Video report by ITV News Political Correspondent Paul Brand
The majority of care homes in England won’t fully reopen to visitors despite a change in the government’s guidance, a survey has suggested.
The survey - carried out for ITV News by the National Care Association - found most homes will allow families to see their residents outdoors but not indoors, as the advice is altered across the country.
While the advice is that outdoor visits are preferable, it also allows for indoor visits from the same one family member if PPE is worn, which would allow residents to see their relatives during the winter months.
However, a survey of 41 care providers for ITV News found the vast majority will not fully reopen. While most will allow outdoor visits, only 8 said they would permit people to come inside.
26 providers said the government advice wasn’t clear, with only 15 saying they fully understood it.
In Sheffield, Palms Row Health Care Director Nicola Richards, is building pods for residents to meet their relatives outside, but is refusing entry to the home.
"Given what many providers have been through, we're extremely nervous about opening up to visiting at the moment," she said.
"We want to open up, but there's issues around that which we're worried about," she added.
ITV News filmed the touching moment one care home resident in Bolton was reunited with her daughter for the first time in four months.
Deborah Fisher said it felt like she had "won the pools" being able to sit with her daughter.
While she still misses her grandchildren terribly, she it was "wonderful" to be able to sit with her daughter in a gazebo set up outside her care home.
But indoor visits are particularly important for many residents who have mobility issues or are bed bound.
Almost all of them have been unable to see their families for five months now, except for in very rare circumstances.
There is anecdotal evidence from care homes that those with dementia have suffered especially, with the lack of contact worsening their condition.
In Bolton, Farnworth Care Home regional operations director Sarah Willets has built a visitor’s room indoors, with painstaking precautions including a dividing screen, PPE, constant sanitising and temperature checks to eliminate as much risk as possible.
But she believes it’s a balance.
She says visits from loved ones are "so important" for residents at her home.
"It affects their health and wellbeing, how they feel about themselves," she said, "and the last few months have been difficult."
"At the moment, our top priority is still preventing the transmission of Covid-19, but we also need to balance that with the health and wellbeing of our residents.
"So we've built these visitors rooms to keep them as safe as possible, but also enable those face to face visits."
She said staff at her home are doing "everything" they can to minimise the risk of infection by providing PPE, doing full screening on visitors before meeting residents and following all the guidelines.
"We believe that the transmission risk is as low as we can possibly make it, whilst balancing the wellbeing of the residents."
There are also concerns among care home managers about insurance policies not covering coronavirus infections and deaths - our survey has confirmed the worries are widespread.
35 respondents said they were concerned their policy wouldn't cover residents or visitors becoming infected, while 32 said their policies would not cover any claims made over deaths relating to coronavirus.
Nicola shared her concerns about care providers being unable to find cover upon renewal.
She said: "We're raising this at a national and local level, but we are worried that exclusions apply to care homes at the minute, which is really unhelpful and will force lockdown for a longer period of time."
"We can get renewal for insurance, it's the renewals around Covid at the minute that are causing problems for many providers," she added.
She believes the issue around insurance is "being ignored at the moment" and says "that should have been a priority before we then allow visiting back into care homes".
By issuing guidance for care home visits, without addressing insurance concerns, Sarah believes the government put "pressure on providers to open sooner than they should do".
Reporting on the crisis in care homes from Paul Brand:
However, our survey reveals that trust between the government and the care sector has deteriorated to such a degree that many homes are reluctant to follow the advice to reopen. 33 care providers told us they didn’t think the government had handled the crisis well, only 7 said it had.
And today an influential committee of MPs agreed.
Committee Chair Meg Hillier told ITV News the care sector was an "afterthought" for ministers when planning the coronavirus response.
The Labour MP said care homes were used to "support the NHS" but did not receive "proper support" themselves in terms of PPE, testing or guidelines from the government.
She says a "lack of understanding" around infection control in care homes was a "critical" factor in what led to the crisis in care homes.
"It was reckless not to plan for that in advance - you take a decision in one area, it will have a knock on impact elsewhere.
"This knock on effect was devastating and people lost their lives as a result," she said.
Ministers have rejected the criticisms of the PAC report, with Culture Secretary Oliver Dowden defending the government by saying there were 40% less discharges from hospitals into care homes than the previous year.
"I don't accept the characterisation of the Public Accounts Committee," he told ITV News.
"We were in the middle of a pandemic and we were being accused of checking people out of hospitals into care homes carrying Covid.
"Actually, there were fewer people discharged from hospital into care homes during that period than in the previous year," he said.
He appeared to concede errors had been made, but said they were addressed "immediately".
"Of course there were challenges in care homes and we accepted those challenges, we've accepted there were lessons to learn. And indeed we took action immediately."
Death has not been the only damaging aspect of the coronavirus crisis in care homes.
One resident told us today that Covid-19 had left him feeling “trapped in a prison”.
As winter approaches, each home must strike a balance between locking out the virus without making its residents feel locked in.
A Department of Health and Social Care spokesperson said the survey was of a "tiny fraction" of care providers and "therefore not representative".
They added: “We have worked hard with the care sector putting an extra £1.3 billion in to support the hospital discharge process, providing 172 million items of PPE and testing all residents and staff, including repeat testing for staff and residents in care homes for over 65 or those with dementia.
“We know how important it is for families and friends to be able to visit their loved ones, and the latest guidance sets out how families and residents can safely come together again."