Family Visits in Health and Social Care Settings: Covid-19

[Esther McVey in the Chair]

I remind hon. Members that there have been some changes to normal practice in order to support the new call list system and to ensure that social distancing can be respected. Members should sanitise their microphones using the cleaning materials provided before they use them, and then place those materials in the bin. They should also respect the one-way system around the room. Members should speak only from the horseshoe, and they can speak only if they are on the call list—that applies even if debates are undersubscribed.

Members cannot join the debate if they are not on the list. Members are not expected to remain for the wind-up speeches. I remind hon. Members that there is less of an expectation that they stay for the next two speeches once they have spoken—that is to help manage attendance in the room. Members may wish to stay beyond their speech, but they should be aware that if there are lots of speakers, doing so might prevent Members in the seats in the Public Gallery from moving to the horseshoe.

I beg to move,

That this House has considered family visit access in health and social care settings during the covid-19 outbreak.

It is an honour to serve under your chairmanship, Ms McVey. My main focus in speaking today is to highlight the need for improved patient advocacy and adult safeguarding via visitation rights for family members of working-age disabled adults in full-time residential care, including those admitted to hospital. Such patients often cannot speak for themselves and need additional access to family members who are able to advocate and communicate on their behalf.

I applied for the debate because of an awful situation of a mother in my constituency—a mother, much like me or any hon. Member present, who has had to endure a situation that I hope no mother has to face in the future. She is a teacher, a local community advocate, a single mother and someone who has tirelessly fought for her child’s care needs. She was prevented from caring for her son, Jamie, and forced to abandon him to a care home that did not live up to its name. At 21 years old and with no visitors, he was left isolated, bewildered and depressed, often calling out in anguish, “I want my mum. I want my mum.”

Jamie was a warm and affectionate young man who loved touch, kinaesthetic learning and being with people. His mother was denied access to her child, and I cannot begin to imagine what it must have felt like, knowing that her son was denied the care of his family for months—denied a hug, denied the comfort of a warm hand holding his, and denied dignity in his suffering. As a mother, my constituent felt powerless but sure that, had she been able to see him, she would have identified his decline and been able to intervene.

Underfed, Jamie wasted away, getting thinner and thinner in his confusion and isolation. Separated from those he loved and trusted, with multiple bedsores and open wounds left untreated, he began to withdraw within himself and into a catatonic state of unresponsiveness—a young adult with complex disabilities and care needs, left to suffer in silence. By the time his mother was able to see him, it was too late. She reflected on the lack of status that she felt as a mother, which she felt was shared by many family members. It felt to her as though families are often seen as a nuisance or even a threat, and they are sidelined and ignored by some in adult care homes. This mother also felt strongly that some adult care homes do not embrace the care of the whole person.

It might be helpful to colleagues to know that I intend to call the Front Benchers by 3.30 pm at the very latest. I would like to ensure that all colleagues get to speak today.

It is a pleasure to serve under your chairmanship, Ms McVey. I thank my hon. Friend the Member for Beaconsfield (Joy Morrissey) for securing this debate on such a hugely important topic.

Throughout the pandemic I have received devastating correspondence from my constituents, as I imagine all Members have, regarding the inability to see their loved ones in care homes. Although the restrictions placed on care homes are for the protection of the most vulnerable and their carers, the loneliness and isolation that people feel, especially those with dementia, has increased due to covid-19 preventing them from seeing their family and friends.

Although more needs to be done for residents with dementia and other diseases, I welcome the guidance that was provided by the Government last week, which sets out plans on how our care home residents and their families can be reunited. For areas such as mine that have experienced heightened restrictions for more than three months, the measures will help tackle the mental health and wellbeing of care home residents and reunite families.

Prior to those tougher restrictions being imposed in July, the images of family members being able to see one another again were truly heartwarming. The joy in the faces of residents and their families will stay with me for a long time. To have that taken away seems not only heartbreaking but cruel. I truly sympathise with all families and care workers who have had to endure that hardship.

Some care homes in my constituency are extremely limited as to what contact between families they can provide, with either limited window space for window meetings or limited telephones to speak to family members. One care home, which I will not name, has only one phone for residents, and that frequently does not work or is not answered.

