Coronavirus (COVID-19): Guidance for visiting loved ones in an adult care home

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Bringing contact back to normal

Care homes are expected and encouraged to support meaningful contact between residents and their loved ones both in and out of the home unless there are exceptional circumstances.

People living in care homes are typically more vulnerable to severe illness as a result of coronavirus (COVID-19). So care homes continue to have coronavirus safeguards in place. Safeguards ensure that residents and relatives can spend meaningful and regular time together.

Safeguards include:

infection prevention and control measures
vaccination (including booster vaccines)
testing

It's important that meaningful contact is maintained for residents. Every individual care home should find the right way to do this. Speak to the care home to find out about their current arrangements.

Read the latest guidance from the Scottish Government on the remaining protective measures in adult care homes, including updates on visiting.

Safeguards will be reviewed regularly to ensure they're proportionate to the risk of coronavirus.

Visiting

Care homes should continue to support visiting and outings in all but exceptional circumstances.

Before you visit

Family and friends should check with the care home whether they need to arrange visits with the home in advance. Sometimes this can help to manage the number of people visiting at a time. Overcrowding should be avoided and care home staff should consider the number of people that can use an area where individuals have their own space. The duration of visits should not be limited if safe visiting practices can be maintained.

Vaccination is encouraged for all visitors but is not obligatory.

You should not visit a care home or meet up with a resident if you:

have symptoms of or think you may have coronavirus (COVID-19) or any other respiratory virus
have tested positive for coronavirus

Visitors should follow the stay at home advice instead. Visitors who live with someone following the stay at home advice are recommended to avoid visiting the care home and meeting up with residents during this time.

Children who are unwell should not visit care homes.

Anyone who visits an adult care home should take a lateral flow device (LFD) test. You may be asked to show proof of the recent negative LFD test before each visit. This includes family, friends, children over the age of 12 and visiting professionals. You may take the test at home before you visit. You can order LFD tests online or by phoning 119. If requested in advance, the home should be able to help you to carry out the test when you arrive at the care home.

If you visit multiple times per week you should test twice weekly, with 2 to 3 days between each test.

During your visit

Visitors can choose not to physically distance from their friends and family they are visiting. They can also choose not wear a face mask or covering when in the resident's personal room. However, not wearing a face covering or maintaining physical distance can increase the risk of coronavirus transmission. Visitors should discuss this with the individual they are visiting and care home staff.

All visitors should:

wear a face covering or mask in all communal areas of the care home
remain in their designated visiting area, for example the resident’s room
follow infection prevention and control measures as instructed by care home staff including increasing ventilation and hand hygiene – this is particularly important when visiting during an outbreak

Community group visits to care homes (including older adult care homes) can begin to be re-introduced. Care home staff may wish to invite community groups (including groups of children) into the care home to engage with residents and enhance wellbeing. The Public Health Scotland COVID-19: information and guidance for social, community and residential care settings contains principles that should be followed to reduce the COVID-19 risk to residents from community group visits.

Routine visiting

Unless there's an outbreak in the care home or the resident is self-isolating, there are no limits to the frequency and duration of visits, as long as they can be managed safely.

Visiting a resident who is self-isolating

If the care home does not have an ongoing coronavirus outbreak, the care home should support residents who are self-isolating to have 1 visitor per day in their private room if they wish. This does not need to be the same person or a named visitor. Named visitor is applicable during outbreaks only.

If a resident tests positive for coronavirus, the care home should still support the resident to have 1 visitor per day. This can happen following a risk assessment by the care home team. Particular precautions will be required compared to normal visiting.

Visiting a resident during a care home coronavirus outbreak

When a care home has a coronavirus outbreak, residents can receive a visit from a named visitor once per day in their private room.

Residents or their representatives should be encouraged to identify up to 3 named visitors, though only one can visit at a time. If a named visitor needs support from another individual to visit, exceptions can be made to enable two named visitors to visit at any one time. Please discuss this with the care home. Care homes should fully support visits by named visitors. This is to minimise the impact of self-isolation on the resident's wellbeing.

In some exceptional circumstances, the local health protection team may pause visiting. However, named visiting should resume as soon as possible once circumstances allow it.

Visitors should wear a fluid resistant surgical mask where possible. They should also follow all infection prevention and control measures as guided by the care home.

Residents who do not have coronavirus, or symptoms of coronavirus, do not need to self-isolate. They may use communal areas of the care home.

