COVID-19 guidance for prison settings
Version 2.5

Recovery

Most people recover quickly, usually starting to feel better in a few days. Some people take longer and symptoms can affect the whole body.

SIGN has produced a booklet for anyone with ongoing signs and symptoms of COVID-19.

NHS inform provides a variety of useful information on long-term effects. 

Advice for people at highest risk

Some individuals are at higher risk of severe illness if they are infected with SARS-CoV-2, even when fully vaccinated.

This includes those with a weakened immune system.

View the Scottish Government COVID-19 advice for people who are immunosuppressed.

Scottish Government ended the highest-risk list of individuals in Scotland on 31 May 2022.

Pregnancy

View further information on COVID-19 and pregnancy on:

• NHS inform
• Royal College of Obstetricians and Gynaecologists (RCOG)

COVID-19 vaccines are recommended in pregnancy.

Ending self-isolation

Residents can end self-isolation if they meet all of the following criteria:

• five full days of isolation completed
• have been without fever for 48 hrs without use of medication (such as paracetamol)
• no longer feel unwell

When other symptoms have resolved, a cough or change to taste and smell is not a sign of ongoing COVID-19 infection. Further testing is not usually needed. These symptoms can persist for weeks in people who have had recent COVID-19. However, cough and fever can be symptoms of other infectious and non-infectious conditions and may require GP investigation if they do not improve.

On some occasions, the HPT may extend self-isolation. See the section on symptom vigilance and self-isolation during an outbreak for further information.

Guidance on discontinuing IPC precautions in community health and care settings for COVID-19-positive service users can be found in the NIPCM Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings  and from the local HPT.

Resilience planning

To reduce the spread of SARS-CoV-2, staff should follow measures in this guidance.

Plan ahead to prepare for extra demands on staffing needs due to outbreaks or staff absence.

This is known as resilience planning.

It should include:

• encouraging a high uptake of COVID-19 vaccine and annual flu vaccine amongst all staff
• a regular review of resources needed to support residents when they are unwell or in self-isolation
• time and resource required to follow NIPCM Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings  – this includes:
  • PPE use
  • good hand hygiene and cough/respiratory etiquette
  • increased cleaning
  • staff cohorting
  • training updates
  • guidance review

Workplaces and their staff should risk assess the infection risk, both within and outwith the workplace.

This is particularly important for small departments where even a few staff absences could have significant impacts on resilience arrangements.

To enable home working, hybrid working and safer office working, follow the Scottish Government advice in COVID-19 safer businesses and workplaces.

Prison staff working in more than one prison

If staff are required to work in more than one prison, a risk assessment should be documented.

During an outbreak, sharing of staff across prisons should cease and staff should only work in one prison at a time to reduce the risk of transmission.

Staff who have contact with a COVID-19 case

Staff who come into contact with a COVID-19 case are no longer automatically required to self-isolate. However, a risk assessment may need to be conducted.

The service manager should check appropriate IPC measures are in place, if the contact occurred in the workplace.

Staff need to be vigilant to COVID-19 symptoms at all times. This is very important during the incubation period after contact with a COVID-19 case.

If symptoms develop, see the measures for staff who become symptomatic or have positive PCR or LFD test.

Risk assessment

The service manager should risk assess the placement of staff who may be contacts of a case if there are any extremely vulnerable individuals in the setting.

This includes those who are severely immuno-suppressed. Risk assessment may result in a temporary change to location or tasks of work.

This applies regardless of where contact with a COVID-19 case occurred.

Staff who become symptomatic or have a positive COVID-19 test

Staff who are symptomatic should not attend work.

If symptoms develop at work, they should put on a FRSM and return home immediately.

Staff not eligible for testing

See Table 2 for testing eligibility.

See the stay-at-home guidance on NHS inform for more information. It also provides advice on other actions to take outside of the work environment.

Return to work

You can return to work when you feel better and no longer have a high temperature.

Staff with persistent symptoms should be risk assessed by their line manager when returning to work. This would be part of a return to work interview, as per usual processes. Particular consideration should be given to the placement of staff working with individuals at higher risk of serious illness.

Follow all relevant infection control precautions on your return.

Staff eligible for testing (prison healthcare)

See Table 2 for testing eligibility.

