Government Issues Tier 4 Care Home Guidance

New guidance issued by The Department of Health and Social care has banned close-contact care home visits in Tier 4 areas.

THE GUIDANCE issued on Saturday night (19 December) states that care home visits in tier 4 areas can only happen behind substantial screens, in visiting pods or through windows.

All care homes – regardless of Tier – and except in the event of an active outbreak – should seek to enable:

  • outdoor visiting and ‘screened’ visits

All care homes in Tier 1, 2 and 3 – except in the event of an active outbreak – should also seek to enable:

  • indoor visits where the visitor has been tested and returned a negative result

Visits in exceptional circumstances including end of life should always be enabled, in all tiers.

The guidance also states that in all cases it is essential that visiting happens within a wider care home environment of robust Infection Prevention and Control (IPC) measures, including ensuring that visitors follow (and are supported to follow) good practice with social distancing, hand hygiene and Personal Protective Equipment (PPE) use.

In the event of an outbreak in a care home, the home should immediately stop visiting (except in exceptional circumstances such as end of life) to protect vulnerable residents, staff and visitors.

A Department of Health and Social Care spokesperson, said, ‘We know visiting restrictions in care homes have been very difficult for residents, their families and staff, and we have done everything we can to safely enable visits and reunite loved ones. In the face of a new variant of the virus, we have acted to protect those most at risk in care homes.

‘Visits to care homes can still take place in Tier 4 with arrangements such as substantial screens or visiting pods but, for the safety of loved ones, close-contact indoor visits supported by testing cannot take place in tier 4 areas.’

The National Care Forum (NCF) has said that the last-minute change to Christmas rules will cause a ‘significant challenge to all care providers’ and that care providers are receiving different instructions from local authorities and Government in relation to the use of lateral flow devices in care homes.

Vic Rayner, Executive Director, NCF, said, ‘Visits can and should continue in tier 4. However, the change in government policy to refuse the use of on-site testing in tier 4 will cause enormous distress to residents and loved ones. It will also be a huge blow to providers who have spent the last week preparing and training staff to use lateral flow devices (LFDs), and communicating and planning with relatives to enable meaningful visits by Christmas.

‘Visiting is absolutely key to the delivery of great care. Therefore, it is deeply unhelpful for local authorities and central government to be providing vastly different instructions in relation to the use of lateral flow devices in Tiers 1 to 3. Visits can be supported by LFDs, but they are only part of the picture alongside the continued use of PPE and Infection Prevention and Control procedures.

‘The last-minute changes to Christmas plans will also cause a significant challenge to all care providers – residential and homecare. Staff rotas have been planned to ensure everyone got a chance to spend time with families over the five-day Christmas period. This will of course all have to change as everyone assimilates the impact of this snap change of direction.’

According to NCF, care workers have always been the occupational group with the highest number of people working on Christmas Day and say it’s this lowest paid group of staff who are being asked to make some of the biggest sacrifices.

Vic Rayner, Executive Director, National Care Forum, said, ‘If ever this government was going to follow the lead of Scotland and Wales and reward all those staff for the multiple personal sacrifices they have made throughout this pandemic and will continue to do so to keep everyone safe over Christmas – then this is the time to do it. Care workers need all our respect, and we need government to step up and show just how much it values their contribution.’

Professor Martin Green OBE, Chief Executive, Care England, said, ‘This is a terrible situation for everyone, and the short amount of notice given complicates matters further.  We hope that the next, more transportable, vaccine will be rolled out to care home residents and staff as quickly as possible in order to see any light at the end of the tunnel.’












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