Information for adult social care providers on COVID-19 guidance and support.
Applies to England
This document provides information for adult social care providers about COVID-19 guidance and support. See the full list of adult social care guidance produced by the Department of Health and Social Care (DHSC) and Public Health England (PHE).
This page will be updated to reflect new DHSC, NHS and PHE advice.
The guidance relates to England unless stated otherwise.
Help with infection prevention and control
Guidance for social care providers on how to prevent, control and protect care workers and those they care for from COVID-19 infection.
Links to appropriate PPE resources:
- care home workers: how to work safely in care homes
- home care workers: how to work safely in domiciliary care
- unpaid carers who do not live with the person or people they care for
- all social care settings: personal protective equipment (PPE) illustrated guide
See Securing PPE and related supplies below for information on how to access PPE.
Supporting staff members at higher risk from COVID-19
The adult social care risk reduction framework focuses specifically on how employers can support workers with factors that may make them more vulnerable to infection or adverse outcomes from COVID-19 to make decisions about their risks in the workplace. This should be used alongside relevant guidance, including PHE guidance on how to work safely in care homes, how to work safely in domiciliary care and DHSC guidance on health and wellbeing of the adult social care workforce.
Reducing contact between staff
To help reduce possible transmission among staff and residents consider:
- limiting or ‘cohorting’ staff to groups of patients or floors/wings (segregation of COVID-positive and COVID-negative patients)
- holding team meetings and handovers remotely
- staggering times of entry to collect equipment, including PPE
- access to regular remote supervision for teams and individuals
- remote, secure sharing of information relating to care between agencies (see NHSmail)
See guidance on reducing workforce movement between care homes and and other care settings for information on managing the movement of care home staff between settings.
Running a medicines re-use scheme during the COVID-19 pandemic
The National Institute for Health and Care Excellence (NICE) has issued good practice for managing medicines in care homes. A new Standard Operating Procedure (SOP) has been designed to help providers manage medicines during the COVID-19 pandemic. You can find updated information in the new SOP.
Testing social care workers and people in care homes
See our guidance on how to get social care workers and people in care homes tested, below.
Financial support for infection control and prevention measures
The Adult Social Care Infection Control Fund was first introduced in May 2020. It was extended in October 2020 and, by March 2021 had provided over £1.1 billion of ring-fenced funding to support adult social care providers in England for infection prevention and control (IPC). The Rapid Testing Fund was introduced in January 2021 to support additional lateral flow testing (LFT) of staff in care homes, and enable indoors, close contact visiting where possible.
Due to the success of the Infection Control Fund and the Rapid Testing Fund in supporting care providers to reduce transmission and re-enabling close contact visiting, these funding streams have been consolidated and extended until June 2021, with an extra £341 million of funding.
This is a new grant, with separate conditions to the original Infection Control Fund, the extension to the Infection Control Fund and the original Rapid Testing Fund. This brings the total ring-fenced funding for infection prevention and control to almost £1.35 billion and support for lateral flow testing to £288 million in care settings.
What to do when you suspect an outbreak
Symptoms of COVID-19
The most important symptoms of coronavirus (COVID-19) are recent onset of any of the following:
- a new continuous cough
- a high temperature
- a loss of, or change in, your normal sense of taste or smell (anosmia)
Any resident presenting with symptoms of COVID-19 should be promptly isolated (if not already) and tested. Care homes should be implementing social distancing measures and supporting individuals to follow the shielding guidance for the clinically extremely vulnerable groups.
Guidance on caring for residents, depending on their COVID-19 status and particular needs has also been developed.
What is an outbreak?
An outbreak is defined as 2 or more confirmed cases of COVID-19 or clinically suspected cases of COVID-19 among individuals associated with a specific setting, such as care homes, with onset dates within 14 days.
In line with the new definition, one confirmed case will be reported as an incident. If there’s a single laboratory confirmed case, this would initiate further investigation and risk assessment.
What care homes and other social care settings must do during an outbreak
- Care home managers should contact their local health protection team (HPT) if they suspect an outbreak. (See Reporting an outbreak below). The HPTs will provide advice and support to manage the outbreak, including advising regarding restrictions during the outbreak. Care homes should seek advice from their local HPT if they have a single possible case of COVID-19. The HPT will confirm what testing the care home needs to carry out in event of a single positive case or an outbreak – see the outbreak testing policy.
