COVID-19: provision of night shelters
Operating principles for commissioners and providers of night shelters for people experiencing rough sleeping.
Applies to England
What has changed
The government has published its plan for living with COVID-19.
This means from 24 February:
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You will no longer be legally required to self-isolate if you test positive for COVID-19. New guidance will advise people who test positive to stay at home and avoid contact with other people. We continue to encourage providers to support guests and staff to self-isolate where possible.
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You will no longer be legally required to self-isolate if you are an unvaccinated close contact, and will no longer be advised to test for 7 days if you are a fully vaccinated close contact. The government has published new guidance for people with symptoms of a respiratory infection including COVID-19. We continue to encourage providers to support guests and staff to self-isolate where possible.
1. Introduction
Local authorities and voluntary, faith, and community groups have gone to extraordinary lengths since March 2020 to protect vulnerable people who sleep rough from the risks of COVID-19. This has seen communal shelters either being closed or transformed into self-contained accommodation to reduce the spread COVID-19. These adapted models often provide safer environments, offer greater protection to individuals with underlying health conditions, and can produce better move-on outcomes for individuals.
However, we know that local circumstances may mean that there are limited occasions where a service provider decides to put in place communal models to prevent people sleeping rough, particularly in extreme weather. These settings should not be opened without written agreement from your local authority and the local Director of Public Health, based on a comprehensive risk assessment
This guidance has been drafted with advice and input from the UK Health Security Agency (UKHSA). This guidance sets out advice on how night shelters can operate more safely, based on public health principles.
It has been updated to reflect the publication of the Living with COVID-19 strategy.
There is no longer a legal requirement to wear a face covering. The government suggests that you continue to wear a face covering in crowded and enclosed spaces where you may come into contact with other people you do not normally meet, including night shelters. For more information please see the guidance on face coverings.
Following this guidance will help people attending or working in shelters to take steps to reduce the spread of coronavirus (COVID-19) infection in the community, stay safe and save lives while the risk of infection remains.
This guidance applies in England alongside the relevant associated changes to the law. It applies to night shelters only. It does not apply to private dwellings.
2. Priority actions to take
Let fresh air in
Make sure you let plenty of fresh air into any shelters. You or the venue manager can do this by uncovering vents, and opening doors and windows.
Letting fresh air into indoor spaces is important because when a person infected with COVID-19 coughs, talks or breathes, they release droplets and aerosols which can be breathed in by another person. The more fresh air there is to breathe, the less likely a person is to inhale infectious particles.
Limit close contact
Although social distancing is no longer required, staff, volunteers, and guests may choose to limit the close contact they have with people they do not usually live with, particularly if they are not fully vaccinated. This is a personal choice which can help reduce the risk of catching or spreading COVID-19.
Shelter providers should be prepared to support those who wish to maintain social distancing, especially around those who may be more vulnerable. Providers of shelter accommodation may also want to consider the proximity and density of guests, as well as the duration and regularity of any interactions.
Face coverings
There is no longer a legal requirement to wear a face covering. The government suggests that you continue to wear a face covering in crowded and enclosed spaces where you may come into contact with other people you do not normally meet. For more information please see the guidance on face coverings.
Providers of night shelters are strongly recommended to limit close contact between people in enclosed spaces and to support the use of face coverings in these circumstances and where people are unable to maintain social distancing.
Wash your hands
Guests, staff, and volunteers should wash their hands with soap and water or use hand sanitiser regularly throughout the day. Regular hand washing is an effective way to reduce the risk of catching illnesses, including COVID-19.
Guests, staff, and volunteers should wash their hands:
- after coughing, sneezing and blowing their nose
- before they eat or handle food.
- after coming into contact with surfaces touched by many others, such as handles, handrails and light switches
- after coming into contact with shared areas such as kitchens and bathrooms
- as soon as you return home
- along with hand washing, providers should conduct regular cleaning and encourage guests to cover their nose and mouth when coughing or sneezing.
Support those with COVID-19 symptoms or who have tested positive to self-isolate
Self-isolation is no longer legally mandatory for those who test positive for COVID-19. In order to keep people in shelters safe, we recommend that providers should continue to support guests who test positive for COVID-19, or have COVID-19 symptoms to self-isolate, even if their symptoms are mild. Any individuals who test positive should follow the guidance for people with symptoms of a respiratory infection including COVID-19.
Please see further guidance below on what to do if a guest develops COVID-19 symptoms.
Encourage vaccination
Vaccinations significantly reduce the risk of catching COVID-19. Anybody entering a shelter, whether as a member of staff, a volunteer, or a service user, should consider getting vaccinated, if they haven’t already.