Along with all Members, I agree that we need to tackle this pandemic but we also need to be fair in tackling it. I fear that is one factor that we are forgetting. It is more important than ever to use technology to help mitigate some of those issues, but a lack of understanding of how to use technology, on the part of residents and even staff, has prevented it from being fully utilised. What is being done further to mitigate those issues?

I thank the hon. Member for Beaconsfield (Joy Morrissey) for securing the debate and I congratulate her on her moving speech on Jamie’s behalf. I lived in her constituency through my teens, and in fact I stood against her predecessor a long time ago. My mother is still one of her constituents. She is living very much independently, but maybe one day I will need to go to the hon. Member for help with my mother regarding the issue that we are debating today.

I will also place on the record my thanks to those working in the social care sector. Their courageous work during the pandemic, delivering quality care in horrendously difficult circumstances, has not gone unnoticed. The pandemic has been difficult for everyone, but for those residing in care homes, or for those with loved ones living in them, it has been nightmarish. Over 40% of covid-19 deaths have taken place in care homes—more than 26,000 deaths. The combination of fear and isolation, coupled with a dearth of familiar emotional support, is creating a mental health crisis in our care home settings.

Recently, I received this letter from a constituent:

“Dear Alex, my letter is concerning my bedbound 81-year-old mother. who is currently resident at a care home in Leeds North West. My mother, Patricia, has been a resident for many years. Along with many families, we had no contact with mum over the course of the pandemic, apart from a very short video, which lasted around a minute, sent when requested at desperation in the early months of the pandemic.

We requested that should a window room become available, could mum be moved, so we could at least visit her from a safe distance without entering the premises. Six weeks ago, a room did become available and we have been visiting mum at a window since. Today, however, I was contacted by the care home manager to inform me that we can no longer visit mum.

It is a pleasure to serve under you as Chair in this important debate, Ms McVey. I thank the hon. Member for Beaconsfield (Joy Morrissey) for securing it and for sharing the harrowing story of Jamie from her constituency. It will stay with every single person who heard it.

I will begin my remarks, as others have done, by sharing a passage from a letter from a constituent called Penny Hutchinson. Her mother, Yvonne, is living with dementia in a care home in Halifax. She said: “Imagine that you had not seen your mum for eight months because she has been locked away in isolation with no meaningful family contact. Then imagine the huge feeling of relief and elation as restrictions are lifted and the vulnerable are told they no longer need to shield. Now imagine the feeling of complete desolation when you discover that those freedoms and privileges don’t apply to your mum and dad. Add to that the overwhelming feeling of guilt when you try to explain to your loved one why you can’t come in to see her, hold her hand or give her a hug, and that there is no end in sight.” I sent that letter on to the Secretary of State for Health and Social Care because it said more than I could have done on her behalf.

Like Penny’s mum, more than 70% of people living in care homes have a form of dementia. Visits from family members have a really important part to play in the cognitive state of those residents, but instead of being able to be close to loved ones at this anxious time, the best they can hope for is a socially distanced meeting behind plexiglass or outside in this weather. Although that is well intentioned, it can often cause confusion and distress.

Efforts to protect those who are older and clinically vulnerable by managing contact diligently will still of course have to be a priority in the coming weeks as we strive to avoid outbreaks in care homes and manage them where they have occurred. The Alzheimer’s Society has been keen to make it clear that for those with dementia, limiting visits in that way can lead to their symptoms increasing and their condition deteriorating more rapidly, ultimately leading to premature death, so a rebalancing of those risks is required.

It is a pleasure to serve under your chairmanship, Ms McVey. I offer sincere thanks to the hon. Member for Beaconsfield (Joy Morrissey) for securing this vital debate.

It is clear that many MPs have been contacted by worried—often terrified—constituents whose parents, children, relatives or friends are in care homes. I for one have felt utterly heartbroken listening to some of them describing the fear and isolation that they know their loved ones are experiencing, and I, too, have an example—one of many. The mother of my constituent Steph is in a care home. Steph is one of five children and for a long time they have each spent hours on end with their mother. They lovingly held her hands, combed her hair, remembered stories together and reminisced about the past. They were not just visiting their mum; they were providing essential care.