- Staff should immediately instigate full infection control measures. See guidance on how to work safely in care homes. Advice is also provided on admission and care of residents in a care home.
- Residents who have been exposed to a person with possible or confirmed COVID-19 should be isolated (or cohorted if not possible) with other similarly exposed residents until 14 days after last exposure.
- Care home managers must postpone routine non-essential medical and other appointments, where possible, and discuss with the healthcare providers whether these could be delivered remotely.
- During an outbreak, restrictions to visiting set out in the visiting guidance should be followed.
- At 14 days with no new cases, in discussion with HPT, the care home should undertake end of outbreak testing: test all staff and residents using PCR 14 days after the last positive result (unless a variant of concern (VOC) other than the “Alpha variant” and/or “Delta variant” has been identified). The local HPT will contact the care home if, a VOC (other than the “Alpha variant” and/or “Delta variant”) has been identified and discuss additional measures which may include delaying the “end of outbreak testing” until 28 days after the last positive case.
- If there are no positive PCR results from this “end of outbreak testing”, the Health Protection Team will declare the outbreak over.
If there are further positive tests after the end of outbreak testing is completed, the outbreak process should be restarted and the local HPT contacted.
Advice on what you can and can’t do in an outbreak is a helpful guide for care providers. All staff and residents should be retested again 28 days after the last resident or staff had a positive test result or showed coronavirus-like symptoms. If no further cases are identified at this point, the outbreak is considered to have ended. Any further cases after this point is a new outbreak and the care home must contact the HPT.
Reporting an outbreak
- Care homes should record clinically suspected or confirmed cases in staff or residents daily onto the Capacity Tracker (including nil returns). This is important in notifying HPTs of a potential outbreak and notifying of recovery from an outbreak.
- Report any outbreak in a care home or adult social care setting to the local HPT. They will provide advice and support to manage the outbreak.
- If a new case is identified, follow HPT advice and undertake a risk assessment to see if all communal activities should be stopped.
How to manage staff during an outbreak
Staff who have COVID-19 symptoms should:
- not attend work
- notify their line manager immediately
- self-isolate for 10 days, following the guidance for household isolation and guidance on management of exposed healthcare workers
See further guidance on restricting workforce movement and minimising workforce transmission.
Advice on when symptomatic staff can return to work
A flowchart advising when symptomatic staff can return to work has been developed by PHE.
Symptomatic staff can return to work no earlier than 10 days from symptom onset, provided clinical improvement has occurred and they have been afebrile (not feverish) without medication for 48 hours and they’re medically fit to return.
If a cough or a loss of or a change in normal sense of smell or taste (anosmia) is the only persistent symptom after 10 days, and they have been afebrile for 48 hours without medication, they can return to work on day 11 (post-viral cough known to persist for several weeks in some cases) if they are medically fit to return.
If needed, work risk assessments for staff returning to work during an outbreak can be accessed from your local HPT or from your infection prevention and control (IPC) lead via your local CCG.
See more information on going to work and being COVID-19 secure during an outbreak.
Support if you are struggling to manage during an outbreak
All care providers should contact their local authority and local health services for support during an outbreak. This is true whether the care provider has a contract with the local authority or not.
If local authorities are unable to meet the emergency needs of a care provider they should report to their Strategic Co-ordination Group or Local Resilience Forums (LRFs) for additional support. For more support on how to manage during an outbreak see the action plan for adult social care and the care home support package.
Caring for patients discharged from hospital or another social care facility
Guidance for social care providers caring for patients discharged from hospital or other social care facilities during the COVID-19 pandemic.
Safely discharging people from the NHS to social care settings
Any person who does not need an NHS hospital bed will continue to be discharged in line with the current discharge service requirements. To ensure the safety of residents and staff, all individuals being discharged to care homes should be tested prior to discharge.
See advice on how to safely admit residents being discharged from hospitals to care homes. There is also further advice on discharge into domiciliary care and supported living settings.
Escalating inadequate discharge summaries
Where home care agencies identify inadequacies in discharge summaries, these need to be escalated to the local co-ordinator. Contact your local authority for clarity around who this person is if required.
