Dan Carden (Liverpool, Walton) (Lab) I beg to move, That this House
has considered the matter of guaranteeing the right to maintain
contact in care settings. After much delay due to circumstances out
of our hands, I am grateful that we now have the opportunity in
this Chamber to debate this incredibly important issue. I thank the
Backbench Business Committee for its efforts in finding us time to
speak about this in the Chamber today. I also want to extend
my...Request free trial
(Liverpool, Walton) (Lab)
I beg to move,
That this House has considered the matter of guaranteeing the
right to maintain contact in care settings.
After much delay due to circumstances out of our hands, I am
grateful that we now have the opportunity in this Chamber to
debate this incredibly important issue. I thank the Backbench
Business Committee for its efforts in finding us time to speak
about this in the Chamber today. I also want to extend my
gratitude to the hon. Members for Chatham and Aylesford () and for St Albans () and the right hon. Member for
Dwyfor Meirionnydd () for their steadfast
and resolute support and advocacy on this matter throughout.
People across the United Kingdom are still having to face their
time in hospitals, care homes and other care settings completely
alone and detached from the people they hold dearest. They are
some of the most vulnerable and frail people in our society; some
of them will be nearing the end of their lives. The devastating
impact of this isolation and of denying contact with loved ones
affects those in receipt of care and also their loved ones. It is
difficult to imagine, unless we have personal experience, the
anguish, pain and stress of not knowing when we will next see our
loved one—our husband, wife, mother or father—and repeatedly
asking ourselves, “Are they okay? Are they comfortable? Do they
even know that I care?”
That same anguish and pain is experienced by the individual
receiving care, not understanding why family or loved ones are
not able to visit. Shirley from my constituency said:
“My father forgot I was his daughter during the period I was
unable to visit. When I was finally able to visit, my dad was
unrecognisable. It broke my heart. He has never recovered.”
The support and care given by partners and by parents and
children is not an optional extra: contact with loved ones is
absolutely vital to dignified care. This point was also made by
the 363 members of the public who in the last few days alone
provided written evidence for this debate, and I want to thank
them for their brave contributions and the Chamber engagement
team for collecting them.
Throughout today’s debate we will hear further personal
experiences from across the Chamber, but I hope the House will
not mind if I take a moment to talk about my own family’s
experience last year. My mother and brother contributed a few
words, too, and I am grateful to have the opportunity in the
Chamber to express them.
My father, Mike, died last year: he was diagnosed with lung
cancer in February and died in December. Like many people
undergoing cancer treatment, one evening he suddenly became
unresponsive and we had to rush him to A&E. At the hospital,
it was confirmed that he had sepsis, and he was therefore
isolated in a side room on the A&E ward, which was overrun
with patients on beds or trollies in the corridor. My dad was in
an A&E side room for three days, during which time he did not
receive any hot food, he was not showered or washed, nor assisted
to change his clothes, and he was unable to get help to go to the
toilet. Instead, he was given cardboard containers which were
often left full on his bed table for days despite regular
requests that they be taken away and replaced. Throughout this
time, he had no means of contacting us, because there was no
phone signal where he was and he could not access the wi-fi
despite repeated attempts.
There were other occasions: once he had to be moved to a ward,
when he was left with his emergency buzzer out of his reach; and
one time he could not breathe and began to panic, and he phoned
my mum, who was unable to get through to the ward by phone and
therefore rushed to the hospital. After these experiences he told
us that he had felt so lonely and neglected, and unable to alert
anyone to his basic needs, and my dad was a man who never liked
to make a fuss.
The hospital policy at the time was that visitors were only
allowed for patients in end of life care. The NHS website defines
that as follows:
“End of life care is support for people who are in the last
months or years of their life.
End of life care should help you to live as well as possible
until you die and to die with dignity. The people providing your
care should ask you about your wishes and preferences and take
these into account as they work with you to plan your care.
They should also support your family, carers or other people who
are important to you.”
However, at the time, the hospital defined end of life care
differently and restricted visiting rights to those patients who
were “actively dying”. In other words, they were displaying the
physical symptoms of dying.
My mum said:
“This meant that instead of being able to focus on caring and
supporting my husband through his final weeks, we had to battle
with the hospital to see him. The trauma of my husband’s
death—and in particular the neglect he experienced in his final
weeks of life—remain with me. It is almost exactly one year since
Mike was admitted to hospital, where he spent the last month of
his life, and I am still overwhelmed each time I attempt to talk
about what he went through.”
I turn to the words of one dementia sufferer, who said:
“I’d forget that I had an allergy, but my daughter was there to
correct me. If alone, I would simply have said I didn’t have an
allergy—that could be so dangerous.”
The lack of input from the family and friends of those receiving
care—the people who know them best—leads to much worse
outcomes.
In March, we invited affected constituents to an event where they
could share their experiences with parliamentarians on the
estate. The testimonies that we heard were harrowing, and the
collective trauma was palpable. To give just one of the
contributions from that day:
“Sitting with my mother’s body was the longest time I had been
allowed to spend with her since she had entered the care home 16
months before.”
That powerful event left those hon. Members present united in the
view that a legal right was needed to secure the right of care
users to nominate an individual to provide support or care in all
circumstances. Many of us at the event were disappointed by the
response of the Government and the Minister for Care.
Since the event, 60 Members sent a letter to the right hon.
Member for Bromsgrove (), who at that point was
Secretary of State for Health and Social Care, pushing for
codification—a legal right to be put into law. We were again left
disheartened by the Minister’s response. While we were told that
the Government were committed to ensuring that care home
residents had access to the support and companionship that loved
ones bring, there was no answer to our request for a meeting or
consideration of our proposals. Understandably, the campaign
groups felt ignored once more. I hope that the Minister will not
leave those affected feeling the same way.
The problem is not exclusive to the coronavirus pandemic. There
are still rigid restrictions on visiting as well as shocking
instances of denying contact. Another of my constituents
reported:
“My family and I have never been allowed into the care home that
he now resides in. Restrictions have caused unnecessary stress
and anxiety to my family and I.”
(Dwyfor Meirionnydd)
(PC)
The hon. Member is making an excellent speech. Does he agree that
now is exactly the time that we should be considering this
matter, because, as we go into the winter, many care settings
will be considering the option of imposing restrictions, and
guidance alone has proven insufficient? That is among the lessons
that we should have learned over the last two years. The
Government should now be acting.
I am grateful to the right hon. Member for that intervention. The
Government have previously pointed to guidance as a defence
against bad practice, and we have enough evidence to show that
that is not good enough. Indeed, while there are excellent
examples of good practice across the sector, significant levels
of uncertainty and variability throughout the system seriously
undermine the rights of individuals. The guidance leads to a
postcode lottery as separate settings interpret guidance
differently.
That difference is compounded by the response of the Care Quality
Commission, which is an organisation that many have had difficult
and negative interactions with. The Government encourage those
affected to report care providers who do not meet the guidance to
the CQC, but by then it may be too late. The poor response is not
because the CQC ignores complainants, although there was evidence
of that as well, but that it simply does not have the proper
powers or data to support people who have their access rights
compromised. In the CQC’s own words:
“We do not have the power to require care homes to report live
data on levels of visiting, neither do we have the power to take
action against those care homes that are not reporting changes to
their visiting status to us.”
The CQC, which regulates all health and care services in England,
bases its enforcement action on the capacity tracker. However,
providers are not obligated to use the tool—they are merely
encouraged. That has led to very little, if any, clarity on the
true extent of the problem.
By comparison, in Scotland, the National Care Service (Scotland)
Bill, places a duty on Ministers to require providers to comply
with any direction made regarding visiting. What assessment has
the Department made of the Bill and would it be minded to
introduce similar provision in England? The evidence suggests
that the only way to guarantee contact in care settings is a
legal right to an essential care supporter. An essential care
supporter would be able to visit or accompany a person in any
health and care setting to help communicate their wishes and
needs, and to ensure they receive the correct care. If the
Government are serious about their support for these calls, if
they are serious about acting in the interests of families and
loved ones, if they are serious about balancing clinical
restrictions with the impact of restrictions on residents’ health
and human rights, then I ask the Minister to immediately consider
how to put that into law.
I cannot think of any other issue that commands such unanimous
cross-party support. Indeed, as my right hon. Friend the Member
for Leeds Central (), who I know supports these
calls wholeheartedly, said at our meeting in Parliament:
“How can anyone be opposed to this?”
There are also 35 organisations in this area who support these
calls, including Mind, Mencap, Disability Rights UK and Dementia
UK. The new Secretary of State for Health and Social Care, the
right hon. Member for North East Cambridgeshire (), has previously signalled
support for this right. We are ready and willing to work with the
Government to make this legal right a reality as swiftly as
possible. The Joint Committee on Human Rights has also been
unequivocal in its call for legislation in this area. In its
report from July this year, “Protecting human rights in care
settings” it stated:
“The Government must introduce legislation to secure to care
users the right to nominate one or more individuals to visit and
to provide support or care in all circumstances, subject to the
same infection prevention and control rules as care staff.”
We have not yet had a response from the Government to that
report, so may I ask the Government Minister to take that up? We
have opportunities in the draft Mental Health Reform Bill and the
Bill of Rights to codify this right. The Government could also
introduce secondary legislation, which I know campaigners are in
favour of. Will the Minister meet me, others and the affected
families as soon as possible to discuss making this right as
strong and effective as possible? The Government have previously
said that legislative options are under active consideration, so
please can the Government give much more specific detail on what
that actually means?
I want to finish by paying tribute to the tireless campaigning of
organisations in this area, in particular the Rights for
Residents campaign group, the Relatives and Residents Association
and John’s Campaign. The work of Jenny Morrison, Diane Mayhew,
Helen Wildbore, Julia Jones, Nicci Gerrard and Kate Meacock has
been absolutely inspirational, and they are all in the Public
Gallery today watching this debate. Their dedication to this
campaign has been phenomenal. I pay tribute to them. In the face
of immense loss and personal grief, they have shown incredible
selflessness and service to guarantee that no other family member
will have to endure the pain of being denied contact again.
Families do not deserve any further delay; they have suffered
enough. We must learn from this trauma and bring in legislation.
I hope that when the Minister rises to give the Government’s
response, she will agree and set out the steps that we can take
to get this right.
Mr Deputy Speaker ( )
Deepest condolences on your loss, Dan.
I call the debate’s co-sponsor, .
3.45pm
(Chatham and Aylesford)
(Con)
Ordinarily when we stand up in the Chamber, we say that it is,
for example, “a pleasure to follow my hon. Friend,” but given the
very powerful speech from the hon. Member for Liverpool, Walton
(), may I say that it is an
absolute privilege and that I am very humbled to follow him in
this debate, which I am very proud to co-sponsor? I echo his
thanks to the people who have engaged with us and taken time to
give us their testimony, especially the groups and the people he
referred to, as well as those who have sent briefings for the
debate.
In 2015, my father had a stroke, which left him physically and
neurologically impaired, requiring him to spend the rest of his
days in residential nursing care. My sister and I visited him on
a regular basis, observing his decline from manly patriarch to
someone with childlike vulnerabilities in just over the course of
a year. I will not romanticise the relationship that I had with
my father, which had been fractured since my teenage years, but I
can honestly say that those months of us visiting him in care
were the closest that we had felt to him in years. It is true to
say that, during covid, I often remarked that I was glad that he
had died long before the pandemic, because while no one wants to
see their parent or loved one lying on a bed—a thin, pallid
skeleton—saying their final goodbyes, blessings or apologies
hours before their death, nor should they be denied that
right.
Tragically, during the pandemic, and in some cases still today,
many of my constituents and others around the country were denied
visiting rights, whether that was to care, to celebrate or,
sadly, to say goodbye. We should pause for a moment to cast our
minds back to the start of the pandemic in early 2020, when the
virus was ripping around communities, transport systems, offices,
retail places and, of course, health and social care spaces. It
was killing people in large numbers, especially the most
vulnerable in society. People were frightened and our
understanding of the virus was limited. We went into lockdown and
isolated our loved ones because we thought that it was the
kindest and safest thing to do. We all understood why.
When I looked back through my casework files in preparation for
the debate, I found hardly any complaints about limited access to
relatives in the first lockdown, because in a Blightyesque
spirit, we got on with it and found alternative ways to
communicate with those we could not ordinarily see. Many of us
here stamped our feet about care workers not getting enough
personal protective equipment and rightly included them in our
doorstep clapping, because they were heroically looking after
their residents when family and friends could not visit any more.
We understood the fear that if one resident caught the virus, it
could be devastating for the entire setting, and the duty of care
that they held. But then lockdown ended, the summer arrived, the
virus declined, our understanding of it improved and our hopes of
going back to see residents in health and social care settings
were raised—yet when I looked at my casework, I saw that that was
when the problems began, and, unfortunately, they still
continue.
I stress that I am in no way criticising any individual care home
manager or any staff for the examples that I am about to cite. My
criticism lies squarely with the Department of Health and Social
Care. Its guidance that was published for managers to interpret
was wishy-washy at best and is why I now firmly believe that,
although we can still respect the individual business that a care
home is, a right of access should be enshrined in law to give the
manager, the resident and the relative clarity about
visiting.
In November 2020, I was contacted by Francesca, whose nan was
admitted to a care home following a short stay in a local
hospital. Francesca’s family were not able to visit, despite
having been told that Francesca’s nan was dying and that they
would potentially be allowed only a one-hour goodbye. That was
hugely distressing, not only for Francesca and her family but for
her grandmother, who was coming to the end of her life without
her loved ones around her.
The guidance was often cited, but its lack of clarity left care
settings making decisions that were understandably in their own
interest, but not in the interest of the resident or the family.
After my intervention, visits to Francesca’s nan were allowed and
goodbyes were said, but the uncertainty and distress caused could
perhaps have been averted with a simple right of access that was
clear in its intention.
Likewise, Mura’smother was in a specialist nursing home that
houses some very vulnerable and elderly people. Everyone,
including Mura, understands the need for caution. When the virus
surged in December 2020, care settings like the one that Mura’s
mother was in effectively went back into lockdown. Named visitors
were allowed if they underwent testing, a process that no
relative has ever complained about. However, because the guidance
enabled homes to design and implement their own covid outbreak
procedures, many were able to prevent access even to the defined
essential care giver, denying love and support from loved ones
during another period of isolation.
One important point was reiterated when I listened with
colleagues to powerful and—as the hon. Member for Liverpool,
Walton said—harrowing testimony on access and support rights from
campaigners, many of whom are in the Gallery today. This is not
just about older people in care homes, or those at the end of
life. We heard from Wendy Mitchell, who is living well with
dementia, as those who follow her joyous Twitter feed know. She
highlighted her experiences of going to appointments alone during
the pandemic. I do not need to explain in detail the utter idiocy
of allowing people with dementia to attend a healthcare setting
where there are discussions about condition, medication and so
on. In the head of a 1970s scriptwriter, it would have formed an
idea for some sort of sketch show, but it is serious and
potentially extremely dangerous.