Further guidance on visiting during outbreaks is available from Public Health Scotland:

COVID-19: information and guidance for social, community and residential care settings – all r care home settings now including care homes registered for older adults

Essential visiting

An essential visit is when it's very important that a friend or relative is supported to have meaningful contact with their loved one. This includes for end of life care or for relief when someone is in distress.

An essential visit can take place at any time, including during an outbreak or, when a resident is in self-isolation.

Essential visiting is in addition to named visiting.

Read further information on essential visiting from Public Health Scotland

Outings and activities away from the care home

Meeting others and taking part in activities away from the care home is an essential part of care home life. This might include staying overnight with family or friends.

All care homes should continue to support residents to take visits out.

If there is an outbreak in a care home / residential setting, service users who are not identified as possible or confirmed cases of COVID-19 may leave the setting to go on outings. Such outings should be discussed and arranged with staff, in line with the service users care plan and the overall management of the outbreak.

During an outbreak, residents who do not have coronavirus may leave the care home to go on outings with their loved ones. This should be discussed and arranged with care home staff, in line with the resident’s care plan and overall management of the outbreak. Residents and their friends and family should be aware that staff resource will be prioritised on managing the outbreak and providing safe care, and this may mean care staff cannot accommodate outings for a temporary period of time.

Residents who are coronavirus cases should self-isolate for a minimum of 5 days and outings should be paused during their self-isolation period.

Residents, family, and friends who want to plan outings or activities should work together with the care home to arrange this. When residents take trips out of the care home, the following is advised:

residents and visitors are recommended to have had their coronavirus vaccinations, including booster if eligible
residents are recommended to avoid mixing with a large number of people indoors
everyone should follow good hand hygiene
everyone should wear face coverings as applicable
if the resident returns with symptoms, they should self-isolate in line with care home guidance

If the resident becomes aware they have been in contact with a coronavirus case whilst on an outing, they should advise care home staff and should remain vigilant for the development of coronavirus symptoms

If you’re spending time with a resident outside of a care home, you should follow guidance on how to keep yourself and others safe.

Even if you’re planning to meet outdoors, you should not meet care home residents if you think you may have coronavirus symptoms or any other illness.

Further guidance on outings is available from Public Health Scotland:

COVID-19: information and guidance for social, community and residential care settings – all care home settings now including care homes registered for older adults

Raising concerns around visiting

The Care Inspectorate is the independent regulator for care homes. They advise care homes on good practice that helps people stay connected with their loved ones, have visits, and take part in their community. Where this support is not happening, they can use their powers to ensure it does.

The Scottish Government has introduced two new Health and Social Care Standards for care homes. These say that people living in care homes should:

have the right to see someone who is dear to them, even during a coronavirus outbreak
be able to name a person or people who can directly participate in meeting their care needs

You can read information on the Care Inspectorate website about your rights and visiting. The Care Inspectorate has published guidance for care homes on how they must implement visiting and the new standards.

If you have any questions about visiting you can contact the Care Inspectorate.

If you’re unhappy with the visiting arrangements in your loved one’s care home, you can talk with the care home manager or your named nurse or care worker.

You may still have concerns after discussing the issue with the care home. In this situation, ask for your concern to be considered through their existing complaints processes. The care home can tell you what these are and they should be readily available to you.

You can also complain to the Care Inspectorate if you have concerns about visiting or any aspect of the care provided. You can:

contact the Care Inspectorate at any time – you do not have to go to the care home first
ask for your complaint or concern to be kept confidential
speak to them informally – you do not have to make a formal complaint to ask for help
speak to the inspector to share your concerns

The Care Inspectorate can provide you with advice and guidance. The inspector can also:

speak to the care home to help improve visiting arrangements, in confidence if you’d like
make sure the care home is following care home visiting guidance

Further support

There are a number of organisations to help residents and their loved ones.

Action on Rights is one of the helplines available. It has been set up specifically to help anyone with a loved one living in a care home to have meaningful visits. They offer practical and emotional support to anyone who needs it. This support is not only for families and friends of people living with dementia. It's for anyone needing support.

The team will also work with care homes to help facilitate visits where appropriate. This includes circumstance where family and friends view the contact with their loved one too restrictive. You can reach the Action on Rights team by phoning the free 24-hour Alzheimer Scotland helpline on 0808 808 3000.

The following helplines are also available and can provide information on visiting your loved ones in care homes. They can also give specialist advice on particular conditions: