Contact in Care Settings

Andrea Leadsom Excerpts

Thursday 27th October 2022 Commons Chamber

[Helen Whately (Faversham and Mid Kent) (Con)]

I would say that it is a rare Minister who welcomes a debate on day one following their appointment, but truly I do welcome this particular debate because it is so important. Visiting in care settings is something I have spoken to many people about, and I had hoped that by now it would no longer be a problem now we have put lockdowns behind us, but it is still a problem.

I thank and commend the hon. Members for Liverpool, Walton (Dan Carden) and for St Albans (Daisy Cooper) and my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) for leading this debate and for their powerful speeches, and I thank all the other Members who also contributed very powerfully. I would also like to thank those who have been campaigning so hard for visiting rights, such as the Rights for Residents campaign, John’s Campaign and the Relatives & Residents Association. I know that some of them are here with us in Parliament today, and I am sure that many others are watching from home.

I do recognise the efforts that so many care homes have made to get back to normal, or as close to normal as they can, on visiting after the enormous challenges of the pandemic, because visiting matters. Visiting matters for the resident in a care home—we must never forget that it is indeed their home—and for family and friends who want to spend time with their loved ones. It can be the moment a resident looks forward to all week, a time that keeps their connection to life beyond the doors of a care home and—not to be underestimated—the chance to hold the hand of or have a hug with someone who loves them. I say this knowing that, sadly, many residents in care homes are living with dementia and may be confused or unable to remember things for long. Visits matter for them and their families, not least because dementia can progress so cruelly, as was mentioned in particular by the hon. Member for St Albans.

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

My hon. Friend is absolutely right to talk about the impact of dementia in particular. During lockdown, a large number of people wrote to me, including a close family member of mine, whose dementia significantly worsened because they were not able to see family members just to keep those memories going. It was absolutely terrible, and I think we should do everything we can to make sure that cannot happen ever again.

[Helen Whately]

I thank my right hon. Friend for making that point, which we have heard from others in the Chamber.

Visiting is not just a “nice to have”, as we have just heard—all the stories we have heard today can leave us in no doubt about that. The hon. Member for Liverpool, Walton spoke very movingly about the experiences of others, but also about his own personal experience with his father, which he very courageously shared with us. The right hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts)—I cannot pronounce her constituency, but Hansard will resolve it—also spoke very powerfully about her mother. I say to both of them that I am sorry for their loss.

Very importantly, my hon. Friend the Member for Chatham and Aylesford reminded us that this is not just about older people. Visiting, both into a residential setting and out of it, is also so important for younger people—for instance, those with learning disabilities. However, I am short of time, so I will press on.

On top of the stories, there are the facts. We know there is a body of evidence that supports the argument that not having visitors can be detrimental to the health of people living in residential care, as my right hon. Friend the Member for Tatton (Esther McVey) mentioned. For instance, there is a connection between social isolation, loneliness and mental health. In fact, back in October 2020, when I was previously the Care Minister, I commissioned research on the benefits of visiting as well as an assessment of the risks at the time and the options for opening up visiting.

I can also say that I do know personally what it feels like not to be allowed to visit a relative. In the summer, my mother was admitted unexpectedly to hospital and I was not allowed to visit her, even though I did not know whether I would ever see her alive again. The same was the case for my father, her husband for 50 years, who was also barred from entry to her ward, and that was even though we were clearly not in the heart of the pandemic by any stretch of the imagination.

I will look at this issue in three parts, at pace: what has happened to get us to this situation; what is really going on; and what can be done.

Sadly, during the pandemic we saw how hugely vulnerable to covid people who lived in care homes were, and the Government priority was to keep people safe, which meant doing everything possible to prevent covid from getting into care homes. It meant reducing the number of people going in and out who might take in covid. It meant requiring the use of personal protective equipment. It meant regular testing for care home residents and staff, and when we got the covid vaccine it meant prioritising vaccinations for care home residents and staff.

However, even back in 2020 we knew that residents in care homes and their families were suffering from the visiting restrictions, although I should mention that not all residents and their families had the same views. While some wanted more visiting, others did not because they were more worried about the risks. Balancing those two things, the Government sought to enable visiting in ways that would be safe, and we also made it clear that end-of-life visiting should always be possible.

In March 2021 we introduced the concept of the essential care visitor who would be able to visit a resident who needed personal care in any circumstances, including during an outbreak, following the same covid testing regime as staff. In June 2021 we expanded that to apply to all residents. At all times we worked with social care providers—with care homes—because they were the ones that had to put the guidance into practice; they were the ones at the frontline, balancing the prevention of covid with the practicalities of supporting visiting. I do not underestimate the demands that put on care homes, which were also carrying out testing, providing PPE and everything else.

Moving on to the situation today, since April 2022 the Government guidance has been that there should not be any restrictions on visiting in residential settings unless there is a covid outbreak, and even if there is an outbreak every resident should be able to have a visitor. Local public health teams may advise other restrictions on visiting if there is a particular local risk, but that should be proportionate and should stop visiting only in extreme circumstances.

Some Members have said today that the guidance is not clear, while others have said that it is not being followed; it has also been said that the problem is that it is guidance. On the content of the guidance, we have heard from many accounts that it is not being followed, and I will do further work on that.

Knowing the concerns during the height of the pandemic about visiting, the Department of Health and Social Care started tracking visiting restrictions; indeed, I started that as Care Minister, to try to get data about what was going on, because one of the challenges is knowing what is going on at the frontline, as the social care system is so diverse and fragmented. Our data told us in September that 98.4% of care homes were allowing visiting, but I recognise that that data is not the whole answer.

The CQC has been referred to in the debate. I spoke with Kate Terroni, chief inspector of adult social care at the CQC, many times during the pandemic about visiting and she, too, saw the importance of it. The CQC looks at visiting when inspecting care homes, and a lack of visiting or access is a red flag for it. Families should be reporting visiting concerns to the CQC, which then investigates them. I heard, however, the points made by the hon. Member for St Albans about some families feeling they got a mixed response or who were fearful of reporting to the CQC because of the possible consequences. Again, I will take that away from today’s debate.

Under the existing regulations, the CQC can take action if it believes that safe and proportionate visiting is not being facilitated, but I also took note of the point made by the hon. Member for Liverpool, Walton about the CQC powers to get live data being limited and its not having powers to require care homes to report changes to visiting restrictions. I will look into that, too.

Although we have the guidance and the CQC is able to take action on care homes, there is clearly still a problem. I have also seen the data from the Rights For Residents survey showing that 45% of responses said that restrictions on visiting had still been in place since April, and in 11% of outbreaks no visitors were allowed at all. Again, I am concerned to see that.