Indoor and outdoor visiting – reconnecting residents and loved ones

Learn about the coronavirus (COVID-19) safeguards when going to see someone in an adult care home.

Care homes have a range of protections against coronavirus including:

These protections mean care home residents and their loved ones can have more regular time together.

Open with Care guidance supports meaningful contact between residents and loved ones. This guidance will be followed in care homes in all but exceptional circumstances.

This guidance is based on the best available advice from a wide range of clinical and professional experts. Family and friends of care home residents have also contributed to the guidance.

As we learn more about coronavirus, advice may change.

Visiting loved ones in care homes more often, and for longer

Care homes have been working towards increasing people’s time together. With the move to level 0 across Scotland, residents’ contact with loved ones should continue to become more normal.

Seeing loved ones at the care home

Please speak to the care home about the level of visiting they are able to support safely. They’re likely to be moving towards daily visits or family groups. The number of visitors will be in line with wider coronavirus restrictions around meeting indoors and practical factors in the care home.  From level 0 there is no need to have a named ‘designated visitor’ because residents’ contact should be getting closer to normal.

Visits may take place indoors or outdoors and should be arranged in advance with the care home. 

Garden and window visits in and around care homes might continue, depending on each resident’s wishes.

Outings and activities away from the care home

Additional guidance on activities and outings away from the care home is now available. Care homes should support outings and activities that take place away from the home, but there still might be times when these aren’t possible. Reasons might include if there is a coronavirus outbreak in the care home.

Residents might wish to meet people outdoors, away from the care home. This could include:

  • going for a walk
  • meeting in a public place like a park or café
  • staying overnight with family

These should generally be supported unless there’s a good reason to be more cautious.

Outings will be a big change for many people, and care homes also have to consider any risks to staff and residents. Residents, family and friends who want to plan outings or activities should work together with the care home team in advance.

The frequency and duration of contact should increase gradually. The Open with Care guidance is there to provide examples of how care homes can enable safe and meaningful visits, while being flexible.

Residents can take car trips out as long as they follow safety guidelines and use infection prevention and control measures.

It’s also possible for residents to visit other people in their homes or have overnight stays away (in the resident’s own home or someone else’s home).

Care home residents are subject to the same coronavirus guidance as everyone else when it comes to meeting people indoors and outdoors, in public places or private homes. These restrictions change depending on local protection levels.

If you’re spending time with a resident outside of a care home, you should follow all coronavirus physical distancing, safety guidelines and the latest government advice.

Even if you’re planning to meet outdoors, anyone experiencing coronavirus symptoms, or symptoms of any other illness, should not meet up with care home residents.

Before spending time with a care home resident, please speak to the care home about whether you should take a coronavirus test in your own home or at the care home.

Coronavirus protection levels and care homes

Under the Strategic Framework, each local council has a protection level. Currently all of Scotland is at level 0.

From February 2021, contact between care home residents and loved ones will not usually be tied to the local level.

When residents leave the care home they will be subject to the same restrictions as the general population.  As these are subject to change and might differ across areas, you should always check current restrictions before a visit.

Changes to visiting arrangements

Visiting arrangements may change at times, depending on conditions within the care home or the local area. For example, if there’s been a case of coronavirus in the care home in the 14 days before your visit, you would not be able to see residents until the outbreak is declared over. The care home will keep you up to date with these changes.

Essential visits should always continue.

Garden and window visits are also likely to always be supported.

Travelling to visit a loved one

Residents wishing to travel to see loved ones outside the care home should first consult coronavirus travel (and wider) restrictions.

Read more about coronavirus protection levels

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.

COVID-19 vaccinations

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

It’s important to still try to maintain physical distancing even if you or your loved one has been vaccinated. This is because we are still learning about the COVID-19 vaccine.

Read more about coronavirus vaccines

Essential visitors

Essential visitors are any family members or friends who visit a resident in pressing circumstances.

Pressing circumstances include:

  • a need to prevent or respond to a deterioration in health and wellbeing
  • times of distress
  • circumstances approaching end of life

People providing spiritual care are also essential visitors, in urgent and non-urgent circumstances.

Essential visits should be supported at all stages of the pandemic, including in lockdown. Care homes are asked to generously support these visits.

The care home manager should support essential visits in these circumstances. Or you can ask the care home manager/senior staff member for essential visits if you’re 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 for the resident and/or their family
  • other pressing circumstances – for example, where there is concern that the resident may be approaching end of life

If there’s serious concern for the resident’s health and wellbeing

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 visits and how many people can visit at once. This will include ensuring that safety measures are in place including:

  • personal protection equipment
  • symptom awareness
  • infection prevention and control

If the resident is in distress

If the resident is in distress, an essential visitor may be 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.

If the resident may be approaching the end of their life

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

Children and young people visiting

Children and young people can visit indoors or outdoors and should be included in any group size limits.

This includes essential visits, where desired. During essential visits, children and young people should follow advice from the care home on infection prevention and control and personal protective equipment.

Organised groups of children and young people (for example community groups or choirs) are not currently recommended to attend care homes. This is due to the higher risk of infection from groups of unvaccinated people.

How decisions are made about visiting in care homes during the coronavirus pandemic

A group of experts in each local area make recommendations about visiting safely in care homes. This is known as local oversight arrangements. The group includes experts in:

  • public health
  • nursing
  • infection prevention
  • health protection
  • social work

The care home manager makes decisions about visiting for their individual care 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 factors such as:

  • current national advice for preventing coronavirus infection – for example, guidance around physical distancing
  • advice from public health – for example, 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

Raising concerns around visiting

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

Complaints processes

You may still have concerns after discussing the issue with the care home. In this situation, 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.

Care Inspectorate

You can contact the Care Inspectorate if you have concerns about any aspect of the care provided, including about visiting. You can:

  • contact the Care Inspectorate at any time – you do not have to go to the care home first
  • ask for your complaint or concern to be kept confidential
  • speak to them informally – you do not have to make a formal complaint to ask for help
  • speak to the inspector to share your concerns

The Care Inspectorate can provide you with advice and guidance. The inspector can also:

  • speak to the care home to help improve visiting arrangements, in confidence if you’d like
  • make sure the care home is following Open with Care guidance

Access further advice and support

For many people, reconnecting will be an emotional time.  A new Action on Rights team has been set up to help anyone with a loved one living in a care home to have meaningful visits under the Open with Care guidance. They offer practical and emotional support to anyone who needs it.

This support is not solely for families and friends of people living with dementia – it is for anyone needing support. The team will also work with care homes to help facilitate visits where appropriate.

You can reach the Action on Rights team by phoning the free 24 hour Alzheimer Scotland helpline on 0808 808 3000.

These helplines can provide information on visiting your loved ones in care homes. They can also give specialist advice on particular conditions:

Find more information

Read guidance on keeping everyone safe when visiting an adult care home

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