Caring for individuals coming from the community
The Admission and care of people in care homes guidance sets out a service model for testing people moving from the community into a care home. It is intended to supplement existing local arrangements. New residents admitted from the community do not need to self-isolate if they satisfy the requirements set out in guidance.
Help to quarantine and isolate patients
COVID-19 positive people should not be admitted into a care home other than a designated setting. Where it is not possible to admit a person to a designated setting and there are exceptional circumstances that mean it is unsafe for them to be cared for in their own home until they have completed isolation, the local authority and local NHS Trust should agree a risk assessed plan for their care during their isolation period.
Visits to care homes and other care settings
See guidance for providers on visiting arrangements in care homes. This includes advice on establishing visiting policies, infection-control precautions and communicating decisions to families and other visitors.
If the person is clinically extremely vulnerable, then they should be helped to continue to follow the current advice for the clinically extremely vulnerable.
Information for providers of care in supported living and domiciliary settings
Guidance for providers of care in supported living settings
We have published comprehensive supported living guidance on a wide range of COVID-19 related topics for supported living settings, including safe systems of working, social distancing, respiratory and hand hygiene, enhanced cleaning and how infection prevention and control (IPC) and personal protective equipment (PPE) applies to supported living settings.
Although it is primarily intended for the managers, care and support workers, and other staff in supported living settings, it is also relevant to local authorities, clinical commissioning groups, primary care networks and community health services.
Local managers should use the guidance to develop their own specific ways of working to protect people’s wellbeing and minimise risks.
Guidance for providers of care in domiciliary settings
We have published comprehensive guidance that brings together all guidance for home care settings.
It aims to answer frequently asked questions from registered providers, social care staff, local authorities and commissioners who support and deliver care to people in their own homes, including supported living settings, in England.
This includes the most recent guidance from Public Health England on the use of PPE, supporting clinically extremely vulnerable people receiving home care during COVID-19, reducing transmission risks and contact, and safely discharging from hospitals to home care.
Advice for local authorities and the NHS to support home care provision
Steps for local authorities and the NHS to support the provision of home care during COVID-19 are set out in the provision of home care guidance. The use of voluntary groups to support home care provision and linking home care providers with the voluntary sector should be considered.
See a resource maintained by the Housing Learning and Improvement Network on access to wellbeing support for people in extra care and retirement housing.
How to get social care workers and people in care homes tested
Guidance for social care providers on how to get workers and people in care homes tested for COVID-19.
Symptoms of COVID-19
The most important symptoms of coronavirus (COVID-19) are recent onset of any of the following:
- a new continuous cough
- a high temperature
- a loss of, or change in, your normal sense of taste or smell (anosmia)
Any resident presenting with symptoms of COVID-19 should be promptly isolated (if not already) and tested. See our guidance on caring for residents, depending on their COVID-19 status and particular needs for more details.
How to access testing for adult social care staff, residents and service users
Testing for COVID-19 in adult social care (ASC) is crucial to help protect those who receive care and adult social care staff.
Within adult social care, the government’s asymptomatic testing regime covers care home staff, residents, visitors and visiting professionals. We have also rolled out regular asymptomatic testing to day care centre staff and volunteers, homecare staff including personal assistants, high risk extra care and supported living staff and residents, and wider extra care and supported living staff.
Any adult social care setting with a suspected or confirmed COVID-19 outbreak should contact their local Health Protection Team.
Testing is an important part of the government’s approach to reducing risk. It is critical that everyone in adult social care settings continues to adhere to all infection control measures in order to help keep residents, service users and staff safe.
Anyone in the UK with COVID-19 symptoms can get a test.
Managing care workers during COVID-19
Managing workers with suspected or confirmed COVID-19
See our section above what to do when you suspect an outbreak.
Recruiting and training new workers
We have launched a new online platform, Join Social Care, to fast-track recruitment into the adult social care sector. The online platform allows candidates to access free training via Skills for Care (SfC) and the opportunity to be considered for multiple job opportunities. This will streamline the recruitment process for candidates and employers and will sit alongside the many local initiatives that have been put in place to recruit staff.
SfC continue to provide digital induction training, provided free of charge under DHSC’s Workforce Development Fund. This training is available for redeployees, new starters, existing staff and volunteers through 12 of Skills for Care’s endorsed training providers. This is free of charge for employers when accessed directly from SfC’s endorsed providers. Training can be accessed via the Skills for Care website.
Restricting workforce movement to minimise transmission
Restricting the movement of staff between care settings remains essential to minimise the risk of COVID-19 outbreaks and infection in care homes. The government has published updated guidance to care home providers on the need to restrict staff movement between care homes, unless in exceptional circumstances.
Providers can use the funding provided under the Infection Control Fund to pay for additional costs associated with restricting workforce movement for infection prevention and control purposes.
Further advice can be found on the Skills for Care website.
Securing PPE and related supplies
Guidance on how to use PPE
To support the social care sector in using PPE, PHE have published tailored resources on how to work safely in care homes and how to work safely in domiciliary care. These include summarised tables and a specialised training video on putting on (donning) and taking off (doffing) PPE in social care settings.
PHE has also published an illustrated PPE guide for community and social care settings. This translates the existing PPE guidance into a simple, visual format that is applicable to all settings.
These are the main sources of PPE guidance for the social care sector.
How to order PPE
In the adult social care winter plan, published 18 September 2020, the government committed to providing the adult social care sector with free PPE for COVID-19 needs until March 2021. This has now been extended until the end of March 2022.
Adult social care providers are able to access their free PPE provision through the PPE portal if CQC-registered, or via their local authority (LA) or local resilience forum (LRF) if not CQC-registered.
Where there is an emergency need, all adult social care providers can access the emergency PPE stockpile held by LRFs. Where this need is urgent and PPE is required within 72 hours, providers can access PPE through the National Supply Disruption Response (NSDR).
Adult social care providers should continue to order their business-as-usual PPE requirements through their usual channels.
The online PPE portal serves all CQC-registered residential care homes and domiciliary care providers. Providers will have received an email at their CQC-registered email address inviting them to register on the PPE portal.
Any provider who has not received an email invite but believes they should have can contact the customer service team on 0800 876 86802. The team is available between 7am and 7pm, 7 days a week.
Providers can place orders through the PPE portal once every 7 days and the amount that can be ordered will depend upon the size of the provider. See the categories of provider and the volume of PPE each can order.
Local resilience forums and local authorities
Adult social care providers who are not CQC-registered and therefore not covered by the PPE portal should contact their local resilience forum where it is continuing to distribute PPE, or local authority if the LRF has stood down regular distribution, to obtain their free PPE provision for COVID-19 needs.
Providers who are not on the PPE portal should contact their local authority for more information.
National Supply Disruption Response (NSDR) System
You can call the NSDR helpline if you can show an immediate urgent need for PPE. The NSDR does not have access to the full lines of stock held at other large wholesalers or distributers but can mobilise small priority orders of critical PPE to fulfil an emergency need. The helpline is available from 8am to 6pm weekdays at 0800 915 9964.
Help for holders of direct payments, commissioners and care providers
Using your direct payment during the pandemic
- continued use of direct payments during COVID-19, including maximising flexibility of use
- the communication you can expect from local authorities and CCGs to ensure you stay safe during this time
- covering extra expenses during COVID-19
- using direct payment for activities at home
- carer and PA support if you are admitted to hospital
- developing a contingency plan
- payment of family carers or close friends if a PA is not available
For a breakdown of the most important points, see a quick read guide on using direct payments during COVID-19. An easy read version of this guidance is also available. This guidance will be updated shortly.
Advice for people who employ personal assistants (PAs)
See the relevant steps to be taken by people who employ PAs via direct payments. It outlines how employers of PAs should:
- review support arrangements currently in place with the agency or PA to make sure individuals receive the care and support they need during this time
- consider alternative options should the current plans not be robust during COVID-19
- ensure that PAs have access to PPE. Where there are difficulties in getting this locally, even if it’s in somebody’s personalised care and support plan, local authorities and CCGs must help individuals to source PPE, including if the PA is self-employed
- record how individuals prefer their care and support to be delivered, in the case where a PA is unable to support individuals due to self-isolation or contraction of COVID-19
More advice on safely delivering personal care during COVID-19 can be found in the current domiciliary care PPE guidance. If the current arrangements are not adequate due to the wider impact of COVID-19 and there is no alternative, employers should contact the adult social care team or CCG team that provides the direct payment to discuss alternative care arrangements.
