Priors Mead - Garden Visit Declaration
Prior to each Garden Visit, could the person organising the visit (the Organiser) please complete this form once the date and time has been agreed, but before the visit happens.

Once you click 'Submit', your responses will automatically be sent to the home.
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E-Mail-Adresse *
Your Name *
The name of the person completing the declaration and arranging the visit (the Organiser).
Your Mobile Phone Number *
Please make sure you have this phone with you for the visit.
Person Being Visited *
Please give the name of the resident you will be visiting.
People Accompanying You *
Please give the first and last name, and phone number of anyone who plans to accompany you on this visit. If this changes prior to the visit, please resubmit the form.
Date and Time of Visit *
Who Did You Book With *
Please give the name of the person you booked with, who will send you a confirmation email.
Guidelines for Visit
Internal, External or Pod Visits still requiring booking with the following times:

11:00am - 12:00pm
14:00pm - 15:00pm
16:00pm - 17:00pm
17:00pm - 18:00pm

The maximum number of persons who can visit at one time is four (4) internally and an additional four (4) externally.  No allocated person/s are required and children will count within the total number.

We have opened up the Homes to Ground Floor access only, bedrooms won't be accessible throughout all floors. During COVID we’ve kept to a consistent cleaning schedule and we’d like to maintain this during daily internal visits ensuring everybody is safe.
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We understand most would’ve completed their vaccination programme, but to obtain access internally we would require family and friends over 18 years of age  to have their 1st Vaccination as a minimum, and a 2nd by 2nd November 2021. Evidence will be requested via NHS COVID Pass App, NHS Vaccination Card & this declaration - Please show this upon attending.

Visits will be conducted in line with current government guidelines if applicable. These will be confirmed to you when you book.
To book, please phone the home who will confirm your agreed visit time by email. Please do not consider any visit as booked until you have received this confirmation email.

Prior to your visit, please ensure that you are symptom free.

You will need to complete a Lateral Flow Test to confirm you are Covid-19 negative prior to entering the home.

You will be supplied with appropriate PPE and given guidance in how to wear it. Within the services, we will still be asking employees, families and relatives to maintain wearing face masks until further notice. This won't be required externally and can be removed internally for clients who require you to lip read or supporting communication.

You should arrive in good time for the visit, as stated in the confirmation email. The duration of the visit will be specified in the email. If you arrive late, the visit must end forty minutes after the scheduled start time to give time to prepare for the next visit.

A member of staff will come out to conduct your Lateral Flow Test and assist you with PPE before entering the Home. We will accept LFT Tests or PCR Tests completed within a 48 hour period.

We ask that anybody entering the building will make use of the alcohol gel before walking around the service. If you are completing an external visit and wish to use the toileting facility, you will be requested to complete a LFT before entering the home

If the resident requires assistance for whatever reason, the carer will deal with this and may ask you to leave so they can focus on whatever situation has arisen.

The carer or manager will give you two-minutes notice of the meeting ending, please keep in mind others might have booked after.

If you bring any gifts, please hand them to the carer and we'd be happy to wipe this down for you.

Guidelines Declaration *
I, the Organiser, declare that I have read and understood the guidelines above, and undertake that I and anyone visiting with me will abide by them.
Health Declaration *
I further confirm that I and anyone visiting with me are Covid-19 symptom-free, has received a clear test if previously infected, do not have any other infectious diseases, and has not knowingly been close to any infected person in the last fourteen days. I also undertake to immediately inform the home if I or anyone visiting with me becomes symptomatic within fourteen days after our visit.
GDPR Declaration *
By ticking the 'I Agree' box and submitting this form, I give permission for all or part of this data to be held on both computerised and manual records, which I may request access to.
Date Form Submitted *
Version
vPM.4.1.D - 19.07.2021
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