Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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577. To ask the Minister for Health the format that permitted nursing home visits will take during level 3 restrictions; and if he will make a statement on the matter. [31017/20]

Mary Butler (Waterford, Fianna Fail)
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I am very much aware of how difficult the current situation is for families and their loved ones who are in long-term residential care. Continued social interaction is important and I fully appreciate the challenges that have been experienced in maintaining these interactions in a safe manner, especially with older people and those who are medically vulnerable. It is important that the right to have visitors is balanced with the need to ensure that visitations do not compromise overall resident care or adherence to requisite infection control procedures.

Residential settings are people’s homes as well as places where health and social care are provided. The introduction of physical distancing, isolation and restricted contact with family and loved ones has changed the usual dynamic of social interaction. During these times there has been a particular emphasis on retaining a holistic view of the wellbeing of residents, remaining person-centred, being cognisant of their rights as citizens, and being vigilant that in seeking to shield them from infection that these rights are not infringed upon to an extent, or in a manner, that is disproportionate.

The Plan for Living with COVID-19 Framework has been developed to help us to go about our daily lives as much as possible, with measures aimed at the key priorities of protecting health, strengthening employment, and supporting communities. A key aim of the Plan is to provide clarity on what restrictive measures are appropriate around the country based on the pattern and progress of COVID-19 in a particular area at a particular time.

The system is communicated through a numbered system of alert Levels (from 1 to 5) with Level 1 being the lowest with the least amount of restrictive measures in place and Level 5 being the highest with the most restrictions in place. Visits under the framework are; Level 1, open with protective measures in place, Level 2 open with enhanced protective measures and Levels 3 to 5 visits suspended, aside from critical and compassionate circumstances. These Levels are applied to each county based on the current COVID-19 situation therein.

In line with this Framework, new COVID-19 Guidance on Visitations to Residential Care Facilities has been developed by the Health Protection Surveillance Centre (HPSC), to support long-term residential care providers in the discharge of their responsibilities and to support residents, to the greatest extent possible, having regard for the challenging times in which we are living. This guidance is available on the HPSC website. Guidance documents are reviewed regularly.

The new guidance re-emphasises that in circumstances where visiting may need to be restricted or suspended in nursing homes for the protection of residents and staff, alternative arrangements such as “window visiting” is acceptable across all 5 levels of the framework of restrictive measures, providing a nursing home can safely facilitate them, and that arrangements should be in place to support virtual visiting (telephone or video-link) to the greatest extent possible. Crucially, the guidance also provides further clarity on visiting in critical and compassionate circumstances, which is a key issue for residents and families and the guidance should be referred to in making decisions with respect to visits.

At present Cavan, Donegal and Monaghan are at level 4 with the remaining counties at level 3. From midnight 21 October the country will move to level 5. In accordance with these levels and in order to reduce resident contacts, visiting in long-term residential care facilities nationwide is suspended except in critical and compassionate circumstances.

Nursing home providers are ultimately responsible for the safe care of their residents. Under Regulation 11 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 it is the legal responsibility of each registered provider to make arrangements for a resident to receive visitors, having regard to any risks that may present for the resident or other residents. I encourage all nursing home providers to maintain familiarity with the latest public health advice and support, to make every effort to continue to facilitate and ensure that nursing home residents receive visitors in critical and compassionate circumstances, in line with public health advice, and to communicate with family and friends on an ongoing basis in order to support positive mental health and wellbeing. It remains of critical importance that every nursing home provider takes steps and innovates to support ongoing communication between residents and their families and friends, even during periods of enhanced protective measures, while following public health advice.