Vaccination in care homes in England
Anyone who works inside a Care Quality Commission (CQC) registered care home in England must be fully vaccinated against coronavirus (COVID-19), unless they're exempt.
This became law on 11 November 2021. It only applies to CQC-registered care homes that provide accommodation for people needing nursing or personal care.
The law applies to most people who enter the care home for work, including:
- agency workers
- contractors or self-employed people hired to carry out work in a care home, for example tradespeople, occupational therapists or hairdressers
- people not employed by the care home who need to enter for work, for example doctors, nurses and CQC inspectors
- work experience students
- job applicants attending an interview
This includes people who live in Scotland or Wales but work in a CQC-registered care home in England.
The following people are exempt:
- anyone with a medical exemption – see medical exemptions on GOV.UK
- current care home residents and service users
- friends and family of a current resident
- workers who do not enter the care home at all, for example a gardener
- someone providing emergency assistance or urgent maintenance
- members of the emergency services who need to enter the care home to carry out their job
- anyone visiting a dying resident
- anyone giving bereavement support to a resident after the death of a relative or friend
- anyone under 18
Talking about the new requirements
Employers should plan, discuss and agree any steps they'll need to take with staff, contractors and suppliers.
Informing and consulting staff and volunteers
Employers should discuss the new law with staff and any recognised trade union representatives or employee representatives.
Employers should have discussions with anyone who is temporarily away from work, for example anyone on:
- a career break
- maternity, adoption or shared parental leave
- long term sick leave
It's a good idea to discuss:
- the law
- who needs to be vaccinated to enter the care home
- who is exempt
- how you'll check if someone's vaccinated
- how someone should prove they're vaccinated or exempt
- how you'll use, store and delete vaccination data, in line with data protection law (UK GDPR)
- how staff can book a vaccination, if they're not fully vaccinated yet
- policy for time off work related to the vaccine, including sick leave if someone has side effects
- options if someone is not able to enter the care home
- how staff can ask questions or raise an issue if they have any concerns
Informing contractors and people carrying out work in the care home
Employers should contact anyone who needs to enter the care home for work, to let them know they'll need to show proof of their vaccination or exemption. For example, tradespeople, hairdressers or occupational therapists.
Support for care home managers
As a manager, you can find guidance and resources to help encourage vaccinations and retain care home staff:
- operational guidance for vaccination of people in care homes on GOV.UK
- COVID-19 vaccination resources from Skills for Care
- vaccine communications toolkit for adult social care from Public Health England
- COVID-19 medical exemption guidance on GOV.UK
Checking someone is vaccinated
The person responsible for checking who can enter the care home is the care home's 'registered person'. This is the person registered with the CQC as the care home's manager or service provider.
Checks may be carried out by other employees, but the registered person is legally responsible for the checks and keeping a record of them.
Each care home needs to work out the best way to check everyone's vaccination status. For example, they might have a single checkpoint outside the building.
What to record
The care home must keep a record of the date they checked the vaccination or exemption status for:
- all staff members
- other people carrying out work inside the care home (unless they're exempt from checks)
If someone has a medical exemption, the reason for the exemption should not be recorded. This is to protect their confidential medical information and comply with data protection law (UK GDPR).
Storing vaccination status data
Care homes must keep records about vaccination and exemption checks to comply with the law, and process the information in line with data protection law (UK GDPR).
The registered person may need to share these records with the CQC.
How to show proof of vaccination or medical exemption
If someone lives in England, they can show proof of their vaccination or exemption status using one of these:
If someone lives in Scotland, they can show proof by getting a record of their coronavirus vaccination status on NHS Inform.
If someone lives in Wales, they can show proof using the NHS COVID Pass in Wales.
Someone should only need to show proof of their vaccination or exemption status once for the care home to take a record. Care home managers can decide to do checks more often, but there is no requirement to do so.
How the law will be enforced
The CQC will check that registered care homes in England are complying with the law as part of their usual monitoring and inspection processes.
If care home staff are not vaccinated
If someone is not fully vaccinated (and not exempt) they will not be able to enter the care home.
Employers should make it clear to staff:
- they must be fully vaccinated
- what will happen if they cannot show proof of their vaccination or exemption
If a staff member has concerns about having the vaccine, employers should encourage and support them to get vaccinated so they'll be able to enter the premises.
If a staff member refuses to get the vaccine
If an employee is not vaccinated and not exempt, it's best to discuss it, and try and resolve it informally.
The employer and employee should talk about any reason the employee is not vaccinated, and any support the employer can offer.
Depending on the circumstances, they might be able to consider other options. For example, they might agree for the employee to:
- do suitable alternative work outside the care home premises, for example in an office or another place where they do not need to be vaccinated
- take short-term paid or unpaid leave, for example if they're waiting to get the vaccine or proof of exemption
- do training that can be done from home or away from the workplace for a limited time
If the employer has explored all available options and is considering dismissal or any other action, they must follow a full and fair procedure. This includes offering the employee the right to appeal any decision. For example, if the employer is considering disciplinary action, they must follow a full disciplinary procedure.
If an employer is considering taking any action related to getting the vaccine, including dismissal, it’s a good idea to get legal advice.
Employers should treat everyone fairly and follow discrimination law. Find out more about discrimination, dismissal and vaccination for care home workers in annex A of the operational guidance on GOV.UK.
If an employee feels they have been treated unfairly or discriminated against, they can raise it formally by 'raising a grievance'.
To talk through your specific circumstances, you can contact the Acas helpline. We can talk through your options but we cannot give you legal advice.
If other people carrying out work in the care home are not vaccinated
If someone is not a staff member and needs to enter the care home for work, they cannot enter the premises if they cannot prove their vaccination or exemption status.
If they are not vaccinated or exempt, someone responsible for the care home's checks should either talk to the person or their employer to try and resolve the issue.