Staff should report the test result to their line manager.

If the test result is negative, they can attend work if they:

• are well enough to do so
  and
• do not have a high temperature

Positive LFD test result

If the LFD result is positive, the staff member should:

• stay at home
• not attend work
• avoid contact with other people for a minimum of 5 days after the day they took the test

Tests should only be taken by staff that are both:

• symptomatic
  and
• eligible for testing

Situations should no longer arise whereby staff return positive results even when they are advised not to test, since asymptomatic testing is no longer indicated except under the conditions outlined in Director's Letter (DL) (2022) 32. See Scottish Government social care and community-based testing guidance for more information on testing eligibility.

Symptomatic LFD test positive staff who are not eligible for testing should avoid contact with other people for a minimum of 5 days after the day they took the test, regardless of the presence of symptoms. Follow the advice on NHS inform.

Household members of the case should follow the advice on NHS inform.

Returning to work

The Director's Letter (DL) (2022) 32 outlines the requirements for HSCWs returning to work, in particular if they work directly with service users. Further testing is advised in these circumstances.

Risk assessing return to work when symptoms persist

As outlined in Director's Letter (DL) (2022) 32, if symptoms persist, line managers are advised to:

•  undertake a risk assessment, and;
• consider redeploying some staff members until 10 days after their symptoms started
  • if staff did not have symptoms, this would be 10 days after the day of their first positive test.

This may apply to staff who work with individuals at higher risk of serious illness despite vaccination.

For HSCWs returning to work, HPTs should have oversight of how risk assessments are being used to inform these decisions. They do not need to undertake the risk assessments.

New staff or agency staff

Service managers need to ensure that new and agency staff are adhering to all processes applicable to service staff, including training and advised vaccination. A documented risk assessment of the use of agency staff can support good governance.​

Testing

Proof of a negative SARS-CoV-2 test result is not needed prior to starting work.

Symptom awareness

Staff should not start work if they are symptomatic.

They should follow the >measures for staff who become symptomatic or have positive LFD test.

Infection Prevention and Control

Agency staff should follow the same NIPCM Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings as permanent staff.

Vaccination

Support all staff to become fully vaccinated as soon as possible to protect service users and other staff.

Vaccination status should not be a barrier to staff starting work in the setting.

Vaccination against COVID-19 is, however, strongly advised and work placements should be risk assessed.

Further information on testing

Symptomatic testing is only retained for eligible groups:

• in table 1 and table 2
• outlined in COVID-19: guidance for HPTs

Testing advice following confirmed COVID-19 infection

If prison healthcare staff or residents have had a diagnosis of COVID-19 either via positive LFD test or positive PCR test – they should not:

• use LFD tests for 28 days
• use PCR tests for 90 days

Day one is the day after symptom onset or the day after a positive test (whichever was earlier) if asymptomatic or displaying other non-cardinal symptoms.

The advice for symptomatic prison healthcare staff or those that have a positive COVID-19 test / symptomatic residents or those that have positive COVID-19 test should be followed if either:

• new symptoms of COVID-19 develop during the time periods defined above
• a positive test is returned after the time periods above

Contact the HPT for advice in complex situations.

Prison context for outbreak management

COVID-19 outbreak management should follow existing, well-established public health principles and practice.

Find out more information in the management of public health incidents – guidance on the roles and responsibilities of NHS-led incident management teams.

Local HPTs lead on the management of outbreaks in the community, when indicated, including prisons and other closed settings, according to their statutory duties under the Public Health Etc. (Scotland) Act 2008.  

The local HPT has a duty to support these settings in the management of the outbreak.

They make decisions on outbreak control using a population-based dynamic risk assessment approach. This considers the circumstances of the outbreak, the setting itself, and the individuals involved.

Definition of a COVID-19 outbreak

Two linked cases of the disease over a 14-day period within a defined setting.

Higher risk settings

Prisons are considered as higher-risk settings for outbreak management purposes. This is due to:

• the size of prison estates and their large resident and staff populations
• opportunities for infections to spread quickly throughout the facility due to the communal nature of the setting
• the higher proportion of residents originating from more deprived socio-economic backgrounds, as a risk factor for poorer health
• variable levels of vaccination coverage across the prison population

Staff can contact the local HPT if they need further advice.