Youngsters fared particularly badly during the pandemic, and
those within care settings were affected quite acutely. I was
reading back through my correspondence relating to a young man
called Thomas, who has learning disabilities and is in a
residential care home. He had a birthday coming up, but the care
home was denying his parents the ability to take him home to
celebrate, despite the fact that it was—wonderfully, I hasten to
add—taking Thomas out for community visits. My correspondence to
the care home explains perfectly well what the problem was:
“I have managed to speak to colleagues in both the Health
Department and the Education Department about Thomas’ particular
set of circumstances and both encouraged me to look at the
ethical framework that care settings are required to operate
under. I was also reminded that those with learning disabilities,
such as Thomas, are not considered clinically vulnerable and
therefore do not require shielding in the same way as others with
significant health conditions.
I know that Government guidance in residential settings has not
exactly been perfect and that care home managers and teams are
doing their absolute best to navigate their way through, doing
what they think is best for both the client and their staff.
However there is a difference between the home Thomas is in and
that of an older much more vulnerable person and therefore
flexibility is perfectly possible.
It is with that in mind, and with the guidance for the whole
nation being slowly eased to allow greater human interaction,
alongside an appeal to your sense of compassion given Thomas’
mother’s deteriorating health condition, that I write to urge you
to reconsider your decision to not allow Thomas to visit his
family home tomorrow for his birthday. There are no ‘rules’ that
stop you from doing this and I know that the family will forever
be grateful.”
I am pleased to say that the home did allow Thomas to go home for
his birthday, but the fact that Thomas’s case related to two
different Departments, and the unclear guidance, caused great
anxiousness.
In September 2020, a similar case arrived from Dawn about her son
with complex medical needs living in 24-hour nursing care. She
rightly noted the impact that the first lockdown had had on her
son. She wanted me to write to the then Minister, who I am
pleased to see back at the Dispatch Box today, to make it clear
that a family member could be recognised as an essential part of
the care home staff and be allowed to come as much as any member
of staff. She felt that homes like the one that her son was in
were never mentioned because people automatically thought of care
homes in respect of our elderly population. I think that Dawn’s
message and that of many others was heard, but its application
remains sketchy, even today. [Interruption.] Oh—here is a lesson
for Members: make sure you take the last page of your speech off
the printer. [Laughter.]
Having reread the accounts of those cases and having listened,
back in March, to the testimony of others who had suffered as a
result of being unable to visit loved ones, I believe it is a
no-brainer to have an absolute position on this matter. The
guidance was not clear enough, and it caused distress to
residents and relatives as a consequence. I know that the
Minister will cite CQC guidance, but it is not strong enough,
which is why so many now feel that it needs to be enshrined in
one form or another. The Minister will note that there is
cross-party support for such a move. We could do it quickly, in
time for the winter, so I hope she will consider our pleas
seriously. This would protect care home managers, as well as
giving residents the right to have their loved ones with them
providing whatever support and care are necessary.
We can learn a lot from the pandemic, and I am sure that we will.
One of the lessons must be about the devastating impact of
isolation on the physical and mental health of those in social
care settings. Let me finally repeat my initial point, drawing on
my experience with my own father, six years after his death. No
one wants to see their loved one vulnerable, incapable of basic
functions or in their final hours, but nor should anyone be
denied that important time with them. Sadly, many were and some
still are, and it is with that in mind that I urge the Minister
to think carefully about her response this afternoon, but
ultimately to introduce legislation as soon as possible.
Mr Deputy Speaker ( )
I call the other co-sponsor of the debate, .
3.56pm
(St Albans) (LD)
Let me extend my sincere thanks to the hon. Member for Liverpool,
Walton () for leading the debate, and to
the hon. Member for Chatham and Aylesford () for co-sponsoring the
application. I pay tribute to both Members for sharing their own
experiences and those of their constituents in such a powerful
way. I am also extremely grateful to the Relatives &
Residents Association, to Rights For Residents and to John’s
Campaign. Their endless determination to highlight this glaring
gap in the law in order to protect some of our most vulnerable,
at their most vulnerable, has been critical to the securing of
this important debate.
I have to say that, unlike the two hon. Members who have spoken
already and unlike many from the campaign groups—some of whom are
here today—I have not been personally impacted by this matter,
but many of my constituents have. There have been too many
examples of families being separated from their loved ones,
often, as I have said, when they were at their most vulnerable.
Each and every story has been absolutely heartbreaking, and I
wish to share just two of them today.
Nearly two years ago, in November 2020, during a debate in
Westminster Hall secured by the hon. Member for Beaconsfield
(), I was able to tell
colleagues about my constituent Steph. Steph’s mum had dementia,
and had been living in a care home since December 2018, after it
had become impossible for Steph’s dad and sister to look after
her at home. Steph’s mum was visited every single day, by Steph,
Steph’s dad or one of her four siblings, until the pandemic hit
early in 2020. Before then, they had been able to lovingly hold
her hand, comb her hair, remember stories together, and reminisce
about the past. However, this was not just about visiting; Steph
and her family were providing essential care.
Contact with and reassurance from loved ones is incredibly
important to all of us, but it is especially critical for people
with dementia. Family members know their loved ones best. They
can identify the very subtle changes in their physical and mental
health more quickly. Residents often feel more comfortable about
opening up and sharing their concerns with close family members
than they might with a care worker, and that is even more true
when they do not always understand what is happening to them as
well as you or I might.
Suddenly, however, Steph and her family were separated from their
mum. For more than a year, contact was limited. Initially it was
limited to phone calls or sometimes video calls, and although
that was relaxed a little in the latter half of the year, the
family were still only allowed to visit Steph outdoors, in a
garden building. Unsurprisingly, like so many others in this
awful situation, Steph’s mum simply could not understand what was
happening. When presented with an iPad for video calling, she
thought she was watching a television programme. She could not
understand that she could interact with it, and found the ordeal
incredibly confusing. Fences, window visits, plastic screens as
barriers—none of those worked for people living with dementia
either. They became incredibly frustrated because they just could
not hear what was being said. Sometimes, they simply could not
recognise their loved ones at all at such a distance. Others
simply could not comprehend what was going on. Some felt as if
they had been put in prison.
In early spring 2021, Steph’s mum’s condition deteriorated. She
was moved to a hospice, where family members could finally spend
time with and be close to her, and comfort and care for her.
Sadly, she passed away in April last year. After such a long time
of being physically separated from her mum, Steph says that she
was, in a sense, almost lucky that in a different setting she and
her family could actually spend time close to their beloved mum
at the end of her life. Too many others have been denied those
precious final moments together.
Restrictions were not limited to care homes: dementia patients
and the vulnerable were prevented from seeing their children,
spouses and carers in other health settings, too. I would also
like to talk about Lynn, a constituent and friend. She discovered
this whole experience at Christmas time last year. Lynn’s
husband, Andy, also has dementia. Until December 2021, Lynn had
been looking after Andy at home, with the help of regular
professional carers. In a devastating blow, Andy’s condition
suddenly deteriorated on Christmas day. He had to be admitted to
our local A&E department, and was transferred to an acute
admissions ward while a bed in a suitable ward was found.
Although other wards were now accepting visitors, the unit Andy
was in was supposed to be temporary, so Lynn could not see him at
all. The rules were the rules, and there were no exceptions for
people such as Andy, who needed familiar reassurance and help to
communicate their needs. As it turned out, because of a lack of
suitable beds, Andy spent almost two weeks in that ward. It was
not until Lynn contacted me, and I intervened by contacting the
hospital management, that she was allowed access to her husband
Andy.
We all know that the NHS was and continues to be under
considerable pressure, but the lack of suitable one-to-one care
with somebody who Andy trusted had devastating effects. Lynn was
utterly distraught by his very dramatic and sudden weight loss in
the days that she was separated from him. Eventually, after
further direct contact from my office, the ward sister finally
agreed that Andy’s professional carers could also visit.
