Guidance

Guidance for those who provide unpaid care to friends or family

Updated 4 May 2021

Applies to: England (see information for Wales, Scotland and Northern Ireland)

Who this guidance is for

This guidance is for anyone in England who cares, unpaid, for a friend or family member who, due to a lifelong condition, illness, disability, serious injury, a mental health condition or an addiction, cannot cope without their support.

It builds on other guidance published on GOV.UK, including:

• (COVID-19) coronavirus restrictions: what you can and cannot do
• guidance for households with possible coronavirus infection

Young carers and young adult carers

The guidance may also be helpful for those under 25 (young carers and young adult carers) who provide care for someone. The information and advice provided is designed to help young carers understand the changes they need to make and signposts the help available during the coronavirus (COVID-19) outbreak.

You are a young carer if you are under the age of 18 and look after or care for someone who needs support with daily life. A friend or family member (parent, brother, sister, grandparent or other relative) might need support because of illness, disability, serious injury, mental health condition or an addiction.

If you are over 16 but under 25 and look after or have caring responsibilities for someone else, you are a young adult carer. You may or may not live with those you care for.

If everyone is well, you can continue to provide essential care and travel to deliver this care. See information below on what to do if someone has symptoms or a positive test for coronavirus.

General advice

Coronavirus restrictions

The government has published the COVID-19 response – spring 2021 setting out the roadmap out of the current lockdown for England. This explains how restrictions will be eased over time.

Some of the rules on what you can and cannot do changed on 12 April. However, many restrictions remain in place.

Protecting yourself and the person you care for

If you, or the person you care for, have no symptoms then please refer to the guidance on hygiene on the NHS website, which says:

Do:

• wash your hands with soap and water often, for at least 20 seconds
• use hand sanitiser gel if soap and water are not available
• cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
• put used tissues in the bin immediately and wash your hands afterwards
• clean objects and surfaces you touch often (such as door handles, kettles and phones) using your regular cleaning products
• consider wearing a face covering when in shared spaces
• keep windows open in the room you're staying in and shared spaces as much as possible

Do not:

• share towels, including hand towels and tea towels

Please see specific situations below for what to do if you or the person you care for display symptoms.

Getting vaccinated

For the first phase, The Joint Committee on Vaccination and Immunisation (JCVI) has advised that the vaccine be given to care home residents and staff, as well as frontline health and social care workers, then to the rest of the population in order of age and clinical risk factors. Included in this are those with underlying health conditions, which put them at higher risk of serious disease and mortality.

Some carers are now included on the vaccination priority list in group 6. Those who are eligible for a carer's allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable, should be offered vaccination in priority group 6, which includes unpaid carers. Make sure you are registered as a carer with your GP and read more on vaccine advice for carers.

Vaccines are not currently licensed for children under 16 years of age. If you have any concerns or questions regarding vaccination, please see:

• GOV.UK
• the Green Book information on vaccines and vaccination procedures

Or contact your GP or relevant health practitioner or service.

What you should be doing to prepare

We advise all carers to create an emergency plan with the person they care for, to use in circumstances where help from other people to deliver care may be needed. Depending on the circumstances, this could be help from family or friends, or a care provider.

To create an emergency plan that fits the needs of the person you care for, you will need to set out:

• the name and address and any other contact details of the person you look after
• who you and the person you look after would like to be contacted in an emergency
• details of any medication the person you look after is taking
• details of any ongoing treatment they need
• details of any medical appointments they need to keep

You should also ensure that it is in a format that can readily be shared with other people who will need to discuss the plan with the person you care for.

Further information can be found at Carers UK.

You may be able to arrange help and support from family and friends, but it can be reassuring to have the involvement of your local authority or healthcare provider in case informal arrangements fall through. It may also be helpful to contact your local carers support organisation who can help with contingency planning. You can find out about local carer organisations at Carers UK.

You can also find information out about local services on the Carers Trust website.

If you are a young carer talk to your family and the person you care for about what you might do if someone becomes ill. Write this plan down, and make sure everyone knows where to find it. You could leave it somewhere everyone can see, like on the fridge door.

You may find information on the Children Society's young carers services website helpful.

