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The Minister for Mental Health and Older People, Mary Butler, T.D., welcomes the publication by the Health Protection Surveillance Centre (HPSC) of new COVID-19 Guidance on visitations to Long Term Residential Care Facilities.

The new guidance aims to further support long-term residential care services (including nursing homes) and residents in planning visits across all levels of the framework for restrictive measures in the Government’s Resilience and Recovery 2020-2021: Plan for Living with COVID-19. The new guidance also includes further advice recognising that major cultural or religious festivals, such as Christmas, are of significance for residents and their families.

This new guidance outlines an updated definition for ‘critical and compassionate circumstances’, which now provides that residents may be facilitated to receive:

  • Up to one visit by one person per week under Levels 3 and 4 of the framework;
  • Up to one visit by one person per two weeks under Level 5;

It also notes that at all framework levels every practical effort should be made to accommodate an additional visit on compassionate grounds during the period of a major cultural or religious festival or celebration of particular significance to the resident, such as the Christmas/New Year period.

To allow time for making arrangements and planning for the implementation of the guidance, the new guidance comes into effect from 7th December 2020.

Welcoming the publication, Minister Butler said:

Across society, 2020 has been a very challenging year as we try to live with COVID-19 in the safest possible way. That challenge has been significant in nursing homes, where normal life for residents and staff has had to change so much. Social interaction and meeting family and friends is important to the health and wellbeing of residents and factors significantly in their quality of life.

However, as we have sadly learned, COVID-19 can have a particularly serious impact on older people and those who are medically vulnerable. Managing this risk requires vigilance and a range of public health measures as we try to strike the balance between the necessary protective public health measures and the mental health and wellbeing of residents and their family and friends.  I thank the HPSC for its commitment to re-examine importance guidance, such as visiting guidance for nursing homes and other residential care services, on a regular basis.

Minister Butler continued: While unfortunately the risk posed by COVID-19 means that we will all have to celebrate Christmas in a different way this year, the new visiting guidance identifies further opportunity for managed social interaction and residents receiving visits from family. In doing so, as noted in the guidance, we must continue to have the protection and safety of all residents at the forefront of our considerations.”

She concluded: It is important that we recognise the challenges faced by nursing home staff throughout the pandemic and acknowledge their work to care for and keep safe the residents under their care, as they try to balance the range of needs of residents and the required protective measures.

I again request that all nursing home providers make every practical effort to facilitate visiting in a safe way in line with this important new guidance during the Christmas period and beyond. Communication and a collaborative approach is key and I also ask providers to review communication processes, so as to ensure that they communicate with residents and families in a timely and detailed way with regard to visiting arrangements.

Acknowledging the difficult year this has been for families, I ask that families work in a positive and as flexible a way as possible with the staff of the nursing home that you plan to visit, to ensure the safety of all of the residents and staff of that nursing home.

Notes:

  • The ‘Resilience and Recovery Plan for Living with COVID-19’ is a cross-government approach to managing the pandemic for the coming months and was published on 15th Based on this framework, the HPSC have developed new visitation guidance for long-term residential care facilities, which can be read here.
  • COVID-19 is highly contagious and when it is circulating at high levels within the community, there is an increased risk that it will enter into nursing homes and other long-term residential care facilities. Those in these settings are often very vulnerable to this virus and its effects, as well as the settings themselves posing risks in terms of infection control and prevention.
  • In order to reduce the risk of COVID-19 being transmitted to vulnerable populations, it may be necessary to reduce the number of visitors to long-term residential care facilities at certain critical times.
  • Visiting restrictions are widely practiced internationally as a protective measure with some variations in how they are applied. However, as per regulatory requirements, visiting is part of the normal daily functioning of nursing homes. Therefore, the nursing home provider is responsible for doing all that is practical to support safe visiting. The nursing home should have the capacity and relevant skill sets within its staffing complement to manage this appropriately.
  • The HSE’s Health Protection Surveillance Centre (HPSC) has developed this new guidance, which fully aligns with the 5 level framework of restrictive measures as outlined in the Government’s Living with COVID-19 Plan, to support long-term residential care providers in the discharge of their responsibilities and to support in the safe visiting, to the greatest extent possible, having regard for the challenging times in which we are living. The guidance provides public health support and advice for the 5 levels of restrictive measures, when outbreaks/clusters are being experienced and visiting in compassionate and critical circumstances. Building on previous versions, it provides further guidance on supporting residents’ particular requirements at time of major cultural or religious celebrations or festivals, revised definitions of critical and compassionate grounds, noting that additional visiting on these grounds may be permitted, and also makes a number of other important clarifications. The revised guidance has been developed in consultation with key national stakeholders.
  • The publication of this guidance also supports the implementation of recommendation 12.1 of the COVID-19 Nursing Homes Expert Panel Report.
  • Recognising the difficult landscape that COVID-19 has presented for long-term residential care settings, a series of enhanced measures have been agreed by the NPHET to provide support to these settings and these are currently being implemented by the HSE, HIQA and service providers. They include measures to support facilities which have outbreaks of COVID-19, measures aimed at breaking the chain of transmission of the virus and support the provision of PPE and other protective measures.
  • On the 19th November, the European Centre for Disease Control published its latest risk assessment with regard to long-term care facilities. It highlights that “the probability of COVID-19 introduction into a long-term care facility depends on the level of COVID-19 circulation in the community, with a higher risk associated with higher incidence rates in the community.”
  • This highlights the importance of supressing the level of the virus in the community as one of the primary measures for protecting nursing homes. As citizens, we all have a responsibility in this regard and our actions across all of society can directly impact the outcomes for nursing home residents.

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