We all know that dementia is, sadly, a progressive condition, but
neither Lynn nor I were in any doubt that the pace of Andy’s
deterioration in those days over Christmas last year was hastened
by the lack of contact with those whom he loved and trusted. He
had been denied access to his essential caregivers. Andy is now
in a care home. When I spoke to Lynn last night, she simply
said:
“It is so important that people in care homes have access to
their loved ones. Andy isn’t ready to be stuck there until he
dies, without love and physical contact. The humanity needs to
come back into care.”
We have come a long way since last Christmas, and even further
since the beginning of the pandemic, but as winter approaches the
NHS and care settings are once again expected to struggle with a
surge in covid cases. It is not inconceivable that what happened
to Lynn and Andy could happen again to them and to many
others.
We now understand much more about effective infection control
with covid. Regrettably, we now also understand—from harsh lived
experience—the impact of separating those with dementia from
their loved ones and essential carers. Guidance exists so that
safe visiting can be facilitated by care home operators but, as
we have already heard, the overwhelming response from relatives
across the country shows that it is just not being implemented in
a consistent or fair way.
As it stands, care homes continue to apply rules far in excess of
the measures recommended by Department for Health and Social Care
guidance. It has been reported that more than 10% of care homes
permitted no visitors at all during covid outbreaks between April
and September this year; that 20% of care homes confined
residents to their rooms for up to 28 days during an outbreak;
and that almost half of homes have some form of visiting
restrictions in place, even when there is no outbreak at all. As
it stands, relatives do not feel empowered to do anything at all
about the wildly varying rules put in place by the homes they
have entrusted their loved ones to.
In advance of this debate, the CQC got in touch with Members to
set out what it thinks it can do about this scandal. The CQC
agrees it is vital that people are able to spend time with the
people they love. It tells us that, when it becomes aware of
guidance, it will take action but—this is the critical point—the
CQC does not have the power to require care homes to report any
visiting restrictions they put in place.
I am grateful to the Chamber engagement team for conducting
research in advance of today’s debate. As we have heard, 363
people have responded to the survey in the last few days, and
more than 70% of relatives with concerns about their loved ones
in care homes had not contacted the CQC to make a report. Those
who did contact the CQC reported mixed success. Some told us that
things improved, but the vast majority said either there was no
improvement, the CQC was not interested or the CQC simply did not
respond.
This is the crux of it: one person who responded to the survey, a
woman called Joanne, said
“because I spoke to the CQC we were threatened with eviction from
the home.”
This is what so many of my constituents tell me. They fear making
a report to the CQC because there are no legal protections for
visiting their family members. They are terrified of being
labelled a troublemaker, of being stopped from visiting their
loved ones altogether or of their loved ones being evicted. There
is a huge power imbalance, which cannot be right.
Members met the relatives’ campaign group in Parliament in March,
and we heard heartbreaking testimony from families and service
users about the effect of these instructions. Every single person
agreed that the guidance simply was not working, everybody agreed
that enough was enough, and everybody agreed that we needed
protections in law. Everyone except the then Minister, who
unfortunately was not able to make it until the very end of the
session with a pre-prepared speech, and who had not heard the
powerful and harrowing testimonies of those who attended, many of
whom are in the Public Gallery today.
The new Minister is here to hear some of those powerful
testimonies, and I hope she will conclude, as we have, that the
evidence is overwhelming. We must put an end to this scandal. We
have to be able to say, “Never again.” As other Members have
said, there is cross-party support and we will work with the
Government to put this into law. Surely the time has come to
create a new legal right to maintaining contact.
Several hon. Members rose—
Mr Deputy Speaker ( )
Four Back Benchers wish to contribute, and we have three
Front-Bench contributions and Mr Carden at the end, so I ask
people to consider the length of their contributions. We will be
going to the wind-ups just after half-past 4.
4.08pm
(Tatton) (Con)
I congratulate the hon. Member for Liverpool, Walton () on securing this debate, and I
thank my hon. Friend the Member for Chatham and Aylesford () for co-sponsoring it.
It has been deeply distressing to hear the stories that have been
told in this debate. Human beings have rights, including the
right to education, the right to healthcare, the right to bodily
autonomy, the right to equality and the right to private family
life, free from Government interference, to be able to spend time
with their loved ones. It is a sad fact that all those rights
came under attack during the covid lockdowns, but we have moved
on from those lockdowns, and the covid restrictions have ended,
so it is deeply harrowing to discover that it is not the case for
some.
In the stories we have heard today, in the stories I have heard
from my constituents and in the stories highlighted in The Sunday
Times, I am horrified that, seven months after the removal of
official restrictions, care home residents are still being denied
visits from their families and friends. It needs to be mentioned
that some care homes are open and allowing visits, but others are
not and continue to prevent family members from seeing one
another. That is simply inhumane. It is beyond cruel. Isolation
and the loss of social contact has a devastating impact on
physical and psychological health. Without the support of family
and friends, health outcomes are poorer, as residents lose hope
and sometimes even the will to live, and they often refuse
treatment. For residents with dementia this is especially
devastating, as they do not understand why their relatives have
not been to see them. Many also have serious sensory impairments,
and for them physical touch and communication with family members
might be all they have left.
I am more concerned that this situation is concealing neglect and
abuse. As chair of the all-party parliamentary group on pandemic
response and recovery, I heard from campaigners back in April,
and more recently, who warned of widespread and shocking
safeguarding issues involving medication, hydration, hygiene and
a lack of basic care. Families must be allowed full access, to
support, protect and advocate for their loved ones when they need
it most.
What can be done to end this unnecessary suffering once and for
all? It is now beyond urgent that care homes, local authorities,
the UK Health Security Agency and the CQC stop blaming each other
for these appalling failures of policy and take action. Rather
than requiring new legislation, we need to uphold existing laws.
Article 8 of the Human Rights Act and the Mental Capacity Act
2005 should have protected against this situation ever arising.
Instead, that legislation is being wilfully misinterpreted as an
excuse to keep people isolated in care homes; sometimes they feel
as though they are prisoners. So I call upon the Minister to get
tough on any care homes that block residents from seeing
visitors. There should be severe consequences for those who
continue to blight the lives of those in care, and they should
face fines or legal action.
We are failing vulnerable members of our society and it simply
cannot be allowed to continue. We must end all unlawful visiting
restrictions and stop this unnecessary suffering and neglect. It
is deeply shameful and a stain on our history that our country
has allowed this to happen, and that it is still happening so
long after covid restrictions have been lifted. Some care homes
say that these restrictions are due to staff leaving the sector
when mandatory vaccinations were called into use. May I ask
therefore what the Minister and the Government are doing to get
those staff back into the care homes and into those jobs? It
could be that up to 7% of care home staff were lost, which
represents 40,000 employees. What are the Government doing to
reinstate them and compensate them for losing their jobs? As
Professor Robert Dingwall told our all-party parliamentary group
at the inaugural meeting last year:
“A good society is defined by life, health, liberty and the
pursuit of happiness, not by the prevention of one disease
alone.”
4.12pm
(Garston and Halewood)
(Lab)
I, too, congratulate my hon. Friend the Member for Liverpool,
Walton () and the hon. Member for
Chatham and Aylesford () on obtaining the debate, and
I thank the Backbench Business Committee for granting it.
Many Members here know Jenny Morrison and Diane Mayhew,
constituents of mine who were co-founders of Rights for
Residents. Because of the shortage of time, I will not explain in
detail what happened to Jenny’s mother, but it is similar to the
experience that the hon. Member for St Albans () set out in respect of some of
her constituents. However, I wish to say a bit about the ongoing
trauma that the experience causes for those left behind, because
this is about not only the distress of seeing one’s relative go
through the final illness —and the consequences of dementia can
be distressing at the best of times— but the ongoing consequences
of the restrictions for those left behind.
Jenny tells me that she has hardly had a restful night’s sleep
since the doors closed on her mother’s care home, and that she
feels as though her mother was locked away. Even though her
mother has now unfortunately died, Jenny says that she is plagued
by distressing images and painful emotions that will not go away.
They have an ongoing impact on her life because the end of life
can often overwhelm the earlier positive memories if it is
distressing and difficult. Many thousands of people have had the
experience of watching from a distance as their relatives in care
homes deteriorate. They are unable to visit them, comfort them
and watch them die. They have ongoing trauma, and may have for
many years. The bad memories come back instead of the good ones.
Many people affected in this way go on to feel like they are
being selfish for thinking about their own feelings instead of
what happened to the loved-one they lost, but they are not. They
are suffering from deep trauma caused in part by what has
happened.
Jenny Morrison and Diane Mayhew were co-founders of Rights for
Residents. They have sought to turn their terrible experience
into something much more positive—into campaigning for these
changes, and I commend them enormously for that. The fact that
covid is no longer seen as the threat that it was does not mean
that the restrictions have gone away. As many hon. Members have
said, they are still being used in care settings. In that
context, it is tremendously important that a legal right is
established.
The Relatives and Residents Association and Rights for Residents
surveyed some of their families and discovered that the harm was
continuing. One in five outbreaks saw residents confined to their
rooms. One in nine outbreaks saw residents not allowed any
visitors at all. Care homes were still implementing blanket
visiting restrictions, when there was no necessity for any such
thing. Quite often they say that it is because of Government
guidance or that local authorities have suggested that they
should have these restrictions. None of this is accurate or true,
but it is still stopping families visiting their relatives in
care homes. How much longer is this going to go on? How much
longer are the Government going to allow this to go on?
I do not think—something highlighted by the Joint Committee on
Human Rights—that changing the guidance 30 times in a short
period helps any understanding of what the guidance actually
says. That is not helpful. Let us have a law swiftly that says
that residents in care homes and those having care and health
support have a legal right to be accompanied by a relative—at
least one, perhaps sometimes more would be appropriate. That is
unequivocal; it is clear. It can be clearly understood by whoever
needs to understand it. That is the answer to this. I hope that
the Minister will agree and swiftly enact such a change.
4.17pm
(Dwyfor Meirionnydd)
(PC)
Diolch yn fawr iawn, Lefarydd.
My mother Nancy had a stroke sometime between Christmas eve and
Christmas day at the close of 2020. There was no warning, no time
to prepare for this catastrophic event. Overnight she lost her
autonomy, her independence and her agency in her own life. She
went into the local district hospital and was transferred from
there at the beginning of January 2021 to a community hospital
specialising in stroke rehabilitation. She remained there until
the end of that February. She came back to live with us for a
couple of months, with twice daily home carers, while I, her only
child, was still able to vote here and speak in debates without
having to be physically present in the House of Commons. She had
to move into residential care because the period when I could
balance caring and parliamentary duties came to an end.
Last November she had a fall and knocked her head. The
anti-stroke medication resulted in bleeding on her brain. She was
discharged from hospital back to the residential home at very
short notice. Just before Christmas she fell again and broke her
hip. She died in hospital four weeks later. These are the bald
facts of the event. It was my mother’s misfortune to be old and
in need of clinical services during the first covid winter. It
was the misfortune of all of us as a family that my mother fell
ill at a time when covid infection control demanded the absolute
isolation of stroke patients. Many of the key workers with whom
we interacted over those 13 months were extraordinary.
During the last month of my mother’s life, dementia specialist
nurse Delyth Fon Thomas put me in contact with John’s Campaign.
She explained to me that, in the last month of my mother’s life,
family contact was a right rather than an optional favour. She
was the first person in authority to mention that, and she put me
in contact with Julia of John’s Campaign, who is, I am glad to
say, with other campaigners here in the Public Gallery.
Look up the long list of hospitals and other organisations that
have signed up to John’s Campaign. They recognise that a key
family member is more than a visitor—they are a carer as much as
anyone on the payroll. But, I say to Members, try to get that
information volunteered to you, try to find out what your rights
are, because they are not given to you on a plate. People such as
Delyth confounded the cliché of monolithic public sector
organisations, which may well prioritise institutional interests
and risk aversion to the detriment of those services that we
trust them with providing. I think that, as private individuals,
many people will have had that experience.
None the less, despite Delyth’s help, I only touched my mother’s
hand once during the critical six weeks after her first stroke.
Yes, we could arrange to speak to her through a glass window as
she sat in a hospital stairwell and we stood outside in the car
park, peering in. She could not hear us—incidentally, her hearing
aid had been kept in a cabinet all the while and the batteries
had run out. Yes, we could phone and arrange to speak over an
iPad, but she could not hear us; she could not understand us.
There were no hugs.
Health authority infection policy vetoed family bonds of love as
a health hazard to be minimised. Of course, at the onset of
covid, we had to adapt and learn quickly about how to cope with
an unfamiliar, life-threatening and highly infectious virus. We
put in place measures such as lockdowns and visiting restrictions
at hospitals and care homes, because that was the best that we
could do; that is all we knew back in 2020. We had to learn as we
went along, but have we truly learned the most important lesson
of all? Treating the elderly and people with dementia as units of
flesh and bone by meeting the barest minimum of their physical
needs is wrong. We are social animals: take away our social
support and we fail to thrive. Denying family contact causes
immediate welfare harm to patients and longer-term harm to family
members.
That is the context in which we must apply the abstract
terminology of legislation: the Equality Act 2010 recognises the
basic principle that the needs of disabled people should be
assessed and reasonable adjustments made to meet those needs.
People with dementia and cognitive impairments are disabled. Then
there is the matter of human rights, which have been touched on.
Article 2 of the European convention on human rights places an
obligation on the state to secure the right to life. Article 8
protects the right to private and family life, but how these are
balanced in care settings is critical, and how we shift that
balance as we move along is also critical. It is also surprising
that the Human Rights Act 1998 applies only to publicly funded
residents in care homes.
This evidently unjust inconsistency is why the Government must
step in. Why should the owners of private care homes, especially
in England where local authority care is far less available than
in Wales, be able to make such immense decisions, and possibly
prioritise convenience over residents’ and families’ rights?
Indeed, if we start from the point of view of people in need of
care, the care setting itself should not depend on whether it is
in the public or the private sector. If the individual has a
right, that right goes with them throughout their lives—whether
they be in hospital, at home or in residential or nursing care. A
right is not a right if its only guard dog is guidance.
(The Cotswolds)
(Con)
On a point of order, Mr Deputy Speaker. I made a speech in the
previous debate on the national food strategy and food security
and I inadvertently forgot to declare my interest in the Register
of Members’ Financial Interests as a farmer and a Fellow of the
Royal Institution of Chartered Surveyors, for which I wish to
apologise to this House and to put the record straight.
Mr Deputy Speaker ( )
I thank the hon. Member for his point of order and for making it
at the earliest possible opportunity. That is now on the
record.
4.24pm
(Putney) (Lab)
I am very keen to speak in this debate and to raise the
experiences of many of my constituents. I am grateful to my hon.
Friend the Member for Liverpool, Walton () for introducing this debate,
and to the hon. Members for St Albans () and for Chatham and Aylesford
() for sponsoring it.
