Plans are being drawn up to help make it possible for more Lancashire care home residents to receive visits from their loved ones – even while the county remains in the grip of the pandemic.
The Local Democracy Reporting Service (LDRS) can reveal that Lancashire County Council is set to distribute £2.2m to care home operators to fund physical modifications to their properties in order to facilitate safe visiting during the ongoing Covid crisis.
The cash could also be used to cover other costs associated with allowing visits – including increased staffing levels and extra cleaning.
Government guidance states that areas in Tiers 2 and 3 of the new system of coronavirus restrictions should limit care home visiting to “exceptional circumstances” – such as when a resident is nearing the end of their life.
Lancashire was placed in the “very high” Tier 3 alert level earlier this month, with the status due to be reviewed after four weeks.
However, the LDRS understands that County Hall is in the final stages of devising a local care home visiting policy which aims to increase opportunities for safe face-to-face contact between residents and their relatives in more routine situations – whatever the wider restrictions in force in the community.
It is understood that Lancashire’s position will be informed by the general aspects of government guidance on visiting – including a requirement for a “dynamic risk assessment” of the changing circumstances of individual care settings and external factors such as the prevalence of infections in a particular area.
The county council’s cabinet member for adult services, Graham Gooch, said that the aim of the plan is to ensure that – wherever it is safe – residents of Lancashire’s care homes can once again enjoy the most familiar of faces sitting in front of them.
For many, they have gone more than seven months without the thing they look forward to the most.
“It’s having such a drastic effect on people – and some really are going downhill.
“So I want to look at the overall health of those in care homes.
“For most people, this will be their last home and we want them to have some quality of life while they are there – we are not preserving them in aspic.
“At the moment, it’s come down to [allowing visits only] when people are about to draw their last breath – and that’s pretty awful.
“There was a report of a resident in a Scottish care home who is 104 and they won’t let her see her relatives – you just can’t treat people like that,” County Cllr Gooch said.
He added that the policy was likely to involve “buying a lot of Perspex” to install protective screens – something which can be done relatively quickly and simply – but admitted that physical alterations in some homes may be difficult.
Other measures are also being considered, such as funding staff supervision of visits to ensure that safety rules are being complied with.
The LDRS understands that care homes are currently being contacted about their individual needs to facilitate visiting.
The county council is planning to lead the way in implementing the policy in its 17 local authority-run care homes in Lancashire.
However, visiting remains an operational decision for the more than 400 private care homes in the county – and so the move by County Hall to help find practical solutions to the present problems does not provide a universal guarantee that visiting will be possible across the board while the pandemic continues.
County Cllr Gooch says he does not expect Lancashire’s plans to be thwarted by the government – in spite of the current national advice that care home visiting should be highly restricted in higher tier areas. He added that the principles of the soon-to be-finalised policy have been shared with the county’s MPs.
Health and social care minister Helen Whately also indicated earlier this month that the government is planning to launch a pilot scheme designed to enable more regular care home visiting during the pandemic – something with which the county council is understood to be keen to be involved.
“Visiting is incredibly important for residents and their families in care homes – I really want us to enable visiting, but it has to be safe,” Ms. Whately told the health and social care select committee.
Wider government guidance on care home visiting during the pandemic would still apply in Lancashire under its local plans – with decisions being based on the assessment of the area’s director of public health.
The funding for the suggested measures has been taken from Lancashire’s share of the government’s winter infection control fund.
The county was required to distribute 80 percent of its £14.8m grant directly to care providers for them to use as they see fit – but the authority has also forwarded a further 15 percent of the cash to care home operators, with the stipulation that they must use it to facilitate safer visiting.
That means Lancashire’s care homes will receive a £174 for every registered bed in their properties, specifically to fund Covid-secure visiting arrangements. In total, they will be handed £837 per bed for infection control purposes.
The policy appears to have won strong cross-party support in the county after councillors who had raised concerns about restricted visiting were briefed on the plans before a meeting of the full council earlier this month. All councillors have now been contacted about the proposed policy.
The Green Party’s Gina Dowding said at the meeting that “the only thing that keeps [care home residents] going are visits from family – and we saw how visits were curtailed really bad in the first wave”.
Visiting was banned in care homes during the full national lockdown earlier this year – and even after that was lifted, the strong advice in Lancashire was for homes to continue prioritising digital methods of contact between residents and relatives, which many of them went to great lengths to implement.
The early summer dip in Covid case rates in the county soon gave way to concerning spikes in the figures – and as a patchwork of partial lockdowns was imposed, care home visiting again became a near impossibility.
County Cllr Gooch is appealing for operators to “think creatively” about how to use the money now on offer to ensure that residents and their loved ones do not face many more months of being denied some form of in-person contact.
“We’ll do anything we can to help them, because ultimately we exist for those who are being cared for – they are our concern – and also their families, who are dreadfully upset.”
