiting and Visitors in Care Homes