I propose to take Questions Nos. 439 and 440 together.
The Health Protection Surveillance Centre (HPSC) has recently published “COVID-19: Normalising Access in Long Term Residential Care Facilities (LTRCFs)”, which will come into effect on 8 February 2022. The guidance takes account of the significant changes to national public health measures in general, whilst also recognising the need for continued vigilance in healthcare settings, including homes due to the increased vulnerability of people receiving care and/or living in these settings. The guidance continues to recognise the importance of visiting and meaningful social contact for residents. This is a positive further step forward to a return to more normalised access and visiting for people living in nursing homes and their families.
Key changes of note to the guidance are as follows:
- The minimum level of visiting should normally be daily visits by up to 2 people at one time;
- The introduction of a “nominated support person”, who should normally have regular and unrestricted access to the resident in the nursing home for whom they are nominated, except if that person is a specific risk to residents (e.g. is subject to self-isolation) or there is specific public health or infection prevention and control advice to limit visitors. This will be in addition to regular visiting;
- Unless specifically advised by public health, at an early stage of outbreak, the nominated support person should continue to have access for some part of each day. If a resident does not have a nominated support person, visiting should generally not be less than 2 visits per week by one person during an outbreak;
- Limitations on visiting should be justified by an up-to-date risk assessment and should be reassessed twice each week;
- There should be no restrictions on movement of residents within the nursing home after going on outings or visits outside of the nursing home, unless a significant exposure risk occurred during the outing;
- There will no longer be a need for visitors to show immunity through vaccination or previous infection;
- In line with established guidance, there remains no infection prevention and control requirement to restrict window visits.
This revised visiting guidance is yet another significant step forward in the return to more normalised access and visiting for people living in nursing homes and their families. I expect that all nursing home providers will ensure that they facilitate visiting in line with this new guidance to the greatest extent possible.
Visitors are reminded of their responsibilities with regard to self-checks for COVID-19 in advance of visits, and infection and prevention control and social interaction with others other than the resident they are visiting whilst in the nursing home.
It is important to note that nursing home providers are ultimately responsible for the safe care of their residents. Under Regulation 11 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 it is the legal responsibility of each registered provider to make arrangements for a resident to receive visitors, having regard to any risks that may present for the resident or other residents. Public health guidance has been developed in order to assist and support providers in this regard. Furthermore, I will write to HIQA and all nursing home providers, as I did before, to remind them of their obligations for facilitating visiting in nursing homes, in line with the updated visiting guidance, and the rights of residents to receive visitors.
COVID-19 is a continuing risk, especially when community transmission is high. It is appropriate that the significant infection prevention and control and public health guidance remains in place for residential care settings. The State continues to provide substantial support to aid the ongoing management of COVID-19 in these settings.
