Coronavirus (COVID-19): Visiting an adult care home

Safely visiting adult care homes during the coronavirus (COVID-19) pandemic.

This page provides advice and information for family and friends of people living in adult care homes.

Overview

People living in care homes have the right to a private and family life. As many care home residents are particularly at risk from coronavirus, it’s essential that visitors and care homes work together to balance staying safe with supporting residents’ mental and physical wellbeing.

This guidance is based on the best available advice from a wide range of clinical and professional experts, as well as input from family and friends of care home residents. As more is learned about coronavirus, advice is likely to change in order to make sure everyone is as safe as possible.

Coronavirus protection levels and care homes

Under the Strategic Framework, each local authority has been placed in a protection level, with different restrictions for each level.

Learn more about coronavirus protection levels

Care home visiting in some form should continue to be supported at all levels, where it’s safe to do so. Essential visits should happen at all times, in all Levels.

With the exception of some island communities, much of Scotland was placed into Level 4 restrictions on Tuesday 5 January.

Care home visiting guidance could change depending on a number of factors, including spread of coronavirus in local areas. Stay in contact with your loved one’s care home to confirm that visits can go ahead as planned, and to make sure that you find out about any changes to visiting arrangements well in advance.

Care home visits at Level 4

Under Level 4, visiting a care home indoors is restricted to essential visits only.

For outdoor visits under Level 4, visitors can see their loved ones through garden or window visits – these should be arranged with care home in advance. Garden visits are limited to one visitor, and visits by children and young people should be suspended.

Travel into and out of Levels 3 and 4 to see a loved one living in a care home is classed as essential travel.  This travel is exempt from coronavirus travel restrictions.

Read more about coronavirus protection levels

Care home visits at Level 3

It’s currently recommended that a combination of the following visits are supported by care homes in Level 3 areas, as long as it’s safe to do so:

  • essential visits that benefit the resident’s health and wellbeing, or allow families and friends time with loved ones in circumstances approaching end of life
  • indoor visits with 1 designated visitor for up to 4 hours once a week
  • outdoor visits with up to 6 people from up to 2 households for a maximum of 1 hour once a week
  • window visits

Depending on local public health restrictions, some types of visiting may be temporarily paused, but essential visits should always be permitted. Garden and window visits are also generally likely to always be supported in Level 3.

Travel into and out of Levels 3 and 4 to see a loved one living in a care home is classed as essential travel.  This travel is exempt from coronavirus travel restrictions.

Read more about coronavirus protection levels

SAFE HOMES initiative

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SAFE - Stay at home if you're unwell, Arrange your visit in advance, Face coverings and PPE, Engage with the care home gov.scot
Care Homes - HOMES - Twitter adjusted.png
Help you feel supported, Open to your concerns, Manage appointments safely, Enable essential visits, Show you how to visit safely gov.scot

Care home staff have been working hard to keep care home environments safe during the coronavirus pandemic.

Visits can be a way for coronavirus infections to enter, spread, and harm care home residents. However, it’s difficult for both care home residents and their friends and family to be separated and unable to spend time together. The situation can have a negative effect on everyone’s mental health and wellbeing.

Working together

You might feel nervous about care home visiting, so it’s important that you and the care home communicate as much as possible.

Care home residents and their loved ones have a right to know why decisions have been made about infection control. They also have a right to know why restrictions might be different in different health boards, local areas, or care homes.

Care homes can play a part in supporting residents and their loved ones by making them aware of changes as quickly as possible, and giving clear reasons for decisions.

If you have any concerns about your loved one or questions about visiting, each care home will have a key person you can talk to. This is often the Care Home Manager.

To help reduce the number of people moving around a care home, visitors are currently limited to:

  • essential visitors
  • designated visitors
  • professionals providing services

Essential visitors

Essential visitors are any family members or friends visiting a resident in pressing circumstances. These include a need to prevent or respond to a decline in health and wellbeing, in times of distress or circumstances approaching end of life. Essential visits can happen at all stages of the pandemic and no matter the Level that the care home is in. Care homes are asked to generously support these visits.

The care home manager should support you to have essential visits if your loved one meets the criteria below. Or you can ask the manager/senior staff member for essential visits if you are really concerned about the wellbeing of your loved one.

Circumstances that allow for an essential visitor include:

  • where there is concern that the resident’s health and wellbeing is getting or will get worse
  • where visiting may help with communication difficulties
  • where visiting will ease significant personal stress or distress
  • other pressing circumstances – for example, where there is concern that the resident may be approaching end of life

When it comes to deciding if an essential visitor is needed, distress means that the resident is showing signs of being depressed or withdrawn. It can also mean they are showing signs of anxiety – being anxious or restless. This applies whether or not the resident has a condition like dementia, or a learning difficulty.

End of life means the time before a resident passes away. This time isn’t limited to a few hours before or the same day that the resident is expected to pass away – it could be a period of days, weeks, or months.

When there is a serious concern for the health and wellbeing of the resident, and/or they are approaching end of life, care home managers should discuss this with family members. They can then make a plan for the length of family/friends visits and how many people can visit at once. This will include ensuring that full personal protection equipment (PPE), symptom awareness, and infection prevention and control (IPC) measures are in place.

Designated visitors

For areas in Level 4, indoor visits from designated visitors will be paused from 26 December. Outdoor visits will still be possible.