Many constituents I know experienced dreadful times with those
restrictions during covid. In saying that, I pay tribute to all
the care workers and care staff who worked tirelessly through
covid and are still working to take care of care home residents.
My daughter is a care worker, so I have seen the impact that this
has had on her throughout the pandemic. I also express my
condolences to all those affected and pay tribute to the
campaigners for Rights for Residents, who have brought this
campaign to the fore and continue to ask for action.
My hope is that we will hear from the Minister about some action
to make the legislative changes we need to make a difference now
and to ensure that we learn the lessons of covid and of all the
painful stories and experiences we have heard, so that if we are
ever in a pandemic again, the same actions are not taken. It is
understandable that visiting restrictions were put in place to
save the lives of vulnerable care home residents during covid,
but they could have been done differently, with much more
consideration for the fact that a visitor is not just a “nice to
have”, but an essential part of care, and that leaving care home
residents without visitors led to a huge deterioration in their
mental and physical health.
Many constituents have written to me about the effects of that
isolation and lack of contact with relatives during covid. As one
relative of a care home resident said:
“As you are aware my mother-in-law died and that’s attributed to
the effects of isolation and forced separation and it’s paramount
that we learn lessons from what has happened going forward.”
I visited many local care homes myself—respecting all
restrictions in place, obviously—and heard about the lasting
effects that isolation is having on elderly residents and the
disabled even now; for example, residents who have become very
reclusive.
The Government must listen to those care home providers who are
also demanding an end to visiting restrictions and are not happy
with the status quo. Jeremy Richardson, then chief executive
officer of Four Seasons Health Care, the UK’s third-largest care
home provider, said:
“We are depriving people of their right to visitors, which is an
absolute outrage. The government restrictions at the moment are
making it very difficult to give people a quality of life… We run
care homes. We do not run prisons.”
The restrictions must be evidence-based. In December 2021, an
Oxford University study, conducted by a team of eminent
scientists led by epidemiologist Dr Tom Jefferson, found evidence
that many vulnerable residents died of thirst, starvation and
“broken hearts” during the pandemic. They identified that almost
40% of excess fatalities were not caused by the virus, with many
people dying of loneliness and neglect. Without the support of
visitors, vulnerable residents were left to deteriorate and
die.
“Neglect, thirst, and hunger were—and possibly still are—the
biggest killers”.
It is clear that care home staff had a huge amount of additional
work during covid, but visitors would have alleviated some of
that.
The Joint Committee on Human Rights published a report on the
human rights implications of the Government’s response to covid
in September 2020 and a report on care home visiting during the
pandemic in May 2021. Following on from those, it published a
report on protecting human rights in care settings, which
recognised the balance between the state’s requirement to protect
the lives of care users and other rights, including the right to
a private and family life, stating that,
“too often the correct balance has not been struck and too much
has been left to individual care settings to determine”,
and that
“insufficient respect was given to ensuring meaningful contact
between care users and their family members and loved ones”.
We need legislation to ensure that that does not happen
again.
The Committee’s report recommended that care users be given,
“the right to nominate one or more individuals to visit and to
provide support or care in all circumstances,”
subject to full infection prevention measures, and that the
Government should,
“give the CQC the power to require care settings to inform them
of any changes to their visiting status, and to report live
data”,
so that there is transparency about changes in visiting rights.
The Government have not yet responded to this report, as other
hon. Members have mentioned, but I hope to hear a response
today.
As we have heard many times in this debate, the CQC guidance is
just not enough. Rights for Residents is calling on the
Government to take urgent action to pass legislation that would
give every care home resident the legal right to nominate at
least one essential care supporter, who can maintain contact in
all circumstances, regardless of outbreaks, lockdowns, variants
and future pandemics, and to ensure that care homes are supported
in returning to pre-covid, unrestricted visiting arrangements,
without the need for appointments or limits on time, frequency or
the number of visitors.
In this place, we have a duty to give a voice to those who do not
have one, and to fight against injustice. I feel that this debate
has done that. I hope it will be heard and that it will result in
long-lasting legislative changes that will save lives.
4.30pm
(Coatbridge, Chryston and
Bellshill) (SNP)
I, too, thank the Backbench Business Committee for allowing this
debate on such an important matter. I warmly commend the hon.
Member for Liverpool, Walton () for leading it, as well as the
hon. Members for Chatham and Aylesford () and for St Albans (). We have had a thorough and
compassionate debate on what is such an emotional subject for so
many of us, and many more of our constituents. I thank all
Members for their contributions.
I was touched by what the hon. Member for Liverpool, Walton said
about his beloved father, and the anguish felt by his family due
to that separation. My condolences, and those of my party, are
with him. I was touched because it brought back my own experience
of watching those close to me fret about the loss of contact with
a loved one during the pandemic and, more importantly, how that
isolation would impact their beloved parent. Over the last two
and a half years, we have all witnessed the devastating impact of
people being completely isolated in health and care home
environments, with families flatly denied vital contact with
their cared-for relatives. The damage of that to people’s lives
and their health and wellbeing has, I feel, been
immeasurable.
As we have heard from across the House, the reality is that
residents still face the prospect of spending the final days of
their lives in care home settings, separated from their loved
ones. Families are still experiencing major and traumatic
difficulties when trying to support their relatives in ill health
and in residential care settings. We know that social connections
and meaningful activity are so important for the health and
wellbeing, and particularly the quality of life, of people living
in adult care homes. We, as a society, perhaps did not recognise
how much devastation that prolonged separation would cause, or
perhaps how long the pandemic would require such restrictions to
be in place, but as a Parliament we must recognise that and do
all that we can to ensure that it does not happen again.
We must understand how difficult and painful working throughout
the pandemic has been for our care home staff. I am sure that the
House will join me in expressing appreciation and gratitude to
all care home staff who have worked heroically and tirelessly
throughout the covid-19 pandemic. Wherever possible, they worked
swiftly to maximise the opportunities for residents of care homes
to spend some time with their loved ones, whether that be through
glass or whatever. We know that they tried hard to do so as
safely and as carefully as possible, but for long periods there
was no opportunity for that family contact, that loving
connection, and sadly that final goodbye, causing such deep
anguish for so many.
The Scottish Government have recognised that, and we are now
taking the steps required on the path to introducing Anne’s law
in Scotland. Anne’s law aims to give nominated relatives or
friends access rights to care homes, while of course following
the same stringent infection control procedures as care home
staff. That follows on from the Scottish Government’s
introduction of the National Care Service (Scotland) Bill in June
of this year, representing the final steps in the process of
implementing Anne’s law.
Once the Bill is passed, we will be in a position in Scotland to
ensure that people living in adult care homes have a legal right
to see and spend time with those people most important to them,
even in outbreak situations. Those are positive and progressive
steps being taken by the Scottish Government, and I hope that the
Minister will join me in welcoming Anne’s law on to the statute
book, and use it as an example to ensure that all care home
residents have the familiar support and family contact they truly
want and rightly deserve. I am aware that the Rights for
Residents group is campaigning for similar measures to those
contained in Anne’s law to be introduced across the other nations
of the United Kingdom. I fully support that campaign and hope the
Minister will commit to look closer at it.
I urge the Government to go further still and take the necessary
steps to fully integrate health and social care, as has been
successfully done in Scotland. The Scottish Government have
invested over £1.6 billion in integrated joint boards and are
committed to increasing that spend by a further 25%, equating to
£840 million, by the end of the next Parliament. We have invested
an additional £124 million in care at home service provision and
provided £200 million to uplift pay for adult social care
employees in commissioned services to a minimum of £10.50 per
hour. We in the SNP know the value of our care home workers
across Scotland. They deserve a fitting wage for their
outstanding work and service.