Staff shortages

Staff shortages can quickly become an issue during an outbreak due to the size and nature of the setting.

Management teams should complete their resilience planning in advance for this eventuality.

Scottish Prison Service input during an outbreak may be useful in finding solutions to staffing shortages, based on a risk assessment approach led by the HPT.

Reporting outbreaks

Prisons should review reporting of notifiable disease cases and outbreaks to the Health and Safety Executive (HSE) under RIDDOR processes.

The local HPT should also be notified. Further information is available in the initial assessment section.

Initial assessment

If one confirmed resident case arises or two or more linked individuals develop symptoms of COVID-19 within 14 days in a prison, staff should:

• alert the local HPT who will carry out a risk assessment and investigate whether an outbreak is occurring – the level of response to an outbreak from the HPT will be based on the HPT’s risk assessment
• undertake a rapid internal review of the setting's risk assessment and mitigation measures. Consider any improvements to their implementation as a priority – see the NIPCM  Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings for IPC guidance

Where indicated, the HPT can review the services’ COVID-19 workplace risk assessment or other outbreak management plan.

These steps should be undertaken collaboratively with the setting and be used to develop an individualised action plan for outbreak management.

Identifying linked cases

The assessment of linked resident cases when considering any potential outbreak should include those individuals who are present in the location where a case has been identified. It should also include residents who have either been transferred from the setting to hospital, or elsewhere, or died within the same time period of 14 days.

Continue with symptom vigilance in staff and residents and robust application of IPC measures.

Local policies can be implemented for notifying a single staff case in agreement with the local HPT.

When investigating COVID-19 transmission in a setting and implementing mitigation measures, this should be decoupled from the identification of staff cases if no links are found.

Declaring an outbreak

Declaring an outbreak is the responsibility of the HPT.

An IMT may be convened and led by the HPT.

If not, support will be provided directly by the HPT.

Testing

Asymptomatic testing

Asymptomatic residents who were in close contact with a case and are well, should not be tested.

They should be monitored for the development of symptoms.

Testing in this circumstance can lead to unnecessary restrictions and is at the discretion of the local HPT.

Symptomatic testing

A resident with fever and/or new respiratory symptoms should have a PCR sample submitted for SARS-CoV-2 and if indicated, a wider respiratory panel of tests. Residents should be advised of the possibility of wider testing if this is needed as part of outbreak investigation.

This can include influenza and other organisms, in line with local diagnostic laboratory protocols.

PCR is the preferred test for symptomatic residents. LFD tests may also be used to support an initial risk assessment under direction of the HPT during suspected outbreaks.

When a cluster of symptomatic cases arises, it is good practice to submit samples for up to five symptomatic residents to confirm the pathogen.

Additional cases matching the outbreak case definition do not all need to be tested once the pathogen is identified.

There can still be a clinical need to test further cases – for example, to confirm the diagnosis in individuals with other respiratory illnesses or to determine eligibility for some treatments. See COVID-19: guidance for HPTs for more information.

Testing arrangements during an outbreak is at the discretion of the local HPT.

The HPT has autonomy to deviate from the guidance according to local circumstances and risk assessment.

Mass testing

Mass testing is unlikely to be justifiable in most circumstances since it can have unintended consequences. For example, prolonged periods of unnecessary self-isolation.

Any mass testing should be based on a risk assessment by the HPT/IMT. If undertaken, PCR testing is strongly advised, rather than LFD testing, due to increased sensitivity and potential to test for other respiratory viruses. However, when indicated, both may be able to be used effectively in combination, under the direction of the HPT.

Any cases identified should be cared for in line with advice provided in providing care for residents who are symptomatic or have a positive COVID-19 test.

If an asymptomatic resident tests negative but then becomes symptomatic, they should self-isolate. If an outbreak has already been declared and the organism identified, no further testing is likely to be needed.

Consideration should be given regarding the need to inform local microbiology laboratory services where it is anticipated there will be a large volume of samples received.

More information on testing those with recent COVID-19 infection can be found in further information on testing.

Infection prevention and control measures

A number of outbreak management measures are available, as advised by the HPT.  

