4. Ms Armstrong asked the Minister of Health for his assessment of how the updated COVID-19: regional principles for visiting in care settings in Northern Ireland guidance is being implemented by care homes. (AQO 1485/17-22)

I thank the Member for her question. It remains the position of my Department that care home visits can be safely facilitated through compliance with the regional principles for visiting in care settings that are clearly set out in the existing guidance. We encourage all involved to work together to ensure that care home residents can avail themselves of visits from their friends and families while maintaining a safe environment. The decision to permit visitors into a care home and how that is organised remains the responsibility of the care home manager. The discussions should be based on a dynamic risk assessment that takes into account the particular circumstances of the individual care home to ensure the safety of all residents and visitors.

Health and social care trusts have been asked to work with care homes to provide the support they may require to move forward with risk assessments that facilitate safe, managed and meaningful visiting arrangements and the implementation of the care partner concept. In addition, the Public Health Agency is working with relevant stakeholders to continue to support the processes for implementing meaningful visiting and the care partner concept.

I fully understand why some care homes remain cautious about implementing both visiting arrangements and the care partner concept because of their experience of managing the transmission and impact of COVID-19. Nevertheless, there is an appreciation of the right to a family life for those living in care home settings and, in particular, an acknowledgement of the critical importance of sustaining relationships between residents and their families and friends at this time of the year. It is clear that a significant number of families feel that they have not been able to visit their relatives or set up care partner arrangements in line with regional guidance.

Some of the stories that families have told are deeply concerning. We know that the stories do not reflect the sector as a whole. I appreciate how hard many homes are working to facilitate both the care partner concept and safe visiting arrangements between residents and their friends or families.

Thank you very much, Minister. I thank you and all of your colleagues in the health service for taking that forward. Thank you very much for the risk assessments, as we know that will be key. Can you outline how you have sought to communicate and promote that to potential care partners to ensure they are all following guidelines, are all aware of them and can let people know so that visiting can happen safely?

I thank the Member for that critical point. We have been doing a piece of work that has been led by the Patient Client Council (PCC). It is about supporting families who have experienced difficulties in accessing homes that use the Department's guidance and have been implementing the care partner arrangements. We have asked the Patient Client Council to lead that work as an independent body interacting between the Department and the families who have been affected. There are some very harrowing stories, and I am sure that most Members have heard about that through their constituency offices.

However, there are many examples of good practice from good homes as well. I want to put on record my thanks to those homes that are doing extra work to make sure visiting can proceed safely and with less risk — it will never be risk-free — than in some of the homes. The Chief Nursing Officer and the Chief Social Work Officer met the Patient Client Council and a number of families' representatives in the last couple of weeks about that ongoing work and engagement. They discussed some of the particular difficulties in certain homes and regions and the way in which the offer of support and encouragement from my Department to facilitate visiting for families and residents is taken up.

The limitations on visiting arrangements have been a constant source of worry and emotional turmoil for staff, patients and relatives. Can the Minister outline whether the current restrictions on visiting, for example, in maternity wards is likely to change?

I thank the Member for her question. I also welcome her to the Health Committee and look forward to working with her.

The updated visiting guidance that came into effect from 15 January outlines that the specific restrictions for each care setting are aligned to the pandemic surge levels and the R value. The R value represents the risk of the virus spreading from one infected person to another on average. The guidance is based on the best scientific advice available at any given time. Northern Ireland is currently in surge level 5, the guidance for which states that:

"Birth partner will be facilitated to accompany the pregnant woman to dating scan, early pregnancy clinic, anomaly scan, Fetal Medicine Department, when admitted to individual room for active labour (to be determined by midwife) and birth."

The decision to admit visitors to a facility on a day-to-day basis will still lie with the nurse in charge and be based on a risk assessment and the ability to ensure social distancing and the safety of patients and visitors.

This is not the experience that I would have hoped for for expectant mothers, and I recognise that it is an anxious time for all families. Many difficult requests have been made, and will continue to be made, of the public in all aspects of health service provision, in order to reduce the spread of infection and to protect expectant mothers, their families and the staff providing the care.

The Minister has quite rightly identified the challenges in care homes as regards visits. It puts an extra burden on staff who are, in many cases, almost substitute families for the people under their care. Given that so many of our care homes are independently owned, can the Minister give an assurance to those hard-working and heroic staff in our care homes that they will also be eligible for the very welcome recognition payment that he announced last week?

I thank the Member for his question. There is work going on with regard to stakeholders in the independent sector, as to how we carry forward that recognition payment so that it can be properly utilised and get to the people who are the most deserving.

That ends the period for listed questions. We now move to 15 minutes of topical questions.