To support all that, an additional allocation of funding will be
made available to the Scottish Care Inspectorate, to enable it to
support and maintain the visitation rights implemented under
Anne’s law. The Scottish Government are forward-leaning and are
taking the steps necessary to fund social care to support the
people who live and work in social care settings. I urge the UK
Government to do likewise.
Finally, for the sake of all vulnerable care residents, wherever
they may be across these four nations, I urge the UK Government
and the Minister to take the steps required to guarantee their
legal right to maintain contact in care settings.
4.36pm
(Leicester West) (Lab)
I thank my hon. Friend the Member for Liverpool, Walton () and the hon. Members for
Chatham and Aylesford () and for St Albans () for securing this hugely
important debate. I hope my hon. Friend the Member for Liverpool,
Walton will forgive me for saying that I thought he spoke
incredibly bravely and powerfully about his father, who I am sure
would be very proud of him today.
The terrible consequences of banning families from seeing their
loved ones in care homes is an issue very close to my heart. It
is something that Labour has been campaigning on since the very
first covid lockdown in June 2020. Indeed, we first called on the
Government to bring forward a legal right for care home residents
to see a family member or friend in February 2021. We continue to
do so today because, as we have heard in the debate, this issue
has not gone away, and because with winter almost here and, God
forbid, in the event of any future pandemics, we need to ensure
that the rights of residents and relatives are clearly guaranteed
by law. We make this case because it is good for residents, good
for family members and good for care staff.
I will say more about that later, but I want to start by thanking
the organisations that have campaigned so hard on this issue,
including Healthwatch, Mind, Mencap, the Alzheimer’s Society,
Parkinson’s UK, Dementia UK and Disability Rights UK. I
especially want to thank the Relatives and Residents Association,
John’s Campaign and Rights for Residents, which have been at the
forefront of the campaign. In particular, I pay tribute to Jenny
Morrison and Diane Mayhew from Rights for Residents—two
phenomenal women who have blazed a trail on this issue. After
their terrible personal experiences, they set up Rights for
Residents, to give a voice to all the other care home residents
and families who had been banned from seeing their loved ones.
The reaction to their campaign has been astonishing, which I saw
for myself on joining them in Downing Street—or, rather, locked
outside it—in September 2021, when they presented a petition
calling for a change in the law, signed by more than 250,000
people.
Almost all the campaigners I met had never been involved in
protests or petitions before. They were not there because of any
political agenda, but because of their personal experience and
the fact that they wanted to see a change. The reason why so many
people joined Jenny and Diane is that this issue really matters.
It matters to the thousands of families who have faced
unbelievable anguish, guilt and distress because they were banned
from seeing the people they love most—their mothers, fathers,
husbands, wives, brothers, sisters, sons and daughters—at a
terribly frightening time. It matters because of the physical and
mental impact that isolation has on older people and, as the hon.
Member for Chatham and Aylesford said, crucially, on people with
physical and learning disabilities. We have heard much evidence
about increased depression and anxiety, and people losing weight
because they are not eating. The truth is that, as the hon.
Member for St Albans said, families are not just visitors; they
are an essential part of the care given to residents, and should
be treated as such.
Banning families from seeing their loved ones also matters to
care home staff. There is lots of international evidence that
staff in many countries have faced increased workloads because
some of the emotional and other support that was normally
provided by families, such as helping people with eating and
taking them on walks, completely disappeared when they were
banned.
There is much I could say about all the powerful things that hon.
Members said about their constituents; I was contacted by many
deeply distressed constituents too. Because time is short,
however, I will emphasise something that has not really been
mentioned today, which is that families have always understood
the need to protect their loved ones from covid and never wanted
to expose them to unnecessary risks. All they wanted was to be
treated the same as care home staff. They could not understand,
once the PPE, testing and vaccines were finally available, why
they were banned and treated differently from everybody else.
Throughout the pandemic, the Government have resisted calls for
residents to have a legal right to see their family member. They
have consistently said that the guidance they issued was enough,
but the guidance, which changed more than 30 times during the
pandemic, is not enough, as we have seen time and again. I will
make two points. First, anything that is issued 30 times will be
totally unclear. People will lose track and it will not be
properly followed. Secondly, the clue to the problem with
guidance is in the name—it is guidance, which can be ignored.
Neither is oversight from the CQC enough. The Joint Committee on
Human Rights said in May 2021 that there was an
“astonishing lack of awareness by the CQC as to whether care
homes are…allowing visits”.
The Chair of the Committee, my right hon. and learned Friend the
Member for Camberwell and Peckham (Ms Harman), said at the time
that the CQC’s assurance
“that visits are being allowed…is wholly unconvincing”.
We have heard evidence today that that remains the case and we
know that the guidance and regulations are not working or being
enforced.
The Relatives & Residents Association and Rights for
Residents recently surveyed more than 650 families. They found
that visiting restrictions during the majority of covid outbreaks
between April and September this year were more restrictive than
advised by current Government guidance. One in five outbreaks saw
residents confined to their rooms. One in nine outbreaks saw
residents not allowed any visitors at all. Shockingly, 45% of
families who responded said that there were visiting restrictions
in place despite there being no covid outbreaks. That is why
those organisations have repeated their call for a new legal
right to guarantee people’s access to in-person support from at
least one care supporter—a person important to them, such as a
relative or friend.
Opposition Members agree, as does the cross-party Joint Committee
on Human Rights, which says that the default position must be
that those in care homes can receive visits from a “significant
person” and that blanket bans are in breach of the legal right to
family life. We can learn quite a bit from other countries on
this issue. I understand that the Dutch Parliament recently
accepted a corona Act that guarantees that each resident has the
right to welcome at least one visitor in the case of covid-19
outbreaks.
I ask the Minister to look at this subject again. She should heed
what families want, what organisations representing residents and
families demand, and what is done in other countries, and put
this legal right in place.
Mr Deputy Speaker ( )
I remind the Minister to leave a couple of minutes at the end for
the hon. Member for Liverpool, Walton () to wind up.
4.44pm
(Faversham and Mid Kent)
(Con)
I would say that it is a rare Minister who welcomes a debate on
day one following their appointment, but truly I do welcome this
particular debate because it is so important. Visiting in care
settings is something I have spoken to many people about, and I
had hoped that by now it would no longer be a problem now we have
put lockdowns behind us, but it is still a problem.
I thank and commend the hon. Members for Liverpool, Walton
() and for St Albans () and my hon. Friend the Member
for Chatham and Aylesford () for leading this debate and
for their powerful speeches, and I thank all the other Members
who also contributed very powerfully. I would also like to thank
those who have been campaigning so hard for visiting rights, such
as the Rights for Residents campaign, John’s Campaign and the
Relatives & Residents Association. I know that some of them
are here with us in Parliament today, and I am sure that many
others are watching from home.
I do recognise the efforts that so many care homes have made to
get back to normal, or as close to normal as they can, on
visiting after the enormous challenges of the pandemic, because
visiting matters. Visiting matters for the resident in a care
home—we must never forget that it is indeed their home—and for
family and friends who want to spend time with their loved ones.
It can be the moment a resident looks forward to all week, a time
that keeps their connection to life beyond the doors of a care
home and—not to be underestimated—the chance to hold the hand of
or have a hug with someone who loves them. I say this knowing
that, sadly, many residents in care homes are living with
dementia and may be confused or unable to remember things for
long. Visits matter for them and their families, not least
because dementia can progress so cruelly, as was mentioned in
particular by the hon. Member for St Albans.
