We are in touch with some of the care homes in Hampshire that are taking part in the new pilot visitor testing scheme that will allow residents two indoor visits a week and to touch and embrace their loved ones. And we hope this will be rolled out more widely soon.
In the meantime, our 29-bed nursing home in Portsmouth is inviting in friends and family members, although in a limited fashion. Over the summer we held window visits and meetings in the garden, but nursing patients can’t sit outside on anything but the balmiest summer day, so we have set up a visiting centre in our conservatory.
Usually this is a quiet communal space where residents can sit together and enjoy watching the garden but with an external entrance which visitors can use, and being fairly straightforward to clean and ventilate between visits, it’s the obvious place to repurpose into a visiting room.
Because it is our only suitable space, time is limited, but it means that each resident is able to nominate someone important to them and to see that person face to face every week. Latterly, the government’s rules have permitted a second “nominated visitor” who may alternate weeks with the first, something which we greatly welcome, but it is still very difficult for those with larger numbers of friends or family members they want to see.
Still, it’s a far cry from mid-March, when we were completely locked down for 12 weeks, and the anxiety that comes with uncertainty exacerbated our practical problems, which included challenges with supplies of everything from PPE to food, and staff shortages. With so little access to testing, we’ll never know how many residents – or staff – had Covid back in March and April.
Now we know much more about how to keep ourselves and our residents safe. New PPE and cleaning requirements have become routine, and we have stocked up against the potential disruption of a second wave (and Brexit). The summer gave us time to recruit additional staff, to replace those who did not feel safe to come back to work when shielding ended, and to give us capacity to cope when winter viruses start to cause symptoms that keep staff at home until they get a negative test.
We are also used to testing ourselves each week, and our residents monthly, meaning we have a chance of picking up an asymptomatic infection. Issues with supply of kits and lab capacity persisted throughout the summer, but most results now arrive in two to three days.
The guidance issued for this lockdown no longer asks us to supervise visits by a family member or friend, something we believe acknowledges the importance of privacy for both visitor and resident, who is after all entertaining a guest in her or his own home.
It also allows us to place the needs of each resident at the heart of our decisions, meaning that while we must always consider protecting each individual from infection, we can also take into account whether they can interact meaningfully with someone who is sitting 2 metres away behind a plastic screen wearing a mask.
These short and restricted visits are a long way from normal life, but they mean that the people most important to each resident have a chance to see them face-to-face. If someone you care about is not able to tell you for themselves how they really are, to see them in person offers more reassurance than the most detailed report we could give.
For the residents themselves, being allowed to have visitors is a recognition that their circumstances are more constrained than most. The need for care homes to protect all residents means that they have fewer individual freedoms, and all have conditions that restrict what they can do. Unlike the rest of us, when the first lockdown ended, they were not able to hug loved ones close, to meet friends for a walk along the beach or to mark birthdays, anniversaries or other occasions in small gatherings.
We understand well the sacrifices that lockdown asks of everyone. Many of us working in social care have family overseas, and no idea when it will be possible to see them again. With 264cases per 100,000 people in Portsmouth, we are wary of bringing infection into the home, and many of us see less of our own friends and family so that we can better protect the people we are caring for. An outbreak in the home would mean the immediate suspension of visiting.
At nursing homes like ours, most residents are nearing the end of their lives. They have less time to spend with the people they love, which makes this second lockdown a greater sacrifice for them to make.
We hope we are moving closer to being able to include key visitors in our testing, using rapid test facilities on site, and to a vaccine. These advances might make it possible for visitors to sit with residents in their rooms again, and to give them that all-important hug. For our residents and their loved ones, and for us, that will be a very special day indeed.
• Robin Hall is administration manager at the Home of Comfort in Southsea, a charitable nursing home founded in 1896, and secretary of the Hampshire Care Association