Contact in Care Settings

Part of the debate – in the House of Commons at 4:44 pm on 27 October 2022.

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Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care) 4:44, 27 October 2022

I thank my right hon. Friend for making that point, which we have heard from others in the Chamber.

Visiting is not just a “nice to have”, as we have just heard—all the stories we have heard today can leave us in no doubt about that. The hon. Member for Liverpool, Walton spoke very movingly about the experiences of others, but also about his own personal experience with his father, which he very courageously shared with us. Liz Saville Roberts—I cannot pronounce her constituency, but Hansard will resolve it—also spoke very powerfully about her mother. I say to both of them that I am sorry for their loss.

Very importantly, my hon. Friend the Member for Chatham and Aylesford reminded us that this is not just about older people. Visiting, both into a residential setting and out of it, is also so important for younger people—for instance, those with learning disabilities. However, I am short of time, so I will press on.

On top of the stories, there are the facts. We know there is a body of evidence that supports the argument that not having visitors can be detrimental to the health of people living in residential care, as my right hon. Friend Esther McVey mentioned. For instance, there is a connection between social isolation, loneliness and mental health. In fact, back in October 2020, when I was previously the Care Minister, I commissioned research on the benefits of visiting as well as an assessment of the risks at the time and the options for opening up visiting.

I can also say that I do know personally what it feels like not to be allowed to visit a relative. In the summer, my mother was admitted unexpectedly to hospital and I was not allowed to visit her, even though I did not know whether I would ever see her alive again. The same was the case for my father, her husband for 50 years, who was also barred from entry to her ward, and that was even though we were clearly not in the heart of the pandemic by any stretch of the imagination.

I will look at this issue in three parts, at pace: what has happened to get us to this situation; what is really going on; and what can be done.

Sadly, during the pandemic we saw how hugely vulnerable to covid people who lived in care homes were, and the Government priority was to keep people safe, which meant doing everything possible to prevent covid from getting into care homes. It meant reducing the number of people going in and out who might take in covid. It meant requiring the use of personal protective equipment. It meant regular testing for care home residents and staff, and when we got the covid vaccine it meant prioritising vaccinations for care home residents and staff.

However, even back in 2020 we knew that residents in care homes and their families were suffering from the visiting restrictions, although I should mention that not all residents and their families had the same views. While some wanted more visiting, others did not because they were more worried about the risks. Balancing those two things, the Government sought to enable visiting in ways that would be safe, and we also made it clear that end-of-life visiting should always be possible.

In March 2021 we introduced the concept of the essential care visitor who would be able to visit a resident who needed personal care in any circumstances, including during an outbreak, following the same covid testing regime as staff. In June 2021 we expanded that to apply to all residents. At all times we worked with social care providers—with care homes—because they were the ones that had to put the guidance into practice; they were the ones at the frontline, balancing the prevention of covid with the practicalities of supporting visiting. I do not underestimate the demands that put on care homes, which were also carrying out testing, providing PPE and everything else.

Moving on to the situation today, since April 2022 the Government guidance has been that there should not be any restrictions on visiting in residential settings unless there is a covid outbreak, and even if there is an outbreak every resident should be able to have a visitor. Local public health teams may advise other restrictions on visiting if there is a particular local risk, but that should be proportionate and should stop visiting only in extreme circumstances.

Some Members have said today that the guidance is not clear, while others have said that it is not being followed; it has also been said that the problem is that it is guidance. On the content of the guidance, we have heard from many accounts that it is not being followed, and I will do further work on that.

Knowing the concerns during the height of the pandemic about visiting, the Department of Health and Social Care started tracking visiting restrictions; indeed, I started that as Care Minister, to try to get data about what was going on, because one of the challenges is knowing what is going on at the frontline, as the social care system is so diverse and fragmented. Our data told us in September that 98.4% of care homes were allowing visiting, but I recognise that that data is not the whole answer.

The CQC has been referred to in the debate. I spoke with Kate Terroni, chief inspector of adult social care at the CQC, many times during the pandemic about visiting and she, too, saw the importance of it. The CQC looks at visiting when inspecting care homes, and a lack of visiting or access is a red flag for it. Families should be reporting visiting concerns to the CQC, which then investigates them. I heard, however, the points made by the hon. Member for St Albans about some families feeling they got a mixed response or who were fearful of reporting to the CQC because of the possible consequences. Again, I will take that away from today’s debate.

Under the existing regulations, the CQC can take action if it believes that safe and proportionate visiting is not being facilitated, but I also took note of the point made by the hon. Member for Liverpool, Walton about the CQC powers to get live data being limited and its not having powers to require care homes to report changes to visiting restrictions. I will look into that, too.

Although we have the guidance and the CQC is able to take action on care homes, there is clearly still a problem. I have also seen the data from the Rights For Residents survey showing that 45% of responses said that restrictions on visiting had still been in place since April, and in 11% of outbreaks no visitors were allowed at all. Again, I am concerned to see that.