Dame (South Northamptonshire)
(Con)
My hon. Friend is absolutely right to talk about the impact of
dementia in particular. During lockdown, a large number of people
wrote to me, including a close family member of mine, whose
dementia significantly worsened because they were not able to see
family members just to keep those memories going. It was
absolutely terrible, and I think we should do everything we can
to make sure that cannot happen ever again.
I thank my right hon. Friend for making that point, which we have
heard from others in the Chamber.
Visiting is not just a “nice to have”, as we have just heard—all
the stories we have heard today can leave us in no doubt about
that. The hon. Member for Liverpool, Walton spoke very movingly
about the experiences of others, but also about his own personal
experience with his father, which he very courageously shared
with us. The right hon. Member for Dwyfor Meirionnydd ()—I cannot pronounce
her constituency, but Hansard will resolve it—also spoke very
powerfully about her mother. I say to both of them that I am
sorry for their loss.
Very importantly, my hon. Friend the Member for Chatham and
Aylesford reminded us that this is not just about older people.
Visiting, both into a residential setting and out of it, is also
so important for younger people—for instance, those with learning
disabilities. However, I am short of time, so I will press
on.
On top of the stories, there are the facts. We know there is a
body of evidence that supports the argument that not having
visitors can be detrimental to the health of people living in
residential care, as my right hon. Friend the Member for Tatton
() mentioned. For instance,
there is a connection between social isolation, loneliness and
mental health. In fact, back in October 2020, when I was
previously the Care Minister, I commissioned research on the
benefits of visiting as well as an assessment of the risks at the
time and the options for opening up visiting.
I can also say that I do know personally what it feels like not
to be allowed to visit a relative. In the summer, my mother was
admitted unexpectedly to hospital and I was not allowed to visit
her, even though I did not know whether I would ever see her
alive again. The same was the case for my father, her husband for
50 years, who was also barred from entry to her ward, and that
was even though we were clearly not in the heart of the pandemic
by any stretch of the imagination.
I will look at this issue in three parts, at pace: what has
happened to get us to this situation; what is really going on;
and what can be done.
Sadly, during the pandemic we saw how hugely vulnerable to covid
people who lived in care homes were, and the Government priority
was to keep people safe, which meant doing everything possible to
prevent covid from getting into care homes. It meant reducing the
number of people going in and out who might take in covid. It
meant requiring the use of personal protective equipment. It
meant regular testing for care home residents and staff, and when
we got the covid vaccine it meant prioritising vaccinations for
care home residents and staff.
However, even back in 2020 we knew that residents in care homes
and their families were suffering from the visiting restrictions,
although I should mention that not all residents and their
families had the same views. While some wanted more visiting,
others did not because they were more worried about the risks.
Balancing those two things, the Government sought to enable
visiting in ways that would be safe, and we also made it clear
that end-of-life visiting should always be possible.
In March 2021 we introduced the concept of the essential care
visitor who would be able to visit a resident who needed personal
care in any circumstances, including during an outbreak,
following the same covid testing regime as staff. In June 2021 we
expanded that to apply to all residents. At all times we worked
with social care providers—with care homes—because they were the
ones that had to put the guidance into practice; they were the
ones at the frontline, balancing the prevention of covid with the
practicalities of supporting visiting. I do not underestimate the
demands that put on care homes, which were also carrying out
testing, providing PPE and everything else.
Moving on to the situation today, since April 2022 the Government
guidance has been that there should not be any restrictions on
visiting in residential settings unless there is a covid
outbreak, and even if there is an outbreak every resident should
be able to have a visitor. Local public health teams may advise
other restrictions on visiting if there is a particular local
risk, but that should be proportionate and should stop visiting
only in extreme circumstances.
Some Members have said today that the guidance is not clear,
while others have said that it is not being followed; it has also
been said that the problem is that it is guidance. On the content
of the guidance, we have heard from many accounts that it is not
being followed, and I will do further work on that.
Knowing the concerns during the height of the pandemic about
visiting, the Department of Health and Social Care started
tracking visiting restrictions; indeed, I started that as Care
Minister, to try to get data about what was going on, because one
of the challenges is knowing what is going on at the frontline,
as the social care system is so diverse and fragmented. Our data
told us in September that 98.4% of care homes were allowing
visiting, but I recognise that that data is not the whole
answer.
The CQC has been referred to in the debate. I spoke with Kate
Terroni, chief inspector of adult social care at the CQC, many
times during the pandemic about visiting and she, too, saw the
importance of it. The CQC looks at visiting when inspecting care
homes, and a lack of visiting or access is a red flag for it.
Families should be reporting visiting concerns to the CQC, which
then investigates them. I heard, however, the points made by the
hon. Member for St Albans about some families feeling they got a
mixed response or who were fearful of reporting to the CQC
because of the possible consequences. Again, I will take that
away from today’s debate.
Under the existing regulations, the CQC can take action if it
believes that safe and proportionate visiting is not being
facilitated, but I also took note of the point made by the hon.
Member for Liverpool, Walton about the CQC powers to get live
data being limited and its not having powers to require care
homes to report changes to visiting restrictions. I will look
into that, too.
Although we have the guidance and the CQC is able to take action
on care homes, there is clearly still a problem. I have also seen
the data from the Rights For Residents survey showing that 45% of
responses said that restrictions on visiting had still been in
place since April, and in 11% of outbreaks no visitors were
allowed at all. Again, I am concerned to see that.
Will the Minister therefore undertake to implement a legal right
for visitors to visit, as Rights For Residents has called for? We
are all on tenterhooks.
If the hon. Member will bear with me, I am getting to the third
of the three considerations, which is what can be done. On that
point, back in April 2021, I was questioned by Parliament’s Joint
Committee on Human Rights about this very topic. On visiting, I
said:
“I want to get to a position where it is as normal as possible.
This is something to come back to in the future, particularly if
family members and residents feel that the situation is not
working as they would want it to.”
Clearly, family and residents do indeed feel that the situation
is not working.
I understand that things are not easy for care homes. I
understand the staffing pressures caused by the recent increase
in covid—and flu, which many residents are vulnerable to. The
majority of care homes are allowing normal visiting and, as hon.
Members said, many care homes totally recognise the importance of
visitors.
Will the Minister give way?
I am short of time—I have two minutes —so if my right hon. Friend
will allow me, I will continue.
However, we cannot continue to have a situation in which families
and friends are struggling to see loved ones in care homes. That
is why I have already commissioned work today—it was my first
commission since my appointment—on the steps that I can take to
sort this out. On the question from the hon. Member for Garston
and Halewood (), I cannot announce legislation
here and now at the Dispatch Box, but I have commissioned work on
what I can do to sort this out. I assure all hon. Members on the
Chamber and all those listening to the debate that I do not
consider the status quo acceptable, and I am on the case.
4.57pm
I am grateful to you, Mr Deputy Speaker, for chairing the debate.
I was watching the faces of the campaigners in the Gallery, who I
am sure wish they had a voice in the Chamber. Having said that, I
will take the Minister at her word. It may have been a bit much
to ask that, on her first day, she would commit to legislation,
but she knows that the campaigners will not be going away and
that I and other hon. Members will continue to make their
case.
We must put right what has gone wrong during covid. Loved ones
are an essential part of care and, as many colleagues have said,
there is an easy solution: essential care givers and loved ones
should be treated in the same way as staff. The only way to
resolve the situation is for this place to put a right in law
through legislation. I think that we can all agree on the
principle that, whether it is the state, a privately run care
home or a hospital, it does not have the right to separate family
and loved ones. The right to visit a loved one in a care setting
is one that we should all enjoy across the country.
Mr Deputy Speaker ( )
It has been a privilege to chair this emotional and effective
debate.
Question put and agreed to.
Resolved,
That this House has considered the matter of guaranteeing the
right to maintain contact in care settings.
|