A designated visitor is a named person who can visit the care home resident indoors for up to 4 hours each week as long as all necessary safety measures are in place

The number of visitors entering the resident’s room should be kept to a minimum. However a designated visitor can have another visitor named as a backup for when they are unable to visit. This should be arranged in advance when the visit is booked.

The designated visitor can spend time in the resident’s own room. As long as PPE recommendations and IPC measures are being followed, they can help with parts of the resident’s personal care. This can include, for example, hair care and helping at mealtimes.

Keeping care home residents safe

There are a number of things you can do to help people living in care homes stay safe from coronavirus infection.

Don’t visit a care home if you feel at all unwell or have any symptoms of coronavirus.

Coronavirus symptoms

The most common symptoms are:

  • a new continuous cough
  • fever/high temperature (37.8C or greater)
  • loss of, or change in, sense of smell or taste (anosmia) 

A new continuous cough is where you:

  • have a new cough that’s lasted for an hour
  • have had 3 or more episodes of coughing in 24 hours
  • are coughing more than usual

A high temperature is feeling hot to the touch on your chest or back (you don’t need to measure your temperature). You may feel warm, cold or shivery.

Read more about coronavirus symptoms

Talk to the care home before your visit and make sure they know you’re coming – this will let them plan for the number of visitors they’ll have that day. As part of this conversation, let them know if you’re an essential visitor or a designated visitor so the care home can plan the length of the visit.

Follow any guidance the care home gives you about pets, gifts, snacks, and anything else you might want to bring in.

Following infection control measures

The care home can help you with the infection control measures you’ll have to follow during your visit. As part of keeping residents safe, you should:

  • wear a face covering when entering the home, during your visit and when travelling to and from the visiting area
  • wash your hands thoroughly or use hand sanitiser when you enter the care home or outside visiting space
  • maintain physical distance, apart from times when touch is valuable to the resident and visitor
  • to support safe touch, have regular training and supervision from care home staff to properly put on and take off PPE, and ensure other IPC recommendations are met
  • speak to the care home for advice and support if you are concerned a mask might make communicating with your loved one difficult
  • wear a face covering, plastic apron and vinyl gloves if you want to hold your loved one’s hand – this is PPE that the care home will provide

The care home staff will show you the correct way to put on and take off PPE and help to make sure you’re wearing it correctly.

If there has been a positive or suspected case of coronavirus in the care home in the 14 days before your visit, only outdoor and essential visits will be possible.

Coronavirus testing for care home visitors

People who are designated visitors and making indoor visits to care homes may now be offered a test for coronavirus when they arrive. Regular testing of visitors can help to support more meaningful visits with loved ones when combined with other infection prevention and control (IPC) measures, like physical distancing and the use of PPE. 

The lateral flow test will allow you to be tested immediately before a visit. It’s a swab test that gives results in less than an hour, typically 30 minutes. This test doesn’t need to be sent to a lab.

The test checks if you're infectious, even if you don’t have symptoms. If you test positive you will not be able to visit, and you will need to have a second test which will confirm whether you currently have coronavirus. This test will need to be arranged separately.

From 26 December areas in Level 4 will pause designated visitors indoors and so essential visitors may be offered a test in these areas during this time. In Level 3 areas, designated visitors will continue to visit indoors and only they will be offered tests.

Testing is not mandatory – you can refuse the test if you want to. You’re encouraged you to talk to the care home about your reasons for this.

Read more about testing for visitors in care homes

Read more about arranging a coronavirus test

Raising concerns around visiting

If you’re unhappy with the visiting arrangements in your loved one’s care home, the first step is to raise your concerns with the care home.

If you still have concerns after discussing the issue with the care home, you should ask for your concern to be considered through their existing complaints processes. The care home will be able to tell you what these are. 

If you have any concerns about the care itself, or your concern is not resolved through the complaints process, you can contact the Care Inspectorate.

Read more about making a complaint to the Care Inspectorate

Further information

Read the latest Scottish Government guidance on care home visiting

Read the Care Inspectorate’s information for care home services 

Read information from Alzheimer Scotland on how care homes can support residents and their loved ones during the coronavirus pandemic

The following helplines can provide information and support on visiting your loved ones in care homes, as well as specialist advice on particular conditions:

Age Scotland – 0800 12 44 222

Your local branch of PAMIS (Promoting a More Inclusive Society)

Downs Syndrome Scotland – 0300 030 2121

Scottish Autism – 01259 222022

ENABLE Scotland Family Connect Service – 0300 303 0228

Vaccinations

Coronavirus vaccines are safe and effective and are being offered to care home staff and residents as a priority.

Read more about coronavirus vaccines

How decisions are made about care home visits during the coronavirus pandemic

A group of experts in each local area, called an oversight group, provide recommendations about visiting in care homes. This group includes experts in public health, nursing, infection prevention, health protection, and social work.

The Care Home Manager makes decisions about visiting for their individual home. They work to balance the safety and needs of the entire group of residents, and the safety and needs of each individual resident.

The Care Home Manager considers:

  • current national advice for preventing coronavirus infection – for example, current guidance around physical distancing
  • the amount of positive and possible coronavirus cases in their local area
  • advice from public health on whether an outbreak is ongoing in their area
  • the type of care home – for example, whether or not the residents are mostly older people
  • the circumstances of individual visitors and residents

Last updated: 

6 January 2021