SINGAPORE - Nursing homes have tightened their defences against Covid-19.

This follows the rise in the number of community cases, including that of a resident who tested positive after being discharged from Tan Tock Seng Hospital (TTSH) where a cluster has been detected.

It was reported on Friday (April 30) that the resident in question, a 77-year-old Singaporean woman, was admitted to Ward 9D in TTSH on April 22.

She tested positive on April 29, a day after being discharged to United Medicare Centre (Toa Payoh) Nursing Home.

Asked about the case, the Agency for Integrated Care (AIC), which has been supporting nursing homes during the pandemic, told The Straits Times on Tuesday that it has worked with the Ministry of Health to advise homes on the measures to protect their staff and residents.

It added that nursing homes had been implementing precautionary measures in line with these advisories.

AIC said that currently homes which do not have any suspected or confirmed Covid-19 cases have caps on the total number of visitors they can receive each day.

Each resident can pre-register up to four designated visitors but no more than two of them can visit at any one time. Visitation times are limited to one hour.

In addition, nursing homes with more than 100 beds have implemented split zones while ensuring that staff and residents do not mix across such zones.

Other safe management measures such as the use of personal protective equipment (PPE), safe distancing and TraceTogether-SafeEntry are also in place.

AIC said it also works with nursing homes to manage any suspected or confirmed Covid-19 cases, and will help set up a team comprising public health experts from the Ministry of Health as well as medical and nursing resources if need be.

The agency added that it also provides essential items such as hand sanitisers and contactless thermometers to the homes, and helps train staff in infection control practices.

In addition to the AIC guidelines, some nursing homes have also taken the extra step of turning away visitors who had recently been to TTSH.

Peacehaven Nursing Home executive director Low Mui Lang said that anyone who had recently received a text message about monitoring their health because they had been to TTSH or other places visited by infected individuals are barred from entering the home. Instead, they are encouraged to keep in touch with their loved ones through video calls.

Madam Low added that Peacehaven's staff are now working as split teams which are not allowed to co-mingle after working hours.

Other bigger operators of nursing homes are also taking additional precautions.

The head of clinical services at NTUC Health Co-Operative, Dr Goh Siew Hor, said that aside from turning away any visitors, vendors or volunteers who had been to TTSH's inpatient wards in the past 14 days, the group's three nursing homes are also monitoring all residents who had been to such wards during the same period for signs of acute respiratory infection.

"These residents were also segregated in ward rooms and underwent swab testing. Their appointments for visitors were temporarily deferred to prevent potential cross-infection. In addition, we contacted these residents' family members to explain the situation and assured them that their loved ones will continue to receive good care," said Dr Goh.

Lee Ah Mooi Old Age Home, which had a Covid-19 cluster last year with four deaths, has also put the guard up.

In addition to barring visitors who had recently been to TTSH inpatient wards, the home has banned visitors and residents alike from eating during visits to ensure that everyone keeps their mask on and maintain safe distancing.

"We have informed visitors to pass the food to our care staff and they will ensure that the resident consumes the food safely at an appropriate time," said the home's administrator, Mr Then Kim Yuan, on Tuesday.

He added that any visitor who persistently flouted the rules would be asked to leave the premises.

It is not just nursing homes that are tightening their defences. Dover Park Hospice, which cares for the terminally ill, has suspended all volunteering activities, along with home leave for its inpatients.

Its chief executive officer, Mr Timothy Liu, said that aside from barring vendors and visitors who had recently been to TTSH's inpatient wards, the hospice has, among other things, reduced the number of visitors per day for each patient from eight to five, with only two visitors allowed per patient at a time.

Meanwhile, welfare homes, which are overseen by the Ministry of Social and Family Development (MSF), have also been told to turn away visitors who had been to TTSH's inpatient wards, or were inpatients at TTSH regardless of their ward in the past 14 days.

An MSF spokesman added that over 80 per cent of residents and staff in the 11 welfare homes in Singapore had been vaccinated as at the end of April.

The spokesman said: "MSF will continue to monitor the situation closely and stay vigilant. We will adjust our measures in line with MOH's guidance as the situation evolves, to ensure that MSF Homes are safe and protected against Covid-19."