'I want a hug'
When Carl Trowbridge arranged for his recently-widowed mum Ann to go into Brookside Care Home in Bamber Bridge late last year, he never imagined that for so much of the following 12 months he would be unable to visit her.
Eighty-six-year old Ann was still adjusting to her new life when lockdown turned it upside down again back in March.
Visits from her family – including two sons, 3 grandchildren and one great grandchild – came to an abrupt halt. It has not been an easy time for any of them.
“Mum keeps asking when it’s all going to end,” explains Carl.
“I’ve seen her through the window and the door on a few occasions, including for my 60th birthday – but most of the time it has been via video calls.
“She is getting the hang of it now, but at first she would reach out to try to touch me through the screen.
“You always want a hug from your mum – and she really wants it, too, you can tell she’s missing it.
“Initially, she really went into herself and wouldn’t mix – but the home has been fabulous at drawing her out. Now she is very involved and is knitting again.”
Carl says that any modifications to enable some form of face-to-face contact cannot come soon enough.
“I think people would be willing to go through this halfway stage of sitting behind a screen or something, hoping that it was the first step on the road back to normality.
“The staff have worked like Trojans to keep the residents safe and happy and I’m really grateful – but it’s just cruel that the virus has gone on for so long.”
'It's heartbreaking to see'
Louise Newton says that it has been an “all-consuming” experience managing a care home during the pandemic.
As well as the stress of keeping up with ever-shifting guidance and strict infection control measures, she and her staff at Brookside Care Home in Bamber Bridge have found themselves with another equally onerous, but rather more joyous, responsibility – becoming a substitute family for their residents.
“We’re well aware that we could never replace their loved ones, but we’ve got to try to be be the second best thing for them at the moment,” says Louise.
“To see residents having to wave at their family through the window is heartbreaking – and very often, we go home broken by it.
“And if that is how it feels for us, we have had to be very mindful of the residents’ mental health needs while the home has been in lockdown.
“We never forget that we work where they live, they don’t live where we work.”
While Louise stresses that it is a team effort keeping spirits up amongst residents only able to see relatives through panes of glass or video portals, there is one staff member charged with making every day a mini-adventure.
Activities co-ordinator Jo Maxwell joined the home within weeks of lockdown – and has been coming up with ideas to keep the residents entertained ever since.
They have included monthly themes – June being the particularly memorable wedding month, during which residents reflected on different sartorial styles from down the years and even staged a mock matrimony.
Jo says that the activities provided within the home are now the main focus of the day.
“They are usually all gathered waiting for me when I arrive of an afternoon – and I also visit some of the residents in their rooms,“ she explains.
“With the themes, you can take a subject and really expand on it, as we did with national apple day recently.
“Then there are the more usual games like bingo – but even that has had to be adapted, because I’m obviously wearing a mask and some of the residents are hard of hearing, so we now have a headset and mic so that they can make out the numbers,” Jo laughs.
The home’s owner, Graham Parr, appreciates the efforts of his staff during a long and stressful year – which have recently seen them nominated as finalists in the team of the year category at the Great British Care Awards.
However, he says that it will still come as “a relief” to relatives and residents if and when they can arrange safe visits.
He plans to use the money allocated by the county council to convert a conservatory at the property.
“It’s not going to be ideal, but you can obviously understand the desire for it, so that people can see each other after such a long time.
“All you can do is minimise the risk. In our case, visitors will have to go down the side of the building and come in round the back – and they will then be able to go into the conservatory, where there will be six or seven screens, separating them from their relatives.”
What about Blackpool and Blackburn?
The LDRS understands that work on care home visiting options during the pandemic is currently being carried out by the Lancashire Resilience Forum, the collection of organisations leading the whole region’s response to the coronavirus.
However, the infection control fund-supported policy developed by Lancashire County Council applies only in its own area.
The standalone councils in Blackpool and Blackburn with Darwen have each received their own shares of from that fund and it is up to them how they spend it.
However, Blackpool Council’s cabinet member for adult social care and health, Jo Farrell, said similar measures had already been adopted by many of the town’s care homes.
“Financial support measures have been in place for our care homes and other providers since March, and have been assisted further by the Infection Prevention Fund. This has enabled many of our care home providers to invest in the additional measures required to support safer visiting.
“Due to varying operational and environmental conditions, as well as the differing needs of residents, measures vary from care home to care home. Additions include Perspex screens, covered outdoor visiting areas, converted rooms designated solely for visitors and ‘pods’ or conservatory-type extensions, as well as more advanced cleaning equipment and enhanced cleaning schedules.
“Visits to care homes are undertaken on a risk-assessed basis, balancing the benefit of social contact for each resident against the risk of infection, as well as taking into account the current situation within the home with regard to infections and staffing.
“The next tranche of financial support from the Infection Prevention Fund has already been distributed to our care homes ahead of the 31 October deadline.”
Blackburn with Darwen Council had not responded to a request for comment by the time of publication.