CLARiTY Session 1: Visiting Restrictions and Understanding the Lockdown Rules
This is a plan language summary of the topics we talked about during our first CLARiTY Session.
In our first CLARiTY session, we talked about three things:
- Visiting friends and family in care homes and supported living
- Visiting friends and family in hospitals
- Understanding the new lockdown rules
The information summary from this session applies to the rules in England. There are different rules if you live in Northern Ireland, Scotland or Wales.
1. Visiting Friends and Family in Care Homes and Supported Living
Oliver Lewis, Barrister at Doughty Street Chambers talked about human rights, and how important it is to balance everyone’s rights to be kept safe from the coronavirus that causes COVID-19 with their rights to see family and friends. This means that there should not be blanket bans on visiting people in care homes and supported living. The government has also said this in the new guidance on visiting care homes and on supported living. Visiting friends and family in care homes and supported living is an exception to the ban on mixing households during the 5 November – 2 December 2020 Lockdown in England.
If a person in a care home wants to have someone visit them then the care home should do everything they can to make this happen. For some people this might mean using digital tools like FaceTime, Zoom or Skype. But this kind of contact does not work for everyone, and there needs to be some flexibility. Sometimes, visits through a window or in a special visiting booth might work. It is also possible to meet someone in a garden of a care home if that care home has a garden.
When someone visits a care home they need to stick to any rules that help make sure that this visit is ‘COVID secure’. This might include wearing a face covering, washing hands and keeping physically distant. If visits are ‘COVID secure’, this doesn’t mean that there is no risk of catching the virus, but it does mean that a risk assessment has been completed, all of the government guidance has been taken into account, and steps have been taken to reduce the risks as much as possible.
Oliver said that the guidance could/should perhaps change to allow for contact that involves touch. Touch is very important for people who communicate via touch like people who are deaf-blind, but for many people (disabled or not), touch is important for happiness and wellbeing. One way that touch could be allowed would be if visitors could be tested for the virus before visiting a care home. This would help ensure that everyone is safe. Since we had our meeting, the Government have announced a fast testing pilot scheme for enabling care home visits. They hope that it will be possible for all care homes to have access to this technology in time for Christmas 2020.
At the session, someone asked whether care homes can limit visiting to only family members or ‘next-of-kin’. There is nothing in the law or guidance that says that care homes can decide who a resident is allowed to see. Sometimes friends live closer than family, or have better relationships with that person than their family. It should be up to the person who they have coming to visit them.
Supported living is different from care homes, and so the rules are different. But the Government guidance says:
“Supported living managers and care/support providers need to work with the people they support to identify where following the government requirements for visiting and support bubbles will cause distress, and consider options for in-person visits.”
There is guidance from the government about visits to people who live in supported living. If you want to visit a person who lives in supported living, then you should read that guidance in full. But the main points are that visits should be outdoors if possible, and that alternatives to indoor visits like using digital communication tools, meeting in shared outdoor space, or going for a walk in a park should be thought about. If you are visiting a person who lives in a shared house and an indoors visit is necessary, visits should only take place in that person’s room, and visitors should wear appropriate face coverings, stick to social distancing rules, and wash their hands.
The Department of Transport have made some easyread guidance about support bubbles. You can find it on page 11 of this easyread document about safer travel.
If you live on your own in supported living, you are a single adult household (even if you have carers who come and visit). A single household can be in a support bubble with one other household. If you have a carer who lives with you at all times then you could still form a support bubble, but only with a single adult household who are not in a support bubble with anyone else. This means that under the current rules single family carers of a disabled adult and disabled people, who have a live-in carer cannot form a support bubble unless it is with a single adult or a single parent. Since our meeting, the government have announced that more people will be able to form support bubbles from 2 December 2020. This will now include single carers of a disabled adult. We will add more information on this when it is available.
These websites have more information about visiting friends and family in care homes and supported living:
EasyRead or More Accessible Information
https://right2visit.info/ gives information about visiting inpatient mental health settings, care homes and supported living.
EasyRead Guidance from the Department of Transport on Safer Travel: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/935498/coronavirus-safer-travel-easy-read-guidance-document.pdf.pdf
2. Visiting Friends and Family in Hospitals
Sophie O’Connell from Wolferstans Solicitors talked about visiting people in hospitals. This includes general hospitals and long stay hospitals like Assessment and Treatment Units (ATUs). There are different rules about visiting people in hospital depending on the kind of hospital they are in. NHS general hospitals and ATUs have different rules and processes to privately run hospitals and ATUs.
Here is a clip from our session, where Sophie talks about the rules on hospital visiting during COVID-19.
Hospital visiting is still allowed, but only in a very careful and COVID-secure way. Each hospital has to have a visiting policy, but the policies might be different depending on infection rates in the local community or infection control processes in the hospital.
The first place to look for information is on the hospital website. Most hospitals have a link to their visiting policy there. Often there are specific exceptions to general visiting restrictions for parents of children under 18, carers for adult patients, or patients at the end of life.
