Contact in Care Settings

Maria Eagle Excerpts

Thursday 27th October 2022 Commons Chamber

[Maria Eagle (Garston and Halewood) (Lab)]

I, too, congratulate my hon. Friend the Member for Liverpool, Walton (Dan Carden) and the hon. Member for Chatham and Aylesford (Tracey Crouch) on obtaining the debate, and I thank the Backbench Business Committee for granting it.

Many Members here know Jenny Morrison and Diane Mayhew, constituents of mine who were co-founders of Rights for Residents. Because of the shortage of time, I will not explain in detail what happened to Jenny’s mother, but it is similar to the experience that the hon. Member for St Albans (Daisy Cooper) set out in respect of some of her constituents. However, I wish to say a bit about the ongoing trauma that the experience causes for those left behind, because this is about not only the distress of seeing one’s relative go through the final illness —and the consequences of dementia can be distressing at the best of times— but the ongoing consequences of the restrictions for those left behind.

Jenny tells me that she has hardly had a restful night’s sleep since the doors closed on her mother’s care home, and that she feels as though her mother was locked away. Even though her mother has now unfortunately died, Jenny says that she is plagued by distressing images and painful emotions that will not go away. They have an ongoing impact on her life because the end of life can often overwhelm the earlier positive memories if it is distressing and difficult. Many thousands of people have had the experience of watching from a distance as their relatives in care homes deteriorate. They are unable to visit them, comfort them and watch them die. They have ongoing trauma, and may have for many years. The bad memories come back instead of the good ones. Many people affected in this way go on to feel like they are being selfish for thinking about their own feelings instead of what happened to the loved-one they lost, but they are not. They are suffering from deep trauma caused in part by what has happened.

Jenny Morrison and Diane Mayhew were co-founders of Rights for Residents. They have sought to turn their terrible experience into something much more positive—into campaigning for these changes, and I commend them enormously for that. The fact that covid is no longer seen as the threat that it was does not mean that the restrictions have gone away. As many hon. Members have said, they are still being used in care settings. In that context, it is tremendously important that a legal right is established.

The Relatives and Residents Association and Rights for Residents surveyed some of their families and discovered that the harm was continuing. One in five outbreaks saw residents confined to their rooms. One in nine outbreaks saw residents not allowed any visitors at all. Care homes were still implementing blanket visiting restrictions, when there was no necessity for any such thing. Quite often they say that it is because of Government guidance or that local authorities have suggested that they should have these restrictions. None of this is accurate or true, but it is still stopping families visiting their relatives in care homes. How much longer is this going to go on? How much longer are the Government going to allow this to go on?

I do not think—something highlighted by the Joint Committee on Human Rights—that changing the guidance 30 times in a short period helps any understanding of what the guidance actually says. That is not helpful. Let us have a law swiftly that says that residents in care homes and those having care and health support have a legal right to be accompanied by a relative—at least one, perhaps sometimes more would be appropriate. That is unequivocal; it is clear. It can be clearly understood by whoever needs to understand it. That is the answer to this. I hope that the Minister will agree and swiftly enact such a change.

--- Later in debate ---

[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.

[Maria Eagle]

Will the Minister therefore undertake to implement a legal right for visitors to visit, as Rights For Residents has called for? We are all on tenterhooks.

[Helen Whately]

If the hon. Member will bear with me, I am getting to the third of the three considerations, which is what can be done. On that point, back in April 2021, I was questioned by Parliament’s Joint Committee on Human Rights about this very topic. On visiting, I said:

“I want to get to a position where it is as normal as possible. This is something to come back to in the future, particularly if family members and residents feel that the situation is not working as they would want it to.”

Clearly, family and residents do indeed feel that the situation is not working.

I understand that things are not easy for care homes. I understand the staffing pressures caused by the recent increase in covid—and flu, which many residents are vulnerable to. The majority of care homes are allowing normal visiting and, as hon. Members said, many care homes totally recognise the importance of visitors.