In line with the Joint Committee on Vaccination and Immunisation (JCVI) advice in March 2021, homeless people and those experiencing rough sleeping are considered a priority group, alongside cohort 6.
Providers should also consider how to increase uptake among their guests, including encouraging guests who have only had their first or second dose, to have their second or a booster dose.
Guests should be reminded that they do not need an NHS number or a GP registration to receive a vaccine.
Local authorities in England have recently received funding through the Protect and Vaccinate fund to encourage uptake of vaccination amongst people sleeping rough. We strongly encourage providers to work in partnership with their local authority to enable uptake of vaccination.
Get tested
If you develop COVID-19 symptoms, please follow the guidance set out in the guidance for people with respiratory symptoms even if your symptoms are mild and you are fully vaccinated. Staff and volunteers should self-isolate at home while they book the test and wait for the results. You must self-isolate if you test positive. Your isolation period includes the day your symptoms started (or the day your test was taken if you do not have symptoms). It is now possible to end self-isolation after 7 days, following two negative LFD tests taken 24 hours apart. The first LFD test should not be taken before the fifth day.
Providers should support staff, volunteers and guests to access regular asymptomatic lateral flow (LFD) testing, and confirmatory PCR testing where appropriate. Rapid lateral flow testing is available for free to anybody, and is particularly recommended if you will be in a high-risk situation that day. Find out more about how to get LFD tests. Providers should also develop plans to support people with COVID-19 symptoms, or a positive test, to isolate and to trace their recent contacts.
The NHS COVID-19 app is a vital part of NHS Test and Trace in England and Wales. Using the app helps stop the spread of the virus by informing you that you have been in close contact with someone who has since tested positive for coronavirus, even if you don’t know each other. Those who are able to use the app should be encouraged to do so.
Further guidance
We recommend that providers of night shelters follow guidance for people with respiratory symptoms and their contacts.
Fully vaccinated means that you have been vaccinated with an MHRA approved COVID-19 vaccine in the UK, and at least 14 days have passed since you received the recommended doses of that vaccine. See further information on vaccination and proof of vaccination.
3. General advice
The purpose of this advice is to reduce the risk of COVID-19 transmission if self-contained sleeping spaces are not an option.
Providers and commissioners of night shelters should consider whether they can provide self-contained accommodation options. For clear safety reasons individual rooms and individual washing facilities should be the aim to appropriately protect individuals from communicable diseases such as COVID-19.
All forms of night shelter present a level of risk to people with clinical vulnerabilities. However, it is even more challenging to implement robust infection control and outbreak management in rotating night shelter models. These models present greater risks to all those involved.
4. Keeping people safe
Access, referrals and triage
It remains important that anyone to whom the following applies should not enter night shelters. This also applies to staff and volunteers.
- Showing COVID-19 signs and symptoms which include:
- a high temperature
- a new, continuous cough
- a loss of, or change to, sense of smell or taste
- having a positive COVID-19 test in the previous 10 days
- contacts of a confirmed case in the previous 10 days, unless they are fully vaccinated or under 18 and 6 months
If a guest or potential guest has COVID-19 symptoms, even if they are mild, or falls into any of the above categories, providers should work with their local authority to support individuals to access self-contained accommodation to self-isolate as appropriate. This includes any guests who develop COVID-19 symptoms on site.
Testing for COVID-19
Around 1 in 3 people with COVID-19 do not have any symptoms. This means they could be spreading the virus without knowing it. Asymptomatic LFD testing increases the chances of detecting COVID-19 when a person is infectious but is not displaying symptoms, helping to make sure people do not spread the infection.
Rapid LFD testing is available for free to guests, staff and volunteers working on site. Providers may wish to consider supporting staff, volunteers and guests to access LFD tests. Find out more about how to get LFD tests.
Those working with people who experience homelessness and rough sleeping are included in the list of essential workers prioritised for COVID-19 testing.
In line with current public health advice, staff should also consider taking an LFD test before going into physical environments where there is a high risk of transmission, such as crowded and enclosed spaces, or before visiting people who are at higher risk of severe illness if they get COVID-19.
If anyone on site receives a positive LFD test for COVID-19, they should follow guidance for those with respiratory symptoms. We recommend that providers support staff and guests to continue to self-isolate.
Staff should support guests with symptoms to arrange a test to see if they have COVID-19 if the guest can self-isolate safely on site.
