Visiting a care setting during COVID-19

Advice for volunteers, practitioners and professional services

The COVID-19 pandemic has brought many changes to the way that care settings and their staff operate. Not least are the necessary changes to visiting that have been imposed to reduce the spread and transmission of the disease. As a visiting volunteer, practitioner or professional service, there are simple steps that you can take to help protect yourself, residents and staff in care settings.

This helpsheet does not replace local, regional or national guidance, and all visitors must be aware of, and comply with, any infection control policy and procedures of the care setting they are visiting.

Planning your visit

Visit only when necessary. Could you respond in any other way? Make use of technology, such as phones or video calling where possible and available.
Where a visit is required, you must plan ahead. Do not visit a care home unannounced. Agree a date and time for your visit with the care setting. Care homes are coordinating visits for all residents and may have to restrict how many people are able to visit on any one day.
If you have an allocated time to be there, be as prompt as possible. If you are going to be delayed, let the care home know.
Only visit if you are safe to do so. Anyone who has symptoms of COVID-19, has been overseas or to a high-risk area, or had close contact with an infected person should not visit, even if a visit has been previously arranged.
Do not visit if you are coming from an area that has been placed in local lockdown.
Only visit if you have, and are able to wear, the appropriate protective equipment. The level of Personal Protective Equipment (PPE) required in each setting may vary, and visitors must check ahead what is required, whether it is available at the setting, or if they should provide their own. Please note this may require additional PPE to that provided by your own employer.
If you are unable to wear PPE, or if you are unable to have the influenza vaccine, you must let the setting know before you visit, as this may affect your access.
The care setting may ask you to bring only essential items for the purpose of your visit.

Be prepared for change

Infection prevention and control measures mean that each care setting will have had to make many changes to their day-to-day operations. These changes include zoning areas of the care home, moving residents to comply with isolation requirements, and restricting access to activities and certain spaces for residents in their care.

In most care settings you will be greeted by a member of staff who will take your details and ensure you are compliant with their organisation’s stipulated criteria.
The PPE worn by staff and visitors may vary within, and across, different settings. PPE may extend to protective eyewear, gowns and gloves, as well as face masks.
You may be asked to submit to a cleaning process, such as a disinfectant spray for your clothes and shoes, and you will be asked to clean your hands using an alcohol-based hand sanitiser.

There may be barriers and signs in place instructing you to walk through the setting in one direction. Some settings have one-way systems in place, others have corridors or zones. It is important that you follow the direction of each individual setting. Most care homes have public zones. You may not be permitted access to a resident’s personal space.
You might be asked to remain in one area or may no longer be able to access a garden.
Residents might have been required to change bedrooms for a period of time.
Group activities may no longer take place, and activities may be held in the person’s own room.

The person

COVID-19 has been a frightening experience for many of us and may be even more so for people with dementia and people living in care settings. For many residents, the experience has been heightened by not understanding or remembering why their loved ones can no longer visit or hug them. People may no longer recognise loved ones or preferred carers because of the need for face masks.

People with dementia may feel confused, or that they are being punished by requests for them to self-isolate. The impact of changes may mean that people are at increased risk of developing apathy, or even depression. The reduced opportunity for engagement may cause people to feel lonely or bored. As a result, people may be experiencing behaviours and psychological changes that impact on their care.

HammondCare Dementia Support has a range of resources available to assist families and care staff in the care and support of people with dementia. Some of these guides are specific to the COVID-19 pandemic. Resources include guides on Understanding and managing behaviours in a time of pandemic, What you can do to stay connected, and Providing one-to-one care for the person living with dementia.

When you visit

Follow the guidance of the staff on site. Despite the best planning, things may have changed in the setting since your last contact, so always follow the advice and guidance of the staff on the day of your visit.
Allow extra time. You may have to wait to access the setting, and the additional steps, such as putting on PPE, may add time to your visit.
Be kind. Many staff and managers have been under increased pressure due to the additional responsibilities that COVID-19 has brought. We all want what is best for the people we support.

When you are with the person

Allow more time than usual for all communication.
Does the care home have personal information about the person you can learn from to make a connection?
Introduce yourself. If you are a visiting professional, tell the person why you are there.
Show a picture of yourself on your phone or have one with you so the person can see you without your mask. Explain why you have to wear it.
Be present. Make and maintain eye contact as appropriate, especially if you are not able to touch.
Use the person’s name as often as you can in conversation.
Be prepared to repeat yourself as often as the person needs.

Smile. Even though your smile may not be visible through the mask, smiling changes our facial expression and even the way that we talk.
Slow down your speech. Talking through a mask can muffle conversation; slowing down speech, and allowing pauses between sentences and responses, can allow the person time to understand what has been said.
Use gestures and exaggerated facial expressions to support what you are saying.
If appropriate, write messages down, and think about leaving a message for the person to read after your visit, to remind them of your time together.
Let the care staff know how the visit went and what you achieved.

Following the visit

Ensure that all PPE is disposed of appropriately. The setting may have their own guidance and facilities for removing PPE, handwashing and surf ace cleaning after a visit. Check with the setting and follow their guidance.
Agree contact times outside of visits. Many staff have had to take on increased responsibilities at this time and may be exceptionally busy. Talk to the care home setting and agree the best means of maintaining contact.
Reduce the number of future visits needed if possible. Have designated contacts per settings and liaise with other teams to avoid repeat visits.
If you are speaking to the person’s family, remember that they might not have seen their loved one recently, or they may be concerned by the changes they see.
If your visit has raised concerns about the care, health or welfare of any resident, discuss your concerns with the setting manager.

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