These include, but are not limited to:

• regular monitoring of resident's symptoms
• isolation of cases
• appropriate PPE use
• reinstating of admission testing or where this already exists, its reinforcement
• a temporary closure to new admissions
• enhanced cleaning
• restrictions to visiting
• cohorting of residents and staff
• a temporary reintroduction of physical distancing
• pausing of normal daily activities or services - for example, education, hairdressing etc

See the NIPCM Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings for advice on these measures.

Symptom vigilance and self-isolation

Staff and residents should remain vigilant for development of respiratory or other COVID-19 symptoms and be encouraged to report these immediately. This enables isolation and PCR testing for symptomatic residents to be initiated as early as possible - minimising prolonged transmissions and restrictions.

Barriers to reporting symptoms may exist, such as a desire to avoid isolation or testing.

Residents with COVID-19 symptoms require isolation for a minimum of 5 days from symptom onset, whether they have accepted PCR testing or not. Careful consideration may be needed to extend this further in an outbreak, taking the incubation period into account. Extension of isolation periods must be balanced against the risks that this can cause, for example, loneliness, psychological distress and resident unrest.

In exceptional circumstances, the HPT/IMT leading the outbreak response may advise that contact tracing of staff or residents is undertaken. SPS may be asked to support this.

Table 3a and 3b contains additional considerations for case and contact management during an outbreak. The HPT/IMT will advise on appropriate measures and may deviate from those outlined in Table 3a and 3b, due to their risk assessment.

Admissions/transfers

If COVID-19 cases start to appear in a wing, prisons may decide to operate household cohorts (see resident cohorting advice) after the admission phase.

If one member of a household cohort becomes symptomatic and is isolated pending PCR test result, increased symptom vigilance is recommended for all members of the household.

During an outbreak, the admission/transfer of residents within or out with the facility should be avoided where possible. A risk assessment should be undertaken to ensure all required IPC measures are in place.

Cohorting

Resident cohorting

Cohorting may be considered where there is insufficient accommodation to allow cases to isolate in single cells.

Principles for cohorting include:

• cohorting confirmed cases together is possible
• contacts can be cohorted together if indicated by the HPT
• contacts should not be cohorted with cases
• cohorts should be as small as is operationally possible
• those at highest risk from COVID-19 should not be cohorted with others

The IMT may advise for the prison to be temporarily closed to admissions and transfers, e.g. if there are not enough cell numbers to support cohorting during an outbreak.

Staff cohorting

Wherever possible, teams of staff should be assigned to care for residents in different cohorts.

Movement of staff between cohorts should be avoided.

Exceptionally, staff may need to work between residents with COVID-19 and residents who do not have COVID-19.

Efforts should be made to see the residents who do not have COVID-19 first. 

Regime groups

Residents can be assigned to a regime group. These are made up of different households.

They take exercise and domestic periods together. The operation of regime groups may be constrained in an outbreak.

All regime groups are advised to maintain physical distancing and wear face coverings during an outbreak.

If one member of a regime group becomes symptomatic, members of their immediate household cohort or regime group may require isolation and testing. This will be risk assessed by the HPT.

Visiting arrangements

See when there is a COVID-19 case or an outbreak has been declared.

Using communal spaces

Sometimes it is possible to manage selected areas of a facility as a separate unit or units, with no shared activities or staff.

Unaffected areas can continue with normal arrangements, with an increased vigilance for any contact links or symptoms in their residents or staff.

Communal areas may need to be more closely supervised to ensure residents who are symptomatic or confirmed cases do not mix with others.

Keep communal areas open for use by residents who are not identified as cases or symptomatic of COVID-19 – this is the default position during an outbreak if it can be arranged by staff.

If outbreak measures prove particularly challenging to implement or staffing capacity is low, communal areas may not be able to be used temporarily.

They should be reopened as soon as practical.

Transfers

Transfers to and from the prison may be reduced or paused during outbreaks. This is on the advice of the IMT and in agreement with the prison Governor.

Individual risk assessments for transfers during an outbreak should be undertaken and may involve LFD testing (or PCR if the resident is symptomatic).

Consider the:

• service user's tested or presumed COVID-19 status
• size of the outbreak
• spread within the setting
• units which are affected
• physical layout of the building
• vaccination status of the individual and coverage at the setting

Seek support from the local HPT managing the outbreak.

