Consultation outcome

Stopping movement of staff between care settings: response to consultation

Updated 29 June 2021

Introduction

The government hosted a public consultation from 13 November to 23 November 2020 (with a further 2 days for respondents accessing an easy read version of the online consultation) regarding proposed new regulations to limit staff movement between care homes and other health and care settings.

This document summarises the responses to that consultation and sets out the government’s response to the issues raised.

The proposal the government consulted on was to:

1. Create a temporary requirement that CQC registered care home providers do not deploy staff to provide personal or nursing care if they are, or have in the previous 14 days, been carrying on a regulated activity in another health or social care setting (further details on which groups are excluded is set out in this document).

2. Provide a limited temporary exception to the requirement in order that care home providers can continue to ensure enough staff are available to care for service users safely. This would allow providers to use people who are also being deployed in another health or social care setting, but only for a reasonable period of time to allow the provider to make other arrangements to enable them to comply with the requirement.

The Statutory Instrument (SI) would have been made under the Health and Social Care Act 2008.

The government is grateful for the responses received from individuals and organisations and values the comments and views submitted. All the responses have been recorded and analysed. The following sets out a summary of the views received and the government’s response.

Analysis

Where required, responses to the open, qualitative questions were categorised according to topic and sentiment in order to enable descriptive statistical analysis. This involved identifying the emerging themes and topics in the responses and coding them in the topic groups identified. This identified key themes in the responses across the questions as well as generating the main areas of focus and interest within each topic group.

Where respondents made specific suggestions not captured in the consultation questions, these were identified and noted for the response.

Breakdown of respondents

A total of 1312 responses to the online consultation were received through the GOV.UK consultation page with additional written responses.

Over half of responses were from adult social care or health care service providers. This included 44% of respondents replying as providers of care home services, 10% from other care services, and 3% from health care providers.

Over a quarter of respondents (26%) told us they responded as a member of the social care workforce. A further 2% told us they responded as health care workers, and approximately 3% of respondents stated that they were responding as an agency worker or an agency employing agency workers.

3% of respondents answered as an individual who receives personal care and support, or as their family, friends or carers.

Government response

The government has decided not to progress with amending regulations to require care home provides to stop staff movement at this time. However, restricting the movement of staff between care settings remains essential to prevent the spread of COVID-19 in care homes. The government has published updated guidance on restricting staff movement between care homes and other care settings. This guidance makes clear that routine staff movement should not be taking place. In those limited exceptional circumstances where staff movement is necessary to ensure the delivery of safe care, the guidance provides examples of how to mitigate the risks of this with frequent testing.

In the consultation some respondents called for an increase in staffing capacity instead of regulation to achieve the goal of reducing staff movement except in exceptional circumstances. We have recently announced £120 million of new funding to help local authorities to boost staffing levels. The purpose of this funding is to enable local authorities to deliver measures to supplement and strengthen adult social care staff capacity to ensure that safe and continuous care is achieved. This includes supporting providers to restrict staff movement between care homes and other care settings by, for example, increasing the utility of the existing workforce by paying overtime or for childcare costs. More detail on this funding is available in the Workforce Capacity Fund guidance.

Consultation response

General

Overall, several respondents acknowledged the government’s imperative to do everything it can to minimise the risk of infection of COVID-19 and other viral illnesses in care homes.

The majority of respondents (56%) believed that the proposed requirement had the potential to reduce staff movement, although around half of the respondents who expressed this (29% of all respondents) felt that changes to the proposals would be needed.

Examples of concerns about the proposal included:

• confusion about the scope of the regulations and which staff and/or locations it would cover

• the impact it could have on staffing levels and the impact on the provision of care to residents

• the cost of implementing the proposed regulation

Many respondents also flagged the potential for other methods of managing movement, notably through infection prevention and control (IPC) best practice.

Scope of the requirement

The consultation asked respondents to identify whether any specific roles or settings should be excluded from the proposed regulation. Some respondents suggested there should be no exclusions beyond those already proposed (registered managers and individuals deployed to undertake tasks other than delivery of personal or nursing care), while some others responded that the proposal should not go ahead in its entirety. However, many respondents did suggest additional exclusions, with examples including specific job roles within social care, particularly nursing or exempting homes based on, for example size or the nature of their service.

Additionally, respondents raised concerns around undergraduate or postgraduate clinical students on placement in social care settings needing to pause their training or lose their only income source.

Implementing the requirement

Most respondents (86%) believed that the proposed requirement would be difficult to implement, and that the limited temporary exception would need to be used at least weekly (68%).

Some respondents expressed concern regarding the logistical difficulty of implementing the proposal and the extra costs that could be incurred. Some responses, including those from providers, interpreted the proposals as a ban on the use of agency staff, or that it would prevent them from maintaining safe staffing levels.

Impact on individuals and businesses

The consultation asked for views on whether there were groups of people, particularly those with protected characteristics, that might be impacted by the new requirement. The main areas of concern raised in the consultation responses were the high proportion of women in the workforce and that those from black, Asian and minority ethnic communities were more likely to be significantly impacted.

Several respondents raised concerns regarding the lost incomes of those adult social care workers who need to give up one or more jobs to enable care home providers to comply with the proposed regulation and the potential for this to lead to financial hardship. This led several respondents to suggest compensation for those social care workers who may lose earnings.

A similar question was asked about the impact on businesses. The concerns raised included the cost to providers of implementing the regulation, including the challenge in rural locations to recruit additional staff, and additional administrative burden on care home managers to manage workforce shortages.

Ensuring continuity of care

The consultation asked respondents to identify any concerns about the impact of the proposed requirement on the ability of care home providers to maintain a safe service.

82% of respondents told us that they have concerns about the impact of the proposed requirement on the ability of care home providers to maintain a safe service. In the main, the responses raised concerns about providers’ inability to maintain safe staffing levels and the compounding effect of the proposed regulation on existing staff vacancies and absences.

This section of the consultation also asked for views regarding potential conflicts between the proposed requirement and other statutory requirements on care home providers. Out of the people that provided information explaining their answer to this question, the most common concern was that the proposed requirement would risk conflict with regulations to ensure safe staffing levels.

Views of those receiving care services and their family regarding provision of care

While all respondents were given the opportunity to answer all questions in the consultation, this section was aimed at gathering the views of those who are currently receiving care services and their family, friends or carers; however, all responses were read and considered. Of those who responded as an individual who receives personal care and support (or are their family, friends or carers) half of those respondents (50%) told us they had concerns about the current situation where stopping staff moving between settings is advised but is not a requirement in law. 75% of care recipients and their families said they were concerned about the impact of the proposed requirement on the ability of care home providers to maintain a safe service, and 50% were concerned about the limited temporary exception in the proposals.

While some of the responses from care recipients and their families reflected the feedback described elsewhere in this response, particularly regarding safe staffing levels and the impacts on care workers’ incomes. However, their responses also provided some concerns and considerations not covered elsewhere in this consultation response, including the potential for residents to be cared for by people unfamiliar to them and the impact on visiting relatives resident in a care home.