Caring for someone who is clinically extremely vulnerable

The guidance on shielding and protecting the clinically extremely vulnerable people from COVID-19 has been updated. Please see this guidance for the latest advice for this group of people, which includes the definition of 'clinically extremely vulnerable' groups and information on work, socialising and registering for support.

If the person you care for is concerned about their usual paid carer coming in and out of their home and the risk of infection

Care for vulnerable and disabled people can continue. The government has issued the coronavirus (COVID-19): provision of home care guidance to ensure that appropriate levels of hygiene are achieved to reduce the risk of infection. Speak to the care provider about the processes they are following to maintain good hygiene.

Personal protective equipment (PPE)

We are currently rolling out an offer of free PPE for COVID-19 needs to unpaid carers who do not live with the person or people they care for. This will be available until the end of March 2022 and will be available from local authorities (LAs) and local resilience forums (LRFs).

See personal protective equipment (PPE): local contacts for providers for details of LAs and LRFs who are currently making PPE available to unpaid carers. You can contact them to request PPE.

This offer is available to cover needs for PPE that have arisen due to COVID-19. If you would normally use PPE because of the nature of the care you provide, you should continue to access it through your normal routes.

If you live with the person or people you care for, it is not currently recommended that you wear PPE unless advised to do so by a healthcare professional, like a GP or nurse.

If you are a young carer talk to your family and the person you care for if you are unsure what to do.

Recommended PPE for unpaid carers who do not live with the person or people they care for

If you do not live with the person or people you care for, it is recommended that you wear PPE when delivering care.

It is essential that PPE is worn correctly in order to reduce the risk of transmission. PPE should be put on and removed at least 2 metres away from the person you are caring for.

See guidance on how to put on and take off PPE correctly.

The type of PPE you should wear will depend on the type of care you provide. This illustrated guide shows you which items of PPE are recommended for you to wear, depending on the scenario. This is also written in the table below.The type of surgical mask (Type II/ Type IIR) you have been given will be clearly stated on the box.

Scenario	Type of care being given	PPE recommended
1	Personal care involving touching the person or people you care for	- Apron - Gloves - Type IIR surgical mask - Eye protection, either a visor or goggles, can be used (prescription glasses are not eye protection) if there is a risk of droplets (for example, because the person you care for is coughing) This PPE also applies if the person or people you care for are clinically extremely vulnerable to COVID-19.
2	When you’re in the household of the person or people you care for, within 2 metres of anyone who is coughing (whether you are caring for them or not)	- Apron - Gloves - Type IIR surgical mask - Eye protection, either a visor or goggles, can be used (prescription glasses are not eye protection) if there is a risk of droplets (for example, because the person you care for is coughing) This PPE also applies if the person or people you care for are clinically extremely vulnerable to COVID-19.
3	When you’re within 2 metres of the person or people you care for (for whatever reason) but not touching them	- Type II or Type IIR surgical mask - No apron and gloves required (unless you would normally use them for the task you are doing – for example, cleaning)
4	When you’re caring for a person who is clinically extremely vulnerable to COVID-19	You should follow the advice in scenarios 1 and 2 when you’re giving personal care or within 2 metres. If you’re 2 metres or more away but in the home of the person you care for who is clinically extremely vulnerable to COVID-19 then you need to wear the following items: - Type I, Type II or Type IIR surgical mask - Gloves - Apron - No eye protection is required
5	When you’re in the household of the person or people you care for, and are more than 2 metres away from them	- Type I, Type II or Type IIR surgical mask Note: scenario 4 applies when you’re in the home of someone who is clinically extremely vulnerable to COVID-19.

See also:

• COVID-19: how to work safely in domiciliary care in England for more detailed guidance about PPE and procedures that should be followed

This guidance is the same as recommended for domiciliary care workers (home care workers).

Disposable gloves and aprons can only be used once, and should be disposed of immediately after each caring task (for example, after you have bathed the person you care for or after you have helped the person you care for with feeding), before cleaning your hands.

You should not touch the mask when wearing it, other than to put it on or remove it. Your mask should be disposed of once you have removed it from your face, lowered it to your chin or if it becomes damaged, dirty, damp, or uncomfortable to use. When removed, you will need to use a new mask for your next care visit.

You should continue to follow advice in this guidance and the guidance on protecting people who are clinically extremely vulnerable from coronavirus on how to protect yourself and those you care for.