Advice for local authorities and CCGs to support people who use direct payments
See step-by-step guidance for local authorities and CCGs to help people who use direct payments to purchase care and support. This will be updated shortly.
Advice for local authorities and NHS to support home care provision
Steps for local authorises and the NHS to support the provision of home care during COVID-19 is set out in the provision of home care guidance. The use of voluntary groups to support home care provision and linking home care providers with the voluntary sector should be considered.
Supplier relief during COVID-19
Information and guidance is available for public bodies regarding the payment of their suppliers to ensure service continuity during and after the current COVID-19 pandemic.
Information for social care providers on mental health and wellbeing and financial support
Support for social care workers relating to mental health
The Every Mind Matters website provides advice and practical tips to help workers look after their mental health and wellbeing. The list of NHS recommended helplines can also offer support and expert advice if workers are struggling.
Shout have developed a free text-based support system for social care staff struggling to cope. Staff can send a message with ‘FRONTLINE’ to 85258 to start a conversation (service is available at any time, day or night).
Samaritans and Hospice UK also provide a dedicated free-to-call support helpline for social care staff. Staff can call The Samaritans on 0800 069 6222 for non-judgmental listening and support from trained volunteers. The helpline is open from 7am to 11pm, 7 days a week and calls are confidential. Staff can also call the Hospice UK bereavement and trauma support line on 0300 303 4434 (8am to 8pm, Monday to Sunday).
We have supported Skills for Care in developing the online Workforce Wellbeing Resource Finder, making it easier for employers and staff to locate relevant resources in their area.
Resources and training for registered managers
For registered managers, peer support is extremely important. Skills for Care has opened up its members Facebook group to other registered managers and frontline managers in similar roles. This is used to share advice, experiences and good practice.
Similarly, registered manager networks can offer local support and are establishing WhatsApp groups to allow registered managers to stay in touch.
Skills for Care have also opened a new advice telephone line (0113 241 1260) and email RMAdvice@skillsforcare.org.uk to provide registered managers with more support.
Wellbeing and bereavement support for social care workers
Guidance on health and wellbeing, including bereavement and financial support, as well as general sources of support and advice for good mental health and wellbeing during the outbreak, is available to all social care staff.
Losing someone close to you, whether it’s a family member, colleague or care user, can be devastating. We have gathered together some bereavement resources for the social care workforce, which we hope may help during this very difficult time.
Advice for employers and those who are self-employed
The guidance on supporting the health and wellbeing of the adult social care workforce provides advice for employers and the self-employed, including support for registered managers and those who work alone. This includes advice on supporting staff wellbeing and building resilience, managing stress and anxiety, and bereavement support.
Taking time off to care for a relative who has COVID-19 symptoms or is self-isolating
Workers should talk to their employer(s) about their caring needs and what arrangements can be put in place. Information regarding statutory sick pay entitlements can be found in the guidance for employees. Some people may be entitled to benefits as a carer, such as Carer's Allowance.
Financial support for employers of social care workers
The guidance on supporting the health and wellbeing of the adult social care workforce provides advice regarding financial support for social care workers during the COVID-19 pandemic.
More information on financial support for employers can be found in the section above on help for holders of direct payments, commissioners and care providers.
Information for providers of care for adults with learning disabilities and autistic adults
Guidance is available for care workers and personal assistants who support adults with learning disabilities and autistic adults. There is also guidance on providing unpaid care to adults with learning disabilities and autistic adults.
In addition to this, DHSC has worked with the Social Care Institute for Excellence (SCIE) to produce a dedicated portal with a range of guidance for care providers for adults with learning disabilities and autistic adults.
Capacity Tracker and guidance on using it
The web-based Capacity Tracker enables care homes to share their available capacity in real time and allows users to search for care home availability across England. The system helps the user identify suitable care homes, helping the individual to make the right choice for them and ensuring that they don't stay in hospital any longer than is necessary.
The Capacity Tracker was identified as a suitable system to support national and local planning during the COVID-19 pandemic and its re-purposing was announced via the government’s Action Plan (15 April 2020) and joint letter (17 April 2020) from DHSC and NHSE&I together with the CQC and the CPA.