If you can’t find the information on the website, or the website is not accessible to you, you could ask the Ward Manager of the ward that you want to visit. The Ward Manager is the person in charge of that ward. The Ward Manager may be an administrator rather than medical staff so you may need to ask the Matron who will be a nurse. Or you could contact PALS – the Patient Advice and Liaison Service for that hospital. Every hospital has a PALS and this is a team who are in the hospital to support people and give them advice when they are in hospital. You can find the contact information for PALS on the hospital website, or by phoning the hospital main reception. Some hospitals have learning disability nurses who can help you prepare for going into hospital and help you when you’re in hospital. Not all all hospitals have this service, but it can be worth checking to find out.
Some people use ‘hospital passports’ or ‘COVID19 passports’. These are documents that give information about you, and your care and support needs. This can help ensure that hospital staff treat people with learning disabilities, autism or other support needs well. Some hospitals have their own hospital passport templates.
EasyHealth.org.uk have a page about hospital passport templates where you can download them, including an extra template about COVID19: https://www.easyhealth.org.uk/index.php/health-leaflets-and-videos/hospital-passports/
Learning Disability England also have some guidance about going into hospital that might be helpful: https://www.learningdisabilityengland.org.uk/what-we-do/keeping-informed-and-in-touch-during-coronavirus/other-resources-that-can-help/being-prepared-in-case-you-need-to-go-into-hospital-2/
Assessment and Treatment Units (ATUs)
In an ATU, the ward manager or care coordinator may be the first person to speak to. If your loved one has an advocate (a person whose job it is to support the person to express their wishes and feelings), then they might be a good person to contact too.
The Right to Visit website https://www.right2visit.info/ has information which will help you think about what to say about why you should be allowed to visit. If after speaking to the relevant people (the ward manager or care coordinator) you are still not allowed to visit you may need to write a letter. You should ask the ATU for their visiting policy and and you can check that it follows the Government guidance on visiting. The right2visit website can help you do this and has template letters you can use.
Private hospitals and ATUs have different policies to NHS hospitals and ATUs. The three big providers are Priory Group, Cygnet Health and Elysium Healthcare. Links to their coronavirus policies, which may be helpful if you need to challenge them, are here:
- Priory: https://www.priorygroup.com/coronavirus
- Cygnet Health: https://www.cygnethealth.co.uk/help/coronavirus-covid-19/information-for-families-carers/
- Elysium: https://www.elysiumhealthcare.co.uk/family-carers/covid-19-information/
Many of these policies are more restrictive than the Government guidance for hospitals, and all are subject to risk assessment, and COVID-secure policies and processes, like wearing face coverings and ensuring that people with COVID-19 symptoms or who have been told to self-isolate do not visit. As with NHS hospitals, the first point of contact will be those responsible for the service you wish to visit. The Right2Visit guidance gives lots of helpful information on how to challenge decisions to restrict visiting in ATUs and long-stay hospitals.
3. Understanding the New Lockdown Rules
Professor Rosie Harding from Birmingham Law School talked about understanding the new lockdown rules. Keeping up with the rules about what you can and can’t do can be really difficult, because the rules change a lot.
Mencap have published an easyread guide to the National Restrictions from 5 November. It is available here: https://www.mencap.org.uk/advice-and-support/coronavirus-covid-19/coronavirus-latest-guidance-government
The government guidance is available here: https://www.gov.uk/guidance/new-national-restrictions-from-5-november
The current ‘lockdown’ rules, which apply from 5 November to 2 December in England are quite different from the rules that were in place during the first lockdown that began in March 2020. This might make it confusing, as many more services are allowed to remain open, and more people are allowed to go to work, if they cannot work from home. But there are still lots of restrictions on what people can do, especially with friends and family. The main rule is that you have to stay at home, but you are allowed to go out for many more reasons than in the first national lockdown, including for outdoor exercise, to meet another person in outdoor public space, to access services, to go shopping and for various other reasons, like work, education, volunteering or to attend funerals or memorials.
Some services that are allowed to stay open during the new national restrictions that were closed before include:
- Schools and childcare services;
- Healthcare services like dentists, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services relating to mental health.
- Public toilets
- Day care centres
- Support groups
Non-essential personal services like hairdressers and barbers are closed. Lots of “non-essential” shops are open for internet or telephone orders and “click and collect” services. Garden centres have remained open this time. Cafes, restaurants and pubs have had to close, but many are offering takeout or delivery services.
Things that will make a big difference to disabled people and carers are that during this lockdown there is a new exception for people who need continuous care. The term “continuous care” has not been defined in the regulations, so it is not clear who is covered by the rules. Government guidance says that people who need a carer can still go out and meet a family member or friend, and their carer won’t count in the number of people who are present. There is a similar rule for children under 5. Support bubbles and childcare bubbles are also still allowed. There is also an exception for support groups who need to meet in person.
We haven’t reproduced all of the rules here, because the government guidance is the best place to look for detail.
The rules are expected to change again on 2 December, when England will go back into different ‘tiers’ of restrictions, which are aimed at controlling the virus.
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