If you are a young carer talk to your family and the person you care for if you are unsure what to do. You could also talk to your social worker (if you have one) about approaching your local authority to understand what is possible and suitable for you.

We are keeping this position under review.

Wearing a face covering if you have to go out

There are some places where you must wear a face covering by law, unless you are exempt or have a reasonable excuse. Check for information on where you must wear a facemask and exemptions.

You're also strongly encouraged to wear a face covering in other enclosed public spaces where social distancing may be difficult and where you come into contact with people you do not normally meet.

It's important to use face coverings properly and wash your hands before putting them on and taking them off. You can make face coverings at home. The face covering should cover your mouth and nose.

If the person you care for is in a care home

If you have no symptoms, you should keep in contact with the care home to understand any local arrangement to keep in touch with residents and follow the guidance from the care home when visiting.

Maintaining your own health while you're looking after others

It's important that you look after your own health and wellbeing as well as supporting others you care for, especially given the potential for additional stresses at the current time. There is general information in the guidance for the public about mental health and wellbeing about looking after your wellbeing, as well as more detailed guidance on self-care and sources of support for mental health and wellbeing during the outbreak. It also includes some specific advice for people who have dementia, autism, learning disabilities or additional mental health needs.

Tips include taking care of your mind as well as your body and getting support if you need it. Daily physical activity is important for health and wellbeing, including managing stress, and encouraging positive feelings and sleep. You can look for ideas of exercises you can do at home from Public Health England (PHE).

Draw on support you might have through your friends, family and other networks during this time. Try to stay in touch with those around you over the phone, by post, or online. Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing and you may find it helpful to talk to them about how you are feeling.

Remember it is OK to share your concerns with others you trust and in doing so you may end up providing support to them, too. Or you can use a NHS recommended helpline.

If you need specialist support or help, all NHS Mental Health Trusts are providing 24/7 open access telephone lines to support people of all ages and continue to deliver mental health support to children and young people. Further information on how to contact these lines is available through your local Mental Health Trust's website.

It may also be helpful to contact your local carers support organisation who can help with contingency planning. You can find out about local carer organisations at Carers UK. There is also an online forum on Carers UK.

Public Health England has produced guidance on supporting children and young people’s mental health and wellbeing during the pandemic and its 'Every Mind Matters' and 'Rise Above' platforms have information for children and young people.

Young carers and young adult carers may also find helpful information on the Children's Society website.

Young carers

If you are a young carer, you can collect medicines with permission from the person you are caring for. Some pharmacists might refuse to give you the medicines if they think it is not appropriate.

If you normally collect prescriptions for the person you care for and you are self-isolating, you should look to make alternative arrangements. You should try and seek support from friends and family to assist if possible.

Schools and education

Attending school or college

During the national lockdown, schools and colleges remained open for on-site attendance to vulnerable children and the children of critical workers. From 8 March all children and students should return to school or college and attendance will be mandatory once again from this date.Read the latest guidance for parents and carers, students and university students, teachers and educational setting leaders.

If at any time you do not feel comfortable attending school or college, or have concerns about the health of someone in your household or those you provide care for, you should discuss this with your school or college and social worker (if you have one).

Support from your school or college

Your school, college or social worker (if you have one) may be able to offer you support with your education, for example, by giving you extra time for work or putting you in touch with local young carers' services.

If you are not sure whether your school or college knows you are a young carer, you can talk to a teacher, school nurse or someone you trust and tell them you think you need extra support.

You might not want your school or college to know you're caring for someone. But if they do know, they will understand that things are sometimes hard for you. It is a good idea to let at least one teacher or school nurse you trust know that you are a carer. A young carer support worker can also help. You can also talk to your school nurse in confidence.

If you think you are eligible for free school or college meals but were not accessing them before, schools, colleges and local authorities are continuing to accept school and college meal applications. See the eligibility criteria to apply for free school meals (for schools), or free meals in further education funded institutions (for colleges) You can also speak to your college or further education institution who will be able to offer advice.

Further support can be found on the NHS support for young carers page.

Support from your university

Universities are independent and the support they provide will differ. You should speak to someone you trust at your institution about any support that may be available to you.

Read the latest guidance for university students. You can also find information on universities, including latest announcements, on the Education in the Media blog.