Any resident who is a possible or confirmed COVID-19 case should not be transferred. There are exceptions to this if transferring for medical care or during an operational emergency. Appropriate mitigations should be in place. See managing self-isolation in prison settings for more information on transfers to hospital during self-isolation.

Advise any receiving service, for example a hospital ward or ambulance, of the IPC measures needed for each service user they support.

Resident transfer across services may benefit from a multi-agency approach for challenging service user movements.

This could involve having a conversation between key services when needed.

Reviewing control measures

Control measures should be reviewed by the IMT. This may include a visit to the prison setting by:

• the local Health Board HPT
• IPC team
• Local Authority Environmental Health professionals
• other relevant partners

Declaring an outbreak over

For HPT to declare an outbreak over

There should be no new linked symptomatic or confirmed COVID-19 cases for a minimum period of at least 14 days from last possible exposure to a case, whether in a service user or staff member.

The HPT should also consider whether:

• existing cases have been isolated or cohorted effectively
• guidance on IPC and other interventions is being applied appropriately

Sufficient staff to enable the setting to operate safely using PPE appropriately are needed.

Staff working in the service should enable the return to routine visiting, if this is still paused, once the outbreak has been declared over by the HPT. 

Admissions or transfers to prison settings

Respiratory screening

Prison settings are advised to consider appropriate admission / transfer processes, depending on local arrangements. As a minimum, the respiratory screening questions in Appendix 3 of NIPCM Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings should be undertaken and acted upon prior to admission/transfer.

If a resident answers 'yes' to any of the respiratory screening questions - see residents who are symptomatic or have a positive COVID-19 test for information.

Processing admissions

Prisons may wish to consider and implement an admission process that cohorts new admissions or transfers (10 days recommended) before they join the general prison population.

Residents can be grouped into a household cohort by day of admission or individual cells, if needed and advised of symptom awareness.

Residents are encouraged to wear a face covering and physically distance, if they leave their household cohort.

COVID-19 vaccination status should also be checked, and vaccinations offered as appropriate, as soon as possible.

Protecting those at highest risk

Residential facilities should also conduct a risk assessment for their facility to determine if there are residents who are at highest risk of severe illness.

Consider whether additional measures are needed to protect these individuals if COVID-19 cases arise in the setting.

Admission testing

Table 1 contains testing advice for residents being admitted or transferred to prison settings.

There may be circumstances when a local risk assessment determines that asymptomatic testing should be undertaken for admission or transfer purposes.

For example:

• as an outbreak control measure
• when vaccine uptake rates are sub-optimal
• when there are particularly high levels of SARS-CoV-2 circulating in the community

Symptomatic/COVID-19 positive residents

PCR testing is recommended for symptomatic individuals in prison settings. If a newly admitted resident becomes symptomatic or tests positive, self-isolation should commence in their own cell immediately. They should self-isolate for a minimum of 5 days.

Residents can be released from self-isolation if the test is negative, following clinical assessment for possible other infections.

Contact tracing may be considered, even though it is no longer routinely part of the prison management of COVID-19. Any resident who has shared a cell with a case during the symptomatic period from and including the 48 hours prior to onset of symptoms in the case, is advised to be vigilant for symptoms and report these if feeling unwell.

Meals and healthcare interventions including medicine dispensing should be provided for residents within their cell. TBPs should be applied by staff entering cells during this time.

A risk assessment should be conducted when it is deemed that a symptomatic resident may need to leave their cell, for example, for the purpose of attending a healthcare appointment.

Where all single cells are occupied and cohorting of residents by 'household' is unavoidable:

• Those with possible COVID-19 should not be placed with confirmed COVID-19 residents.
• Possible cases who are still awaiting test results should not be cohorted together.
• Those with confirmed COVID-19 can share double occupancy cells.

Admissions to prison settings from hospital

Residents who have been admitted to hospital for non-COVID-19 related reasons are not required to be cohorted on return if infection control measures are followed throughout their hospital stay, and:

• they are not a COVID-19 case
• they have answered 'no' to the respiratory screening questions in Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings

Confirmed COVID-19 cases who have completed at least 5 days of the 10 day hospital self-isolation period should be clinically assessed before transfer to the prison.

