Family Visits in Health and Social Care Settings: Covid-19

Part of the debate – in Westminster Hall at 3:40 pm on 11th November 2020.

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Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care) 3:40 pm, 11th November 2020

It is a pleasure to serve under your chairmanship, Ms McVey. I congratulate and sincerely thank my hon. Friend Joy Morrissey for securing this debate. My thanks also go to all those who have come here today and made such powerful speeches, talking about the really difficult situation of visiting restrictions in care homes. My hon. Friend spoke extremely powerfully on behalf of Jamie, acting as his advocate in this tragic situation. I thank her for discussing this with me in advance of the debate; I am looking into that case.

As many hon. Members have said this afternoon, and as Minister for Care I strongly agree, visiting is incredibly important for those living in care homes. It is hard to put into words how paramount, how crucial, contact with their loved ones is for residents in care homes, but let me offer three reasons. First, for the individual in residential care, it can be what makes life worth living. The chance to see a loved one—a husband, wife, son, daughter, grandchildren or oldest friend—these visits are things to look forward to.

Secondly, visits to see their loved ones are important for family members. I have recently heard about a couple, both in their 90s; the wife is living in a care home and her husband always used to go to see her, but he has not been able to do so for months. This is actually affecting him more than it is his wife, who sadly has much less awareness of the situation due to her advanced dementia. It is affecting him because he is not able to see her. So the visits are important for the family who want to visit as well.

The third reason is the role that families and visitors play in making sure their loved one living in the care home is safe and well—the role they play in their care, in fact. Hon. Members have spoken today about the problem of residents, especially those with dementia, who are deteriorating without the visits they are used to. The advocacy role is also important, as my hon. Friend mentioned.

To step back a moment, the Government’s overall aim is to keep people in care homes safe and well—as safe and well as possible in the extremely difficult circumstances of a pandemic of a virus that is so cruel in in how it affects the old and most vulnerable. As Patricia Gibson said, it is an incredibly hard balance to strike, and I appreciate the way she spoke about that. On the one hand we want to enable visits to care homes, to enable people to have the things that make life worth living, but on the other hand, we know that when covid has got into care homes, when there have been outbreaks, it has been extremely hard for care homes to control it. That we have seen so many deaths of people in care homes is tragic. The hon. Lady is absolutely right; it is a cause of sleepless nights for me and others who are trying to make the right decisions.

In my remarks, I intend to speak first about what has happened, then say where we are now, and finally look ahead. I will do my best to pick up some of the questions and comments from colleagues.

When the pandemic hit us, it is true to say that visits were stopped, other than in exceptional circumstances such as end of life. The problem was so bad and there seemed to be such a risk for care homes that visits were stopped. During that period, I spoke to care workers who really went the extra mile to support care home residents through that time—to try to make their lives still worth living and to have positive moments, and to use technology to keep people in touch.

I am not naïve—I know that having a screen is not the answer to the problem of visiting, but for some people in some circumstances it has enabled more contact between those living in residential care and their families. It certainly does not work for everybody. It is not the whole answer.

That is one reason why, as covid rates came down during the summer, new guidance was published on 22 July to encourage the opening up of care homes and to enable more visiting. It supported local discretion; the director of public health and the local authority would work with care homes to agree a reasonable level of safe visiting, using PPE and social distancing and so on. I was very keen to see care homes opening again. Many people did have the chance to see their family members in care homes during that period. Unfortunately, not every care home managed to open its doors at that point and, as Holly Lynch mentioned, those in tier 2 or tier 3 high-risk areas still maintained strict restrictions on visiting.

As Rachael Maskell mentioned, there is a real problem of closed environments. One of the things that visitors do is raise a concern if there is a situation in a care home. She and I have spoken about an issue in her constituency a while ago, which was of great concern. That is why, when we went into the current lockdown, I was determined that we should not return to the situation of the first lockdown, where care homes were closed. I was determined that we should continue what visiting we could safely allow, and continue to have the Care Quality Commission crossing the threshold of care homes to identify and investigate where concerns had been raised. That is why the current visiting guidance is to encourage care homes to enable covid-secure visits, using screens, windows, visiting pods and so on.

Some care homes have been incredibly creative and innovative. My hon. Friend Andy Carter had a great example of a care home in his constituency. The guidance draws on methods that we have seen care homes using over the last few months, with the aim of getting others to follow suit. It is supported by being able to draw on the infection control fund. We have put £1.1 billion into funding to support care homes with the extra costs of providing covid-secure care.

I absolutely hear the message. This is not where we want to be. I want people to be able to hold hands again, hug again and have the physical contact we all need, which is particularly important for those with dementia and those for whom this whole situation is confusing or frightening. We know it has been bad for their health and wellbeing. Right now, however, to allow such contact goes strongly against the clinical advice I have received.

I have been advised that every single additional person going into a care home takes with them the risk of taking covid into that setting. In some parts of the country, one in 40 people have covid. If there is a care home with 40 beds and each person has a visitor, one of those visitors may well be carrying covid into that care home, unbeknownst to them, because they may well have no symptoms. When it gets in, it can be extremely hard to control. That is why we have taken a cautious approach, but I absolutely want to open up care homes to allow for the kind of visiting that people want. I am looking ahead.

Hon. Members have asked about testing, which will be so helpful in reducing the risk that someone going into a care home is taking covid with them. We have a huge testing programme in place in care homes for staff and residents. Staff are tested weekly, and the vast majority of staff are now undergoing that. That is really valuable in catching covid outbreaks early. Residents are tested every 28 days, and the next step is testing for visitors. A trial will be launched this month in four local authorities in areas of lower prevalence, where the risk is lower. That will launch on 16 November in a range of 30 different care homes both to assess the practicalities of testing and to make sure that we are confident in its safety. That will trial both the polymerase chain reaction—PCR—test that has been used for some time and the newly introduced lateral flow test that can be turned around quickly.

Trialling both will enable us to see which is the best to enable visiting, and we then plan to roll that out more widely across the country in December to see how many visits testing will enable. I am optimistic that that, combined with the lower covid rates that our national self-discipline during the lockdown should achieve, will make it much more feasible to enable more testing. Looking ahead, the prospect of a vaccine that may be effective against covid, alongside testing and a supply of PPE, should put us in a much better position to achieve the level of visiting that we all want.