Identifying contacts of guests that develop signs and symptoms of COVID-19
Providers should consider how they can support in identifying contacts of guests if a guest develops COVID-19 symptoms and/or tests positive for COVID-19 on site, or within 48 hours of leaving the venue. This could include keeping records of each guest’s stay, in order to identify possible interactions.
Cohorting of guests
Providers should work with their local housing and rough sleeping teams to explore options for providing self-contained accommodation for those self-isolating.
If isolation is not immediately possible, ‘cohorting’ based on COVID-19 status may be considered to mitigate some of the health risks. Cohorting is a strategy which can contribute to limiting the spread of disease by supporting people to access different areas/sites depending on their status. For example, contacts can be in a separate area of the shelter and non-contacts in another. The Clinical Homeless Sector Plan published by Pathway provides more details.
Managing an outbreak
An outbreak is defined as 2 or more confirmed cases in a single facility within 10 days of one another. In this event, commissioners and/or providers should seek advice from their local Health Protection Team. This remains the case whether the provider has a contract with the local authority or not. Local authorities should have a clear picture of all alternative local provision that could be used in the case of an outbreak. An outbreak control team may be brought together to consider appropriate mitigation which may include measures to introduce social distancing.
While social distancing will no longer apply, it may be appropriate to retain it depending on the risks. Equally, it may be appropriate to reapply it after it has been lifted if assessments suggest doing so. Assessments will be carried out by service managers in consultation with or as a result of advice from Directors of Public Health or in the context of an outbreak control team led by the local Health Protection Team, who will be able to continue to advise on social distancing measures to control and prevent outbreaks.
The use of social distancing should be targeted, time limited, and kept under review.
5. Vaccination
COVID-19 vaccines are available to everyone free of charge.
People who experience homelessness and rough sleeping are likely to have underlying health conditions, which can make them vulnerable to COVID-19. The Joint Committee on Vaccination and Immunisation has therefore prioritised them for being offered COVID-19 vaccines.
They also may experience additional barriers to accessing vaccination. Providers have a role in informing people about the vaccine and should actively support guests to take up the vaccine where appropriate. This includes encouraging guests who have only received their first dose to access their second, and future access to any potential COVID-19 vaccine booster programme. There are leaflets and posters about the vaccination programme available.
Providers should support local health teams in their vaccination plans, including helping them identify individuals in this group and appropriate sites to deliver vaccinations.
There is no requirement for people to have an NHS number or to be registered with a GP to receive the COVID-19 vaccine from local teams. The COVID-19 vaccine is also available irrespective of immigration status and no data will be shared with immigration authorities when a vaccination offer is accepted.
However, it may be operationally challenging to provide the second dose without GP registration or the ability to call back individuals. Providers should make every effort to support people to become fully vaccinated. While this may be an opportunity to register some previously unregistered people with a GP practice, teams should be careful to communicate that GP registration is not necessary in order to get the vaccine.
6. If guests were previously identified as clinically extremely vulnerable (CEV)
The government will continue to assess the situation and, based on clinical advice, will respond accordingly to keep the most vulnerable safe.
Those previously identified as CEV should continue to follow the same guidance as everyone else, but they may wish to consider taking additional precautions or seek advice from their health professional. Extra precautions could include:
- considering whether those you are meeting have been vaccinated – you might want to wait until 14 days after others’ second dose or booster dose of a COVID-19 vaccine before being in close contact with them, or asking friends and family to take a rapid lateral flow antigen test before visiting you
- considering continuing to practice social distancing if that feels right for you and your friends
7. Social distancing and capacity
Social distancing rules no longer apply in law. This means that you do not need to implement social distancing (2m or 1m+) in night shelters, and guests do not need to keep apart from people they don’t live with. However, the further away guests can keep from other people, and the less time they spend in close contact with others, the less likely they are to catch COVID-19 and pass it on.
Close contact increases the risk of spreading COVID-19. You should consider the guidance on risks associated with COVID-19 and actions you can take to help keep you and your guests safe. Please refer to the guidance on Keeping yourself and others safe, for further information and the actions to take to reduce the chance of spreading COVID-19.
Directors of Public Health, in consultation with providers and relevant departments, are able to advise that social distancing is put in place in shelters, where the risks of rapid spread are particularly acute, if necessary to control outbreaks. This should be targeted and time limited.
While social distancing will no longer apply, it may be appropriate to retain it depending on the risks. Equally, it may be appropriate to reapply it after it has been lifted if assessments suggest doing so. Assessments will be carried out by service managers in consultation with or as a result of advice from Directors of Public Health, who will be able to continue to advise on social distancing measures to control and prevent outbreaks.
The use of social distancing will be targeted, time limited, and kept under review.
