Updated guidance on PPE and visiting in care homes

20 July 2021

The Government has issued updated personal protective equipment (PPE) guidance for all care workers working in care homes in England, visitors and essential care-givers within the care home setting to reflect that, from 19 July, most legal restrictions to control Covid-19 are being lifted.

Friends and relatives visiting care home residents in England will still need to wear PPE and be advised to minimise physical contact beyond July 19.

Public Health England (PHE) guidance, Personal Protective Equipment (PPE): Resource for Care Workers Working in Care Homes During Sustained Covid-19 Transmission in England, provides a minimum standard on the use of personal protective equipment (PPE) and face masks.

It says that, due to the nature of the settings and vulnerability of the population, PPE and other infection prevention and control (IPC) measures should continue to be practised in care homes.

Employers still need to complete a risk assessment, approved through local governance procedures, even for those that “adopt practices that differ from those recommended or stated in the national guidance”.

The same PPE recommendations apply regardless of whether a resident is clinically extremely vulnerable (CEV) or not. For double-vaccinated residents, PHE states: “Until we are confident that the virus is under control, it is vital that you continue to adopt practices that limit infections. This includes the continued use of PPE.”

Key messages in the Department of Health and Social Care’s (DHSC) Guidance on Care Home Visiting is that there is now no limit on the number of "named visitors” that a single resident can have indoors, with no screen or other barrier in between, and there is no nationally set limit on the number who can visit in a single day. They should still be tested using rapid lateral flow tests on the day of every visit and produce a negative Covid-19 test prior to their visit. They should also wear appropriate PPE and follow all other infection prevention and control measures. They are still advised to keep physical contact to a minimum: “Physical contact like hand-holding is acceptable if hand washing protocols are followed. Close personal contact such as hugging presents higher risks but will be safer if it is between people who are double vaccinated, without face-to-face contact, and there is brief contact only.”

Also, every care home resident should now be offered the opportunity to nominate an essential care giver. Essential care givers will need to be supported to follow the same testing arrangements, and the same PPE and infection control arrangements as care home staff.

If the home has an outbreak, defined as at least two Covid-19 cases among staff or residents, visiting should stop immediately except for in exceptional circumstances, such as if the resident is at the end of their life.

Visitors granted essential care giver status can continue visiting if there is an outbreak, but not if they or the resident they are visiting tests positive.