The Health Protection Surveillance Centre (HPSC) published updated guidance on visiting in long-term residential care: COVID-19: Normalising Visiting in Long Term Residential Care Facilities (LTRCFs). This guidance came into effect on 19 July. The public health advice is to restore visiting to near normal in terms of frequency of visits in those settings with a high level of vaccination of residents as quickly as possible, while also recognising the need to remain cautious as we continue to deal with the evolving risks associated with COVID-19.
The new guidance provides that:
- Providers should put in place the necessary measures to progress to more normalised visiting and visiting frequency as quickly as possible in line with public health guidance with no more than two visitors at any one time.
- Routine visiting will no longer need to be scheduled in advance.
- There is no requirement to have a list of nominated visitors.
- The duration of the visit should not be limited.
- Fewer restrictions will apply to residents going on outings or visits outside of the nursing home.
Nursing home providers are ultimately responsible for the safe care of their residents. In a broad sense, visits to nursing homes are governed by legislation under the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013; regulation 11 provides that the nursing home should facilitate visiting and not restrict visiting except in circumstances such as the resident requesting same, or potential risk posed from visiting – this aligns with the risk assessments referred to in the visiting guidance. The regulations also require that the nursing home has suitable facilities in place and available for residents to receive visits. It is the legal responsibility of each provider to assess the risks and mitigation measures associated with their service and how best to manage visits having regards to the specific circumstances that arise in relation to their service. The HPSC has developed public health guidance, mentioned above, to assist and support providers in this regard.
Notwithstanding the current positive epidemiological outlook and the cautious reopening of society, risks continue to remain and emergent risks such as variants of concern present ongoing challenges and the need for vigilance. Visiting arrangements should continue to take account of general public health advice and the necessary infection prevention and control measures, to reduce the risk of introduction and spread of COVID-19 and protect those living in our communities. This is particularly important in the context of the increasing prevalence of the more transmissible Delta variant. This new variant poses a significant risk, in particular to those who are not yet fully protected though vaccination.
Visitors are reminded of their responsibilities with regard to self-checks for COVID-19 in advance of visits, infection and prevention control and social interaction with all individuals, while in the nursing home.
Communications have been issued by Minister Butler emphasising the need for service providers to follow the guidance and the issue of visits continues to be monitored by HIQA as requested by Minister Butler.
The guidance will be kept under continuing review as new evidence and data emerges.
