Open with Care – supporting meaningful contact in care homes: guidance

The Covid-19 pandemic has had a major impact on care homes for adults. The Covid-19 virus presents a significant risk to residents and so every possible step needs to continue to be taken to mitigate against that risk and to protect residents and staff. Managing this risk has necessarily brought enhanced protections in care homes – including recommended limits and restrictions around routine time together for residents, family and friends. Care home staff have worked tirelessly throughout the pandemic to support continued contact between residents and their loved ones but these restrictions have been hugely challenging for residents and their loved ones, as well as for care home staff and colleagues.

Protecting residents from the risk of Covid -19 has rightly been a priority for us all but we know that the consequences of the restrictions in place have been harmful for many residents, relatives and staff. Emerging and recent international evidence on Covid-19, demonstrates potential physical, emotional and cognitive harm for residents from prolonged isolation. This has also been fed back by carers and family members, for example to the Root Cause Analysis (Scottish Government, November 2020). In view of this, the WHO ad hoc COVID-19 Infection Prevention and Control Guidance Development Group has recently unanimously agreed that visiting should be supported, as long as a range of Infection Prevention and Control (IPC) measures are in place to prevent the risk that visitors may contribute to Covid-19 transmission in care homes (see Supporting Documents for details).

As the evidence continues to evolve about how to deal with the virus, so have our safeguards and protections. Alongside risk based and proportionate infection prevention and control, recognised as a core approach that must be embedded in all our practice (Scottish Government, November 2020), multiple levels of wider protections are now in place. These include: • adequate, available and properly used personal protective equipment (PPE) for care home staff and visitors; • testing of residents prior to hospital discharge and admission to care homes; • routine testing for all care home staff and visiting professionals; • care home-based testing for all designated visitors; • Covid-19 vaccination of care home residents and staff; and • support from local oversight arrangements, public health and primary care.

With these levels of protection now in place, maintained and rigorously sustained, we can actively address the harms caused from prolonged isolation and absence of meaningful contact between residents and loved ones. So it is time to return to safe, managed indoor visiting so that everyone living in adult care homes, no matter their age, health, or otherwise, can have meaningful contact with their families and loves ones for the remainder of the pandemic and beyond – provided it is safe to do so.

This guidance is available on the Scottish Government website:

Last Updated on 24th February 2021 by Shanice