They should be:

• showing signs of clinical improvement
• fever free for 48 hours without using medication such as paracetamol

This is subject to a risk assessment with the support of the HPT. This should consider if there is single cell accommodation available to complete their self-isolation period on return to prison, if needed.

Self-isolation is not required on re-admission to the prison if at least 5 days of self-isolation has been completed in hospital. This is providing the additional criteria for ending self-isolation in prison settings has been met.

Court attendance

Those who have confirmed or possible COVID-19 should not attend court. The court should be informed as soon as possible in these circumstances.

It is the responsibility of the prison establishment to inform any impacted court(s) of a COVID-19 outbreak in their prison.

Any court transfer must follow safe escort and transfer protocols ensuring that IPC measures are fully adhered to as specified in the NIPCM Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings.

Virtual court attendance is advised whenever possible for residents who are symptomatic or COVID-19 cases. HPTs can support prison healthcare staff in facilitating this and ensuring IPC measures are maintained adequately. IPC should not be a barrier to the use of virtual courts.

A risk assessment may be necessary for any court attendance where a breach in the above measures has occurred, whether to an outside court or a virtual one, to determine whether resident isolation or testing may be required.

Home leave

The local prison and HPT, with support from SPS when needed, will liaise and develop suitable processes for home leave to be put in place during outbreaks. The guidance on Staying Safe and Protecting others from Scottish Government should be followed during home leave as for the general public.

Residents should inform the prison prior to their return or on return to the prison if they become aware that they:

• have been in contact with a confirmed COVID-19 case whilst on leave
• are symptomatic
• are COVID-19 positive

SPS will arrange transport for this process and organise any self-isolation and testing requirements if required.

Escorting residents between settings

Escorting of residents to courts, other prisons, and hospital is routinely carried out by an escort contractor who will follow their own COVID-19 guidance, which is expected to be aligned with this guidance.

In some instances, such as a medical emergency, prison staff may escort a resident to hospital from prison, rather than the escort contractor.

Escorting symptomatic residents

All escorting staff should follow general measures such as physical distancing where possible and hand hygiene. Where staff are required to share transport, FRSMs should be worn. Escorting staff should follow PPE guidance the NIPCM Appendix 21: COVID-19 Pandemic IPC Controls for Health and Social Care Settings  and adhere to SPS operational policy.

In addition, hospital staff may advise on further PPE required, which may be ward specific. Escorting staff would be expected to comply with such requests.

Any vehicle used to transport a possible or confirmed case will need to be cleaned and disinfected using methods outlined for environmental cleaning before and after use.

Escorting services often operate a 'hub' for COVID-19 issues. GeoAmey can be contacted via their Operation Control Centre: 01698 451738. The SPS Escort Monitor Team (SPSEscortMonitorTeam@prisons.gov.scot) should be informed of any issues.

Liberations

The SPS has no legal authority to detain an individual past their liberation date. Prepare for release in advance and work with key partners to organise this.

Standard pre-release planning should be followed for residents who are not COVID-19 cases. This includes during an outbreak.

For those who are a COVID-19 case and still in isolation, or where there is an outbreak, liaison with key partners and any household setting to which the resident is being released, is essential. Consent of the resident to disclose their COVID-19 status should be sought before disclosure to others. If consent is withheld, other arrangements may have to be made until the period of infectiousness is complete. The local HPT can support this process.

Completion of vaccination course should be offered prior to liberation.

If support with transport or housing is needed, SPS and Local Authority respectively, have roles in supporting arrangements, particularly for individuals who may still be within their infectious period. A case conference before release involving SPS, the HPT and the local authority should be considered for complex cases.

Advice for visitors

Visitors should:

• not visit if they have been identified as a COVID-19 case or aware they have been in contact with a confirmed COVID-19 case or if they have symptoms of an infectious disease
• be strongly encouraged to complete a course of COVID-19 vaccination if eligible - though this is not obligatory for visiting
• perform hand hygiene on entry to the facility and again on leaving the facility
• not touch their face or face covering once in place, wherever possible – individuals may choose to wear face coverings
• observe physical distancing where possible to other residents and staff, if the area is crowded
• remain in areas demarcated for visiting