Andrea Wyllie is the Chief Executive of Greenock Medical Aid Society; she shares her experience of reintroducing indoor visits to care homes during the pandemic. Although this work brought significant media attention and presented many challenges Andrea knew that the meaningful difference for residents and visitors meant it was necessary.
At the start of the pandemic, I had been invited to join Inverclyde Council’s Local Resilience Management Team (LRMT), in response to the crisis unfolding. It was during one of these meetings that I raised the idea of reinstating indoor visiting, suggesting we could use lateral flow tests for relatives. Unfortunately, the testing had not been approved at this time and my original proposal was declined. However, just raising this did plant a seed in the mind of Louise Long (Chair and Chief Officer) who was equally keen and made some enquiries. I reassured her and others that we could do this safely.
It is important to remember that there were still huge levels of anxiety around increasing the footfall into care homes. COVID-19 outbreaks throughout Scotland meant that people were losing their lives and changes had to be considered cautiously. Against this backdrop, I knew how devastating it was for those we cared for to be without their loved ones. Pre-pandemic, our care homes like those across the country were places of vibrant activity. Many people coming and going with no visiting times, relatives and friends were free to visit and stay for as long as they liked, including for meals and overnight stays if they lived further afield. One of the worst things about lockdown was the sudden quietness that came in the day after we closed our care homes back in March 2020. Access was restricted to staff and essential visiting, the sudden change felt unnatural, almost eerie. Not only were there no visitors, but residents were also asked to stay in their own rooms. Time went by and the responsibility of keeping everyone safe weighed heavily upon me. With a second wave looming in autumn 2020, I became acutely aware that some of our residents did not have the same luxury of time.
In the background, Louise was working with us to start a pilot study to see if visiting could be reintroduced safely. The stakes were high, but I had a plan and thankfully my team were up for the challenge. We met and discussed how we could do this safely but also meaningfully. My objective was to balance rights against risks. I worked hard to adapt staff protocols, relative’s protocols and risk assessments before sharing them with my own team and a few relatives. The feedback was so positive that I was encouraged to send them to the HSCP who shared it with NHS GG&C. Following a co-production approach the papers were amended and the green light was given for the pilot to start in November 2020. It was a huge success. We used PCR testing for the relatives and brought them in following a confirmed negative result. We used PPE, visiting coordinators, a booking system, designated visiting rooms and enhanced cleaning. We also made sure that hugs and touch could be safely facilitated. By starting off slow and steady, we were able to build up the number of resident/relative visits each week, assessing them for safety as we went. The changes brought a lot of media attention which in itself was incredibly surreal.
Soon after we got going, we were invited to take part in the Scottish Government’s early adopters and change the PCR testing to Lateral Flow Device testing which had just been approved. The care home staff provided feedback on the process and we met with Scottish Government officials to discuss our learning.
Meanwhile, our risk assessments and protocols were shared throughout all the care homes in the NHS GG&C area, including younger adult care. There was a collective desire to see other care homes reintroduce indoor visiting before Christmas.
Then a major setback, the Kent variant (B117) of the coronavirus was now widespread and causing no small alarm. Before long the announcement we were dreading came, Scotland was going back into lockdown on Boxing Day and all indoor visiting would cease. With indoor visits already arranged and now just over a week to go until Christmas, my teams volunteered to work extra hours. Our mission “hugs before Christmas” was very much on! All our residents were able to have at least one indoor visit before Boxing Day. Our determination to see this happen safely was a collective ambition and all the staff pitched in as we had no idea when we could open visits again.
When the Scottish Government published their guidance Open with Care at the end of February 2021 we set to work immediately. All the work undertaken by the team at the end of 2020 meant we were ready to reopen our doors on Monday 1st March for meaningful indoor visiting. This was a very happy day for everyone concerned and again brought further media attention, including a slot on Good Morning Britain!
From the outset, the team and I believed strongly that care home visiting could be done safely and should happen and as soon as possible for the wellbeing of the residents. On Tuesday 27th April, the NHS GG&C Health Board had their board meeting and the team shared our work on the reintroduction of safe indoor visiting. The board showed how our work was used as the foundation for the nationwide approach to indoor visiting. It was clear that our feedback was implemented in the Scottish Government’s ‘Open with Care’ guidance paving the way for all older and younger adult care comes to open up safely for meaningful indoor visiting. I am delighted to have been a part of this. It’s truly validating to see everything that has been achieved!
We have created a wee video showing the storyboard that was presented at the recent NHS GG&C board meeting which I am pleased to share with you: