Visiting during an outbreak
Care homes with a declared outbreak should move to support essential and window visits only and, where advised by local health protection teams, limited outdoor visiting until the outbreak is declared over. Outings from the home may also be suspended.
After a positive test in a member of staff or a resident, local Health Protection teams should undertake a risk assessment to determine the approach and decide whether a home should close to indoor visiting, and whether outdoor visits can continue. Each situation will be unique so there needs to be an appropriate clinical decision making process by the HPTs before implementing home closure to take account of circumstances. The aims must be to balance minimising the risks of spread from outbreaks with the risks from not allowing home life to continue, including access to loved ones and clinicians. Teams should be thoughtful about the risks to all individuals of continuing with high footfall whilst an outbreak investigation is ongoing as this will change the risk profile.
When routine indoor visiting can resume following an outbreak
A care home can reintroduce routine indoor visiting if they have been COVID free / or fully recovered as agreed with the local health protection team for 14 days from last date of COVID symptoms and subject to a Health Protection Team (HPT) assessment and confirmation of safety.
This aligns to advice from Health Protection Scotland and Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland who declare an outbreak over after 14 days if no new cases or symptoms develop – with a HPT risk assessment.
Where the last date of a positive test is in an asymptomatic staff member, a risk assessment should be undertaken by the local Health Protection team (HPT) (Note – this is your local Health Protection Team, not Health Protection Scotland), to determine whether the full 14 days are necessary.
The public health definition of an outbreak is where there is two or more linked cases. However, the possibility of an outbreak within the care home should trigger investigation where there is confirmation of one positive COVID case within the home.
Health Protection Teams should support care homes with all decisions once a single positive test has been identified, including continuing or pausing visiting.