1. Introduction

In Coronavirus (COVID-19) Vaccination of People Working or Deployed in Care Homes: Operational Guidance (Department of Health and Social Care), the Department of Health and Social Care states: ‘Vaccinated people are better protected from severe illness and death as a result of COVID-19….There is evidence to suggest that the COVID-19 vaccine also prevents those who catch the virus from infecting other people…. The virus will remain in some shape or form and we will have to learn to live with it. It will continue to circulate, potentially evolving into new variants.’

As from 11 November 2021, it is law that anyone entering a care home must have had a complete course of an authorised COVID-19 vaccine or be medically exempt (see Section 5, Medical Exemptions).

This also applies to those visiting a care home in a professional capacity, unless they are exempt or attending in an emergency (see also Guidance for Visiting Professionals, DHSC).

This chapter is a summary of the guidance published by the Department of Health and Social Care. See the full guidance Coronavirus (COVID-19) Vaccination of People Working or Deployed in Care Homes: Operational Guidance (Department of Health and Social Care). Also see Getting the Coronavirus (COVID-19) Vaccine for Work (ACAS) for more information, including guidance regarding staff who refuse to get the vaccine.

1.1 Summary of the regulations

The regulations mean that all CQC-registered care homes must make sure that a person does not enter the care home unless:

  • they have provided satisfactory evidence that:
  • they need to provide emergency assistance in the care home;
  • they are under the age of 18.

The vaccination requirement only applies to people who go inside a care setting (the definition of ‘care home’ does not include any surrounding grounds). If someone is not entering the building, they do not need to show their vaccination status.

2. Guidance for Registered Persons

The person registered with the CQC as a manager or service provider must ensure that they do not allow anyone to enter the inside of a care home, unless they have had a complete course of doses of an authorised vaccine or are exempt (see also Section 5, Medical Exemptions).

While checks may be undertaken by other members of staff with instructions from the registered person, it is the registered person who has the overall responsibility for ensuring compliance with the requirements, as stated in this chapter. See Coronavirus (COVID-19) Vaccination of People Working or Deployed in Care Homes: Operational Guidance (Department of Health and Social Care) for more information.

Staff who visit care homes should be prepared to have their vaccine status checked by a member of the care home staff.

3. Demonstrating Vaccination Status

NHSX are considering how the NHS COVID Pass service could be used to support care home staff to check vaccination status. In the meatime, those who have been vaccinated by the NHS can demonstrate their COVID-19 vaccination records through:

  • the NHS app;
  • the NHS website – NHS.uk;
  • the NHS COVID Pass letter.

An NHS appointment card cannot be used as proof of vaccination status.

4. Record Keeping

Staff visiting care homes should be aware that records will need to be kept regarding vaccine status of those visiting care homes.

The registered person must keep records so that they can demonstrate the care home is compliant with the regulations. These must be in line with data protection principles and legislation. Records may also be accessed by the CQC as part of an inspection.

The registered person should keep a record of:

  • the vaccination or exemption status of staff members and the date it was last checked;
  • the vaccination or exemption status of those entering the care home (unless exempt) and the date that the status was last checked.

Their status should be recorded on the care home’s local system (for example IT system or paper record).

There is no requirement to record the reason behind an exemption; they should only record whether a person is medically exempt or not.

People only need to provide evidence on the first occasion they enter or register. The care home’s record can be checked, rather than evidence being required each time.

5. Medical Exemptions

See also General Guidance on Medical Exemptions (DHSC)

Some people cannot receive a vaccination for medical reasons. If so, they will be able to ask for a clinically approved medical exemption from the need to be vaccinated.

There will be a clear process to follow if people think they may have a clinical reason to be exempt. Guidance for certification is being developed and this information will be updated when it has been published.

Managers should do a risk assessment for those who are exempt from vaccination. This means they will assess the potential risk to the spread of COVID-19 caused by unvaccinated (but exempt) members of staff coming into the care home. They may put in place measures to help reduce this risk, for example by asking exempt members of staff to wear more personal protective equipment (PPE), different types of PPE or by suggesting a change to their duties. See also Section 6, Reducing Risk of Transmission below.

6. Reducing Risk of Transmission

COVID-19: How to Work Safely in Care Homes (UK Health Security Agency)

Although everyone entering a care home will either be vaccinated or exempt, it is still very important that everyone continues to follow infection prevention and control measures, including the correct usage of PPE, to reduce the risk of transmission.

Staff should always follow the instructions from care home staff regarding testing, use of PPE and social distancing for example.