The Care Home Services (Visits to and by Care Home Residents) (Scotland) Regulations 2026: Anne's Law - code of practice 31 March 2026

Chapter 3: Visiting Suspensions

At times, the risk of infection or an environmental hazard may pose enough of a public health threat that care home visits will be affected. In these circumstances, advice from local health protection teams should be sought. There are different ways care homes can help protect residents, visitors or staff which may allow visiting to continue safely. For example, one-way systems, staggered visits, the use of personal protective equipment (PPE) such as gloves or face masks, or grouping infected residents together. Local health protection teams will offer advice on these. Sometimes, an Incident Management Team will be set up which can also offer advice. This is a multi-agency group of professionals whose role it is to investigate, assess and support the management of public health incidents.

Suspension of Visiting

There are some circumstances in which visits should not go ahead. When a care home decides this, it is because there are serious risks to residents or the people they wish to visit. This is known as a ‘suspension’ of visiting.

The Act and regulations state that visits to or by a resident in a care home may only be suspended:

• in very limited circumstances
• if it is essential to do so to prevent a serious risk to the life, health and wellbeing of the resident or the people at the place where the visit is to take place

Suspensions can affect all visitors, particular groups of visitors, or individual residents, and should be for the shortest duration possible.

Decisions to suspend visiting will not be taken lightly. This is because spending time with loved ones is fundamental to a person’s care and identity.

In cases of infectious risk or environmental hazards, decisions on visiting suspensions should be taken on the advice of the local health protection team. Care home providers and managers can also seek advice from other professionals. This includes:

• the Care Inspectorate
• social work representatives
• nursing teams
• local authority teams
• in some situations, emergency services

These professionals can provide advice in specific circumstances, some routine, and others in more acute situations.

Each decision will depend on individual circumstances. For example, the layout of each care home building is different, as are the residents and the nature of the risk.

If a decision is taken to suspend any visiting, then the following must apply and be documented:

• the suspension is essential to prevent a serious risk to the life, health or wellbeing of individuals at the place where the visit is to take place
• the suspension has been robustly risk assessed and is proportionate to the risk of harm
• the suspension is kept under regular review
• the suspension is for the minimum possible period

The care home provider must take all reasonable steps to decrease the serious risk to the life, health or wellbeing at the visiting location so that the suspension can be lifted or its impact reduced as soon as possible. Health protection teams will advise care homes on appropriate steps, in accordance with public health guidance.

Sometimes care homes may need to pause admissions of new and returning residents. For example, if there is an outbreak of infection in the care home. This does not necessarily mean that there is a need to suspend visiting.

Any suspension of visiting may cause concern for residents and those who may visit them. Therefore, it’s important that care homes announce any decision to suspend visits as quickly as possible. There is information and guidance on communicating changes in Chapter 4: Communication and Notifications.

When visits are suspended, care homes should consider facilitating or increasing other means of communication, such as phone calls or video calls on tablets. This can support wellbeing. It also allows family and friends to be able to contribute to any assessment of physical or mental deterioration.

“Families are integral to the identity of the individual. When communication is a challenge then regular contact with the family is essential, they know the resident best, they can tell me if there are subtle changes.”

Care home staff member

In exceptionally rare circumstances, such as during the COVID-19 pandemic, further guidance on care home visiting could be issued. However, unless emergency legislation is enacted, any guidance issued in Scotland will have to be in keeping with Anne’s Law.

Essential Visits

Even in the rare circumstances where visiting is suspended as described above, some visits can still go ahead. The regulations say that care home providers must continue to facilitate some types of visits. These are known as Essential Visits. The Act recognises that the wellbeing harms of these types of visits not going ahead may be more significant than the harm to physical health, so the weighing of risks and harms has to be considered carefully.

Even when visiting is suspended, care home providers must continue to facilitate certain visits if they believe that during the suspension:

• the resident may die
• the resident’s physical or mental condition will deteriorate significantly

This significant deterioration may be due to:

• an underlying medical condition
• a new illness that has worsened and is not expected to immediately improve or could deteriorate further

Care home providers must also continue to facilitate visits if:

• they believe that the suspension of visits is causing, or is likely to cause, serious harm to the resident’s health or wellbeing
• that harm outweighs the serious risk to the health or wellbeing of the resident or of the people at the place where the visit is to take place

Serious harm to the resident’s health or wellbeing might include:

• physical changes (such as a deterioration in their physical health)
• functional changes (such as a significant decline in self-care like dressing, walking or feeding)
• mental health changes (such as anorexia, apathy, distress, behavioural or mood changes and withdrawal)

Each situation will be different and requires a risk assessment at the individual level informed by public health, psychological and clinical considerations. Care homes may wish to seek advice from members of the resident’s medical team, such as a GP or community nurse, and from their family and friends, to help them reach conclusions on these circumstances.

In all cases, the resident and the person visiting must agree to take precautions as directed by the care home. Precautions might be the use of face masks, for example, or other special measures depending on the specific threat.

Essential Care Supporters (ECS)

Some care home residents have visitors who are more important to them than others. These visitors can be important enough that not being able to see them could cause harm to those residents. There is a legal presumption in the Act that suspending visits from Essential Care Supporters would be likely to cause serious harm to the resident. This means that the careful balancing of risks and harms that are carried out when a suspension of visiting is necessary is different when considering a visit for a resident with their Essential Care Supporter.

To facilitate this, the Act gives a new duty to care homes to identify an Essential Care Supporter for any resident who would like one. The term ‘Essential Care Supporter’ is sometimes shortened to ECS. In general:

• a care home resident can identify anyone they would like to be an Essential Care Supporter, as long as that person is able and willing and the care home provider has no reason to think that they might cause harm to the resident or others
• there are no restrictions on the number of Essential Care Supporters that a resident can identify
• Essential Care Supporters do not have to carry out any specific tasks or role
• the names and contact details of Essential Care Supporters will be recorded in a resident’s personal plan
• some residents will choose not to identify an Essential Care Supporter

An Essential Care Supporter will often be the person or people who play the most significant role in the resident’s life. They may provide essential care, support and companionship and work integrally with the care team for their loved one. However, it is up to the care home resident who they want to identify as their Essential Care Supporter. It might not necessarily be the person who visits most frequently.

“I spend every other afternoon with my mum at the care home. It works best when we are in her room. I bring the goodies and make a cuppa and we play all her favourite folk songs on my phone and sing our hearts out. It’s amazing how much music people with dementia still remember. On other days we go through photograph albums and talk about the ‘old days’!”

Cathy - Daughter of care home resident

Identification of an Essential Care Supporter

The care home should discuss with the resident (and their representative if they have one) who they would like to identify as their Essential Care Supporter or Supporters. A “representative” means any person having legal authority, or the consent of the resident, to act on the resident’s behalf. For example, someone who has Welfare Power of Attorney for the resident. A resident’s personal plan may include that certain family members or friends should be consulted about a resident’s care. If that is the case, then the care home must also ask them as part of this process.

The personal details of Essential Care Supporters should be recorded in personal plans in addition to any other people identified there. A person can fulfil more than one role for the resident. For example, someone could be identified as the resident’s Next of Kin or as having Welfare Power of Attorney or Welfare Guardianship and also as their Essential Care Supporter.

Care homes should take a flexible and adaptable approach to identifying Essential Care Supporters, particularly in response to any changing needs and circumstances of care home residents and their family and friends. The personal plan can also contain additional information about the resident’s preferences for visiting people in and out of the care home, and the key relationships that need to be maintained.

Any decisions made about Essential Care Supporters must be made in accordance with the principles of the Adults with Incapacity (Scotland) Act 2000⁸ and the Adult Support and Protection (Scotland) Act 2007⁹. In the rare circumstances where the Essential Care Supporter is a child, their needs and wellbeing should be taken into account.

It is not for care homes to choose Essential Care Supporters for a resident, but to help them identify their Essential Care Supporters.

Visiting and Essential Care Supporters

There will not normally be any differences between a visit to or by an Essential Care Supporter and a visit to or by anyone else.

The difference comes if there is ever a suspension of visiting in a care home. The careful balancing of risks and harms is different when considering visits to or by a resident and their Essential Care Supporter. This is because Anne’s Law states that:

• care home providers must continue to facilitate certain visits if they believe that the suspension of visits is causing, or is likely to cause, serious harm to the resident’s health or wellbeing, and that harm outweighs the serious risk
• it is to be presumed that the suspension of visits to or by a resident’s Essential Care Supporter is likely to cause serious harm to the resident’s health or wellbeing

For these visits to be suspended, the risk to the life, health or wellbeing of those in the care home, or those where the visit would take place, would have to outweigh the serious harm to the resident’s health or wellbeing that is presumed will be caused. It is likely, therefore, that it would only be in rare circumstances that visits by Essential Care Supporters would not be able to happen. This could be where the risk to human health may be so severe, as with a high consequence infectious disease (such as viral haemorrhagic fever) or where disease severity of a novel virus is not yet known, that the risk to life outweighs the serious harm that will be presumed to be caused by the suspension of visits with an Essential Care Supporter.

Potential harm

The regulations state that someone should not be identified as an Essential Care Supporter if the care home provider thinks that they might cause harm to a resident. This could include:

• where a visitor behaves in a way that is threating or abusive, including when under the influence of alcohol or drugs
• where the relevant authority already has adult protection or safeguarding measures in place, has received a report about such concerns or is carrying out an investigation into them
• where a visitor is assessed as causing significant distress, fear or deterioration in the resident’s wellbeing

Care home providers will already be doing this kind of assessment of harm when they are considering the safety of residents and staff, taking into account the views of other professionals where appropriate.

As with all visitors, Essential Care Supporters must not be restricted or excluded because they have raised complaints or concerns, where they pose no risk to the resident or others.