Getting support

It’s important you consider what support you might need and how you can access support to maintain your own health and wellbeing.

Support in providing breaks from care

See the (COVID-19) coronavirus restrictions: what you can and cannot do.

There is an exemption to allow for respite care to be provided to a vulnerable person (which includes a person with an underlying health condition) or a person with a disability. The regulations' definition of a 'vulnerable person' also includes anyone who is pregnant or aged 70 or older. See list for information as to who is considered clinically extremely vulnerable in the guidance for clinically extremely vulnerable groups.

The regulations allow carers to access respite from family and friends where this is reasonably necessary to provide respite care for a vulnerable or disabled person or someone with an underlying health condition.

This means that you can arrange with family or friends for someone else to provide the care you normally provide to the person you care for, to enable you to take a break. This includes someone coming into the home of the person you care for, which can be overnight. It also means the person you care for can go to someone else's home to receive care to give you a break from caring, which can also be overnight. In all these examples, the arrangement must be reasonably necessary for the purpose of respite care being provided for the person being cared for.

The number of adults in either household does not matter when making arrangements for respite care, provided the arrangements are reasonably necessary and amount to respite care provided to the person being cared for. What is suitable for you, the person you care for and the person providing the alternative care will depend on your own circumstances.

Support bubbles

Support bubbles have been expanded.

You, or your family, may be able to form a support bubble with another household (of any size). Below are the different ways a support bubble can be formed:

• you live by yourself – even if carers visit you to provide support
• your household includes a child who is under the age of one or was under that age on 2 December 2020
• your household includes a child with a disability who requires continuous care and is under the age of 5, or was under that age on 2 December 2020
• you're a child under 18 years old living alone or with other children and without any adults
• you're a single adult living with one or more children who are under the age of 18 or were under that age on 12 June 2020
• you (whether under 18 or not) are the only individual in your household who does not need continuous care as a result of a disability
• you (whether under 18 or not) live with one or more persons who need continuous care as a result of a disability, you do not have a disability but you also live with others who do not have disabilities, of which only one is over 18

For example, an adult who provides continuous care for their spouse who needs this care as a result of a disability, can form a support bubble with their parents who live together in another property.

Another example is a young carer, who is under 18, who lives with their parents who both need continuous care as a result of a disability. Alternatively, the same scenario, but the young carer also lives with other siblings, only one of whom is 18. Both types of household can form a support bubble with their grandparents who live together in another property.

You should not form a support bubble with a household that is part of another support bubble. For further information on the other rules that apply to support bubbles, including when they end, and how to change bubbles, see the guidance on making and using a support bubble.

Support from volunteers

You can also get help from NHS volunteer responders who can help with things like collecting medication or shopping. There is information here about what support the NHS volunteer responders can offer.

You can also call 0808 196 3646 between 8am and 8pm.

Carer's assessment

If you need support with caring, you can contact your local council for a carer's assessment. You do not have to live with the person you care for and your entitlement to an assessment is not affected by the type or amount of care you give or your financial means. A carer's assessment is free. It is separate from the needs assessment the person you care for might have, but you can ask to have them both done at the same time.

You will be entitled to an assessment regardless of the amount or type of care you provide, your financial means or your level of need for support. You do not necessarily have to live with the person you're looking after or be caring full-time to have an assessment.

If you have not been offered one, you can contact your local authority. Find your local social services team.

Young carers can also request a young carer's needs assessment. You can speak to your support worker. If you don't have a support worker, you can speak to your social worker or local authority about getting one.

Carer's Allowance

You may be eligible for Carer's Allowance if you, the person you care for and the type of care you provide meets certain criteria. You need to spend at least 35 hours a week caring for someone. This can include:

• helping with washing and cooking
• taking the person you care for to a doctor's appointment
• helping with household tasks, like managing bills and shopping

If you or the person you care for are affected by coronavirus, you can still claim Carer's Allowance if you provide care remotely. This includes giving emotional support over the phone or online.

See information about eligibility and how to apply for Carer's Allowance.

If you are aged 16+ and are caring at least 35 hours a week you may also qualify for Carer's Allowance. You can find out about financial support on the Children's Society website.

Further sources of support

For further sources of information or support, you may find information on your local authority's website or you could contact your local authority.

