Exploring the Experiences of LTCF Staff in Implementing Visitation Policies in England During the COVID-19 Pandemic

<b>Background:</b> Restrictions on family visitation to long-term care facilities (LTCFs) during the COVID-19 pandemic remain an area of contention for residents, family members and staff members. Current research has explored the experience of family members; however, fewer studies have explored the impact of visitation restrictions from the perspective of LTCF staff members. We examined the experiences of LTCF staff members in implementing visitation restrictions, including maintaining contact with families, in England over the course of the COVID-19 pandemic. <b>Method</b>: A sample of twenty-four LTCF staff members employed at eight LTCFs in one region of England was recruited. Qualitative, in-depth interviews were conducted with staff members to explore their experiences of implementing government policies during the COVID-19 pandemic. Thematic analysis was used to analyse data on maintaining contact and visitation with relatives. <b>Results:</b> Five broad themes were identified from the data. These were: (i) engaging with family members on visitation, (ii) facilitating visitation with family members, (iii) maintaining remote contact with family members, (iv) managing visitation restrictions with residents and (v) navigating equitable access for residents and family members. While some staff welcomed the introduction of national guidance on restrictions as a source to refer family members to for justification of the LTCFs' decisions to restrict access, others reflected on the negative effect of limited social contact on resident wellbeing and difficulties in implementing the guidance. At times, LTCFs felt conflicted in their responsibility for supporting family members in visiting at the same time as communicating, enforcing and policing visitation restrictions. Guidance on facilitating remote contact required substantial time and resources required to support it. <b>Discussion:</b> The extent to which restricting visitation was a proportionate response to reducing the spread of COVID-19, within the wider context of negative impacts on relatives and family members, is an ongoing debate. This study identified some of the challenges experiences by LTCF staff in implementing such guidance, and calls into question the practicality of restricting visitation. Further research is needed on how social contact can be maintained between relatives and their families during pandemics, which is both equitable and achievable.