In addition, hospice providers and community rehabilitation settings were also added to the Capacity Tracker in April 2020 with Home Care providers being added in November (replacing the CQC system).
The data collection covers many key items – vaccination, visiting, PPE availability, workforce risk, acute setting discharge COVID testing status, IPC measures, training and wider support, with specific questions for care home and home care providers. It has given invaluable support to the multi-agency response to care homes throughout the pandemic by providing a single source of information.
Questions for care home providers capturing COVID-19 vaccination monitoring were added in December 2020. Throughout early 2021, further COVID-19 vaccination monitoring questions were added to cover home care providers, and LA and non-CQC registered staff working in frontline care.
DHSC set up a stakeholder group to advise on changes to the tracker, including local authority and care home provider representatives and this representation has continued as governance of the tracker has become more formalised.
The Capacity Tracker is managed on behalf of DHSC and NHS England by the North of England Commissioning Support Unit (NECS). NECS maintain a library of materials for those who use the Capacity Tracker, which are available to download from the Capacity Tracker website (you must be signed into your account to access these).
Information for unpaid carers
GOV.UK guidance for unpaid carers provides information, support and signposting to other relevant guidance for people who are caring, unpaid, for friends or family during the coronavirus outbreak.
You can also find guidance for people who are providing unpaid care to adults with learning disabilities and autistic adults during the coronavirus outbreak.
Easements of the Care Act
New guidance created under the Coronavirus Act 2020, Care Act easements: guidance for local authorities, sets out how local authorities can use the new Care Act easements to ensure the best possible care for people during this exceptional period.
This includes information on:
- what duties are replaced by powers under the easements
- protections and safeguards
- principles to govern the use of these powers in social care
- steps to take before exercising the Care Act easements
COVID-19 ethical framework for adult social care
The ethical framework for adult social care is aimed at planners and strategic policy makers at local, regional and national level to support response planning and organisation of adult social care during COVID-19.
The ethical values and principles outlined in this framework should be followed to guide decision-making at all stages, particularly when:
- making decisions on care provision
- making challenging decisions on how to redirect resources where they are most needed
- prioritising individual care needs
- either considering to operate or operating under Care Act easements
The framework must be followed alongside appropriate COVID-19 guidance and relevant equalities-related and human rights frameworks, while meeting statutory duties and professional responsibilities.
Caring for people who are protected by safeguards under the Mental Capacity Act 2005, including the deprivation of liberty safeguards
During the pandemic, the principles of the Mental Capacity Act 2005 (MCA) and the deprivation of liberty safeguards (DoLS) still apply in England and Wales. The MCA provides protection for people who lack or may lack the relevant mental capacity to make decisions about different aspects of their life.
The DoLS are an important part of this act and provide further safeguards for those who need to be deprived of their liberty in order to receive care or treatment in a care home or hospital, but do not have the capacity to consent to those arrangements.
The government has issued guidance about how to care for people who may lack the relevant mental capacity needed to make decisions about arrangements for their own care and treatment, in care homes, in England (see section 2F). This includes information about capacity assessments and testing for COVID-19.
The Social Care Institute for Excellence (SCIE) has produced advice about how social care providers should implement their MCA duties and powers during the pandemic. This covers the principles of the MCA, DoLS and applications to the Court of Protection. SCIE has also published advice about how to consider ‘best interest decisions’ during the pandemic.
The government has published detailed guidance about DoLS during the pandemic, The Mental Capacity Act (2005) (MCA) and deprivation of liberty safeguards (DoLS) during the coronavirus (COVID-19) pandemic.
Like DoLS, this guidance applies to deprivations of liberty in care homes and hospitals, in England and Wales. This guidance covers best interests decisions, life-saving treatment and depriving a person of their liberty. There is additional guidance with more detail on testing for COVID-19, advance planning and self-isolation.
The government’s guidance on visiting care homes in England during the pandemic includes information about residents who may lack the relevant capacity to decide whether or not to consent to a provider’s visiting policy.
Steps to take following a coronavirus-related death of a person who worked in adult social care
In the sad event of the death of a worker in adult social care from COVID-19, there are several actions that employers may need to take. There is step-by-step guidance and information on actions employers may need to take, including resources about bereavement.