You can also look on the Carers UK and Carers Trust websites.

Help and support if you are a young carer

Your school, college or social worker (if you have one) may be able to offer you support with your education, for example, by giving you extra time for work or putting you in touch with local young carers' services.

If you are not sure whether your school or college knows you are a young carer, you can talk to a teacher, school nurse or someone you trust and tell them you think you need extra support.

School nurses have a duty of confidentiality, to all those who receive their care. This means they will ask you for your consent to share confidential health information with others, including your parents and teachers unless they think your personal safety is at risk. If they think this might be the case, they will discuss this with you first before taking any action.

If you or someone in your family has a social worker, you can contact them to say you think you might need more help if someone becomes unwell.

You could ask friends, family or use online services like the NHS volunteer responders to see if they could help drop off shopping or support you in other ways.

If you can't think of anyone who can help you, or if nobody else knows you are a young carer, you can contact a local young carers service and tell them you think you are a young carer and you would like some help. You can find a local support group or get in touch with the Children Society's young carers services.

Helplines

If you would like to speak to someone anonymously, you can call helplines or visit one of the websites below:

ChildLine provides a confidential telephone counselling service for any young person with a problem. It comforts, advises and protects. You can:

• call free on 0800 1111 any time
• have an online chat with a counsellor
• check out the message boards

See, Hear, Respond has been funded by the government to support young carers and other groups of children and young people during the lockdown. It can provide advice and support, including counselling, on a range of issues including return to education. It can be contacted free on 0800 157 7015 or online.

Websites

Further support can be found on the NHS support for young carers page.

The Children's Society has information for young people and professionals about coronavirus which includes links to tools, resources and activities as well as well-being tips for young carers.

Carers Trust has information for young people about coronavirus

If you or the person you care for has symptoms, a positive test or are a close contact of someone with positive test

If you have symptoms of coronavirus

See the stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection for more information on isolation periods and what you must and must not do if you have symptoms of coronavirus, a positive test or are a close contact of someone who has tested positive.

Anyone with COVID-19 symptoms or a positive test result should stay at home and self-isolate immediately. This is because you could pass the infection on to others, even if you don't have symptoms.

You could be fined if you do not self-isolate following a notification by NHS Test and Trace. You may be entitled to a one-off payment of £500 through the NHS Test and Trace Support Payment scheme if you are required to stay at home and self-isolate.

Making alternative arrangements for care

You should seek to make alternative arrangements for the provision of care in the following circumstances:

• You and the person you care for do not live together and either of you get symptoms or a notification of a positive test
• You and the person you care for do not live together and either of you are notified that you are a close contact of someone else with a positive test
• You and the person you care for do not live together and someone in your household, gets symptoms or a positive test
• If one of the people in the caring relationship (either the carer or cared for person) is clinically extremely vulnerable or shielding and the other person has symptoms or a positive test

To arrange alternative care, you can contact your local authority or contact your healthcare provider. If you do not know how to do this, you can contact NHS 111. It may also be helpful to contact your local carers support organisations. You can find out about local carer organisations at Carers UK. Your family can also find information about local services on the Carers Trust website.

If you live with the person you care for and are too unwell to care contact your local authority or healthcare provider.

Collecting prescriptions when self-isolating

If you normally collect prescriptions for the person you care for and you are self-isolating, you should look to make alternative arrangements. You should try and seek support from friends and family to assist if possible.

Most pharmacies provide a home delivery service. Telephone them to see if this is available or if there is another scheme running locally to help you access prescriptions.

You can also get help from NHS volunteer responders who can help with things like collecting medication or shopping. Call 0808 196 3646 between 8am and 8pm. There is information here about what support the NHS volunteer responders can offer.

Pharmacy delivery services will be under pressure at the moment, so it is important that you order your repeat prescriptions in good time, to avoid delays in dispensing. Information on repeat prescriptions and delivery services may also be available via your GP practice website.

If it is not possible to arrange an alternative collection, it is possible for someone self-isolating to leave home where necessary to obtain medical supplies for someone in the same household.

If the person you care for does not live with you and is self-isolating, then provided you are not self-isolating you can enter their household to drop off a prescription if reasonably necessary. You should distance yourself from the person with symptoms or a positive test as much as possible and follow the guidance.