Eight months on from the arrival of coronavirus, Steph still cannot touch her mum. People like her all over the country cannot hug their mothers or fathers, children, siblings or friends. They still cannot hold their hands to comfort or reassure them. All that they can do is watch their often rapid decline, for just half an hour at a time, from a distance—perhaps from a structure in a garden, or sometimes through a closed window, or maybe a screen if they are lucky. Like Steph’s mum those vulnerable people are struggling to understand why their children and families cannot be with them. An entire lifetime of love and closeness is ripped away from them and torn apart. For every person affected, every single passing day is a precious day lost.

Now, as winter approaches and, predictably, we are in the second wave, there are still no guidelines in place to protect loved ones from dying not only in loneliness and isolation, but from it. The Government like to talk up their ambition in many other areas. We have all heard of Operation Moonshot, Nightingale hospitals and world-beating apps, but there has been barely a whisper about allowing family carers to be with their loved ones. The announcement of a trial period was welcome, but for many people it created an even greater desperation, because they could not see any end in sight for the enforced separation.

It is a pleasure to serve under your chairmanship, Ms McVey. I, too, thank my hon. Friend the Member for Beaconsfield (Joy Morrissey) for securing this vital debate and opening it so well. I also want to join in with the calls of thanks to the staff across the social care sector who have worked so hard for residents across the country. I send my thoughts and best wishes to all the residents, and their families and friends.

East Sussex has the highest proportion of care homes in the south-east, and yet our county has the lowest covid rate. That suggests that our care homes have stood up to the challenge and done a great job, despite the enormous task that was in front of them.

The challenge before us now is as follows: keeping vulnerable people safe without taking away their right to live their years in dignity, and in the company of family and friends. I have been helped by many residents across my constituency to put that dilemma into words. A contribution from Heathfield sums it up:

“In the care home where my partner resides, they allow two half-hour visiting slots a day. There are forty residents, that will give each resident one half-hour visit every ten days, even so it is still not enough. On each visit the loved one sits at one end of a room, the visitor at the opposite end and the carer in between…My partner’s mental health has remarkably deteriorated in the last few months, apathy and depression are more dominant on each visit. Every time we visit she seems more and more withdrawn and most likely feels abandoned by her loved ones because of the limited visiting.”

Last week, the Government issued revised guidance for visiting arrangements in care homes, to ensure safe access and visits by families and loved ones. The guidance proposed a range of options to create covid-19-secure care home environments and visits, including visits taking place outside and the installation of wall-to-ceiling screens.

It is a pleasure to speak under your chairmanship, Ms McVey. I thank my hon. Friend the Member for Beaconsfield (Joy Morrissey) for securing this important debate.

One of the harshest features of the restrictions that we introduced many months ago to stop the spread of covid has been for our constituents not to be able to visit their loved ones in care homes. I have received—as I am sure has every colleague in this place—many letters expressing the real frustration and angst that they feel because of the restrictions that we have introduced. The updated guidance released last week is welcome, and it attempts to address some of the concerns, but we need to bring an element of humanity and empathy to the guidance. I know that many in this room, and our constituents, will feel that something has gone wrong over the last few months.

I want to talk briefly about a family in my constituency whose situation is very similar to those already raised by other Members. There is a young man whose family live in my Warrington South constituency, but his care home is in Greater Manchester. While we did not have any restrictions in Warrington, he was existing under restrictions in Greater Manchester, and different approaches were being taken. I tried many, many times to speak to the director of public health in Greater Manchester about the issues facing this family. I must say, it was a real nightmare to communicate across different county boundaries and to try to have a one-to-one conversation with someone from the care home and with the people regulating that care home.

The young man did not get to see his parents for about five months in total. That is simply wrong. Not only did the young man not get to see his mum and dad, but mum and dad did not get to see their son. I can only imagine how awful it would be, as a dad, not to see my son for that length of time. I think we do need to think again about the way we have interpreted some of these rules.