Open with Care - supporting meaningful contact in care homes: guidance

03 Principles to Open with Care

The following principles should be followed by everyone when considering approaches to visiting. This includes residents, relatives, care home managers, staff and local oversight arrangements:

• Responsibility – everyone, including family members, has a responsibility to follow any advice and guidance take action to help care homes stay safe homes.
• Maintaining well-being – decisions should focus on supporting meaningful contact to happen safely wherever possible, to protect and restore well-being of residents and their loved ones, and in line with residents' care needs.
• Safely balancing risks of harm – visiting (or not visiting) carries risks of harm and everyone should work together to consider and minimise these.
• Equitable access for all residents – fairness (or equity) means recognising that some residents will have different needs or preferences for visiting and supporting these where at all possible, within wider safety considerations for the home as a whole. Equity means giving residents the sufficient contact they need to maintain their health and well-being wherever possible.
• Individualised approach – every resident should have an individualised visiting plan (within their care plan) which is person-centred and takes account of individual preferences and needs, and balanced against the needs of everyone in the care home, so that any restrictions to meaningful contact are proportionate.
• Equality/choice – residents (and/or their representative decision-makers) have the right to choose their designated visitors.
• Flexibility – local flexibility and professional judgment remain key to decision making in complex circumstances. Factors such as the characteristics of the home, its staffing availability, COVID-19 outbreak status and use of IPC measures including personal protective equipment (PPE) are all variables to take into account when setting home-specific policies.
• Respect for human rights – local visiting policies should take account of the European Convention on Human Rights (ECHR), and in particular Article 8, which provides a right to respect for private and family life. Whilst it is important that any visiting policies take account of the evolving evidence about the harm posed from the virus, these need to be carefully balanced with the evidence about the positive impact on health and wellbeing from seeing family and loved ones has on residents in considering what is necessary, justified and proportionate.