Care home residents in England face a postcode lottery over visiting because ministers have abdicated responsibility to local officials, according to social care bosses. Thousands of elderly people are still unable to have face-to-face contact with relatives despite guidance from health secretary Matt Hancock last week encouraging operators to allow visitors.
Martin Green, chief executive of Care England, said: “In some areas directors of public health have said they will not allow visiting, so a care home might want to reinstate visiting but the local public health director is saying it can’t.
“It is a postcode lottery. And the problem is that there is no accountability trail for directors of public health. Care homes cannot use the government’s guidance to override the local official. This is really a mistake by government.”
When the country opened up after the first lockdown, many care homes struggled to allow visits; some have not allowed them at all since March.
As the virus began to spread again, those care homes that had opened their doors started to close them. More than 228,000 care home residents in areas under tier 2 and 3 restrictions – 50% of all residents – were being denied visits, according to research by CSI Market Intelligence, a social care research firm.
Then, hours before the second national lockdown began last Thursday, Hancock announced a U-turn, saying visiting was important for care residents, and laying out how it might be handled. This includes creating “pods” – separate visiting rooms, which should have clear screens between visitors and their loved ones.
But the guidance did not make allowing visits obligatory, and care home providers have to carry out a risk assessment taking into account the views of the local director of public health. The guidance also stopped short of creating “key visitor” status, which would allow at least one relative to have regular testing, protective equipment and training to make longer and more meaningful visits. Last week a coalition of 60 care organisations called for each resident to have a key visitor. The Department for Health and Social Care said a pilot study would begin later this month.
Deaths from dementia have risen by 50% in the past six months, according to ONS figures, an increase many relatives believe is related to a lack of contact with familiar people.
“What we needed was urgent action to safely reconnect residents with their vital support networks, by granting family carers key worker status,” said Helen Wildbore of the Relatives and Residents Association.
“What we got is guidance encouraging prison-like visits behind screens, which is completely impractical for many older people, who find this too distressing and demonstrating a fundamental lack of understanding about the crucial role family and friends play in residents’ lives. The government must act now to prevent a human rights crisis in care.”
Families have become increasingly desperate. Last week, Ylenia Angeli, a 73-year-old retired nurse, was arrested after trying to remove her 97-year-old mother, who has dementia, from an east Yorkshire care home.
Vic Rayner, executive director of the National Care Forum, said: “It is possible to make visiting meaningful even within these strictures. There are people like Donna Pierpoint [manager of the Broomgrove Trust nursing home in Sheffield] who’ve done whatever it will take. What we haven’t had is a government that says ‘whatever it takes’. They’re saying: ‘It’s important, but we’ll leave it to you’.”
The home Pierpoint runs has 40 residents, and she has ensured that each of them had at least one visit a week from June until local restrictions were introduced in the city two weeks ago. It will now be able to allow visits from Monday. So far the home has seen no coronavirus cases.
“We are allowing touch – but the relatives have to wear gloves – and we are allowing them to give them a kiss – but they have to keep their mask on,” she said. “Until we have regular testing for visitors, that’s all we can do. The easy option is to stop visits because there’s no work involved in it. You don’t have to complete a risk assessment, write a policy or arrange this visiting timetable. It’s easier for the managers. But they can’t have hearts, that’s all I can say.
“I spoke to a woman this morning whose father is in a care home in Rotherham. She hasn’t seen him since March. Loneliness does kill. You won’t see it on a death certificate, but people are dying of broken hearts.”