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England – ‘3 tier system’

England has introduced a tier system in response to rising Covid-19 cases in different areas of the country. There are regulations for each of the 3 ‘tiers’ across England. These areas are referred to as either ‘Medium’, ‘High’ or ‘Very High’ depending on the Government’s view of risk.

You can read more about each of the regulations here:

There is not a huge difference between the tiers in terms of legal restrictions on contact or ‘gatherings’. The main difference is that in Tier 1 areas the gatherings can be up to 6 people, but in the other areas, there are rules on gatherings of 2 or more people.

Exceptions to the restrictions on gatherings apply where they’re needed for:

  • Work or providing voluntary or charitable services
  • To provide emergency help
  • To help one or two people in the group avoid injury or illness or escape harm.  (This could also mean the risk of harm to the sibling, not just to their disabled brother or sister)
  • To provide personal care or assistance to a vulnerable/disabled person (This could include help with eating/drinking, toileting, washing/bathing, dressing, and care of mouth/skin/hair/nails)

This means that as long as you meet one of the exemptions you won’t be committing an offence by taking part in a gathering. However the legal test is whether it’s reasonably necessary, not whether you believed that it was necessary. This means that it’s wise to have a solid reason to visit your disabled brother or sister.

Even in the High (Tier 2) and Very High (Tier 3) areas people are allowed to visit a person who is dying and also to accompany a relative to a medical appointment.  You can also visit someone who is receiving treatment in a hospital, hospice or care home.  This can be confusing as current Government guidance says that outside Tier 1, care homes should not receive visitors except in ‘exceptional circumstances’. Other living situations,  such as supported living arrangements aren’t specifically mentioned (click here for government advice for supported living providers). For many siblings, the rules regarding avoiding injury/illness and risk of harm are likely to be most important, particularly since ‘harm’ is not limited to physical harm, so could include mental distress.

Key considerations

Of course, just because the rules mean that a sibling can visit their brother or sister, it doesn’t follow that they necessarily ought to visit.

It should go without saying, that if a sibling has tested positive for Covid-19 (or has been advised by the authorities to self-isolate) then they must not visit their brother or sister until they’re clear (and could be guilty of a criminal offence if they ignore this).

Siblings should also think carefully about the purpose of the visit. They should think not only about the benefits, but also about the possible drawbacks of visiting.  Drawbacks could include things such as infection risk, brothers or sisters finding it unsettling wearing PPE or seeing family members in masks or visits being cancelled at short notice.  There may be difficulties if other family members or care providers have different views about visiting rules.

What to discuss with the care home

Siblings should bear in mind that there may be factors in the care setting which mean that any planned visit has to be rescheduled, possibly at short notice. This could happen if a member of staff or resident tested positive for Covid-19.  It would be a good idea to ask staff about their policies and procedures for visits. This might include previous negative tests, temperature checks, wearing PPE, location of visit, whether it needs to take place outdoors, what happens in poor weather, how long the visit will be and the practicalities of maintaining social distancing.

After a visit

If/when a visit has taken place, it would be a good idea for siblings to think about what happened, what worked or didn’t work,  so that they can decide whether to do anything differently on follow up visits.

When to make a complaint

If you feel that your visit is being refused unreasonably, you should consider making a complaint to the care home. It would be helpful to  involve your brother or sister’s social worker if they have one,  particularly if you feel that the lack of contact is posing a significant risk of harm to your brother or sister’s mental health. If you have other concerns, then it’s also important to share these, as the local authority has safeguarding responsibilities towards your brother or sister, and may want to inspect the care home.

Social care providers should also be taking account of the Ethical Framework for adult social care response to Covid-19 which emphasises the importance of having a person centred approach. Click here for the full document and click here for the easy-read version.



We are working hard to update this page, and include information on Scotland, Northern Ireland and Wales.

Our full guide ‘Covid-19: Useful information for adult siblings’ has the answers to our most frequently asked questions from adult siblings, including face-to-face contact, emergency planning, keeping in touch, going in to hospital, and more.

More information:

See also:


This page was last updated: 28th October 2020

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