8. Hygiene
On entering and leaving a shelter, everyone, including staff, should wash their hands thoroughly for at least 20 seconds using soap and water, or to use hand sanitiser if hand washing facilities are not available.
Washing or sanitising your hands removes viruses and other germs, so people are less likely to become infected if they touch their face. Using soap and water is the most effective way to clean your hands, especially if they are visibly dirty. Hand sanitiser can be used when soap and water is not available.
Those responsible for the building should use signs and posters to make people aware:
- of how to wash their hands well
- that they should wash their hands frequently
- that they should not touch their faces
- they should cough or sneeze into a tissue which is binned safely, or into their arms if a tissue is not available
Providing regular reminders and signage to maintain hygiene standards.
Hand sanitiser should be provided in multiple locations in addition to toilet facilities. Consider the needs of people with disabilities.
9. Toilets
Toilets inside or linked to shelters should be kept open and carefully managed to reduce the risk of transmission of COVID-19. Steps should be taken by those responsible to make the use of toilets as safe as possible:
- using signs and posters (see Hygiene above)
- make hand sanitiser available on entry to toilets where safe, practical and accessible. Ensure suitable handwashing facilities are available. This includes running water and liquid soap and suitable options for drying. Namely paper towels, continuous roller towels or hand dryers. Consider the needs of people with disabilities.
- set clear use and cleaning guidance for toilets, with increased frequency of cleaning in line with usage. You should use normal cleaning products and pay attention to frequently hand touched surfaces. Consider using disposable cloths or paper roll to clean all hard surfaces
- keep the facilities well ventilated. For example, by ensuring extractor fans work effectively and opening windows and vents where possible
- special care should be taken for cleaning of portable toilets and larger toilet blocks
- putting up a visible cleaning schedule that is visible, kept up to date, and followed
- providing more waste facilities and more frequent rubbish collection
10. Cleaning
COVID-19 spreads through small droplets, aerosols and direct contact. Surfaces and belongings can be contaminated with COVID-19 when people with the infection touch them or cough, talk or breathe over them.
Viruses on a surface could infect another person if they touch the surface and then touch their eyes, nose and mouth. Cleaning surfaces will reduce the amount of contamination and so reduce the risk of spread. The more a surface is cleaned, the more likely you are to remove viruses from an infected surface before you or another person touches it.
People responsible for shelter provision should clean surfaces often and should pay particular attention to surfaces that are touched frequently, such as handles, light switches, and work surfaces.
See guidance on cleaning in non-healthcare settings.
Sufficient time needs to be allowed for this cleaning to take place, particularly before reopening for the first time or between different types of permitted activities.
A decision should be made locally on how frequently cleaning should take place based on an assessment of risk and use of the building.
If a venue is usually used for day activities with additional guests, providers can consider holding these activities in two different venues. If this is not possible, providers should take care with the cleaning guidance above between the two different uses.
Staff and guests may consider avoiding handling personal belongings that are not their own where possible. Guests should be encouraged to handle their own belongings for the purposes of laundry or storage as far as possible. If this cannot be avoided, then staff and guests should wash their hands with soap and water for at least 20 seconds, or use a hand sanitiser after handling personal belongings that are not their own.
See guidance on waste disposal in non-healthcare settings.
11. Other practical things for providers to consider
Trustees and managers of night shelters venues should confirm that their insurance remains valid for operating their service.
You may also need to consider the impact of any mitigations on capacity of your accommodation provision and your organisation’s finances.
Providers also have a number of duties and liabilities relating to health and safety, and safeguarding. You may want to carry out a COVID-19 risk assessment, and refer to COVID-19 and safeguarding resources and positive practice in adult safeguarding and homelessness.
Last updated 10 March 2022 + show all updates
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Guidance updated due to the removal of the legislative need to self-isolate.
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Updated to reflect the lifting of Plan B measures.
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Call-out box added on the lifting of Plan B measures.
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Amended to reflect new guidance on ending self isolation.
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Updated to reflect Plan B COVID-19 response measures.
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Information box added that England will move to Plan B in response to the risks of the Omicron variant.
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Revised in line with the Prime Minister’s announcement of the COVID-19 response: Autumn and Winter plan.
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Updated to reflect changes to self-isolation regulations.
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Updated to reflect move into Step 4 of the roadmap. Includes updated information on testing, vaccination, and protection for the clinically extremely vulnerable.
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Amended to reflect latest national guidance including changing guidance on the isolation period for contacts of confirmed cases from 14 days to 10 in line with recent guidance changes (sections 3.1 and 3.5).
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First published.