Official Statistics

Adult social care monthly statistics, England: December 2021

Published 9 December 2021

Applies to England

Main points

COVID-19 and flu vaccination in social care settings

As of 23 November 2021, the proportions who had received a booster dose of the COVID-19 vaccine were:

• 70.8% of total residents and 29.4% of total staff of older adult care homes
• 52.5% total residents of younger adult care homes
• 24.8% total staff of younger adult care homes and 15.3% total staff of domiciliary care staff

As of 23 November 2021, the proportions who had received their flu vaccination for the 2021 to 2022 season were:

• 70.7% of total residents and 18.9% of total staff of older adult care homes
• 54.9% of residents of total younger adult care homes
• 16.8% of total staff of younger adult care homes and 9.5% of total domiciliary care staff

Infection control measures in care homes

In the week ending 23 November 2021:

• 93.0% of care homes in England were able to accommodate residents receiving visitors – this has remained broadly consistent since late July 2021
• 82.6% of care homes who had staff required to self-isolate paid those staff their full wages while self-isolating – this proportion has remained consistent since mid-December 2020
• 70.6% of care homes had no staff members working in another health or social care setting – this proportion has continued to gradually decline from 78.2% at the end of April 2021

COVID-19 testing in care homes

ln the week ending 23 November 2021:

• for both care home staff and residents, there has been an overall decrease in the number of positive tests returned from PCR and LFD kits throughout November, in contrast to the increase seen throughout October
• there has continued to be a gradual decline in the number of LFD tests conducted in care home staff since the end of July. While the number of PCR tests conducted in care home staff continues to be lower than July levels, the number has remained relatively stable since October 2021
• the number of LFD and PCR tests conducted in residents has remained at broadly consistent levels since late July but there has been a decrease in the number of PCR tests throughout November compared to October

Introduction

This is a monthly publication by the Department of Health and Social Care (DHSC) of statistics on adult social care in England. This statistical bulletin provides an overview on a range of information on social care settings, with a focus on the impact of COVID-19.

This report provides newly published information on:

• selected infection prevention control (IPC) measures in care homes at national, regional and local authority level

• staffing levels in care homes at national, regional and local authority level

• personal protective equipment (PPE) availability in care homes and domiciliary care at national, regional and local authority level

• testing for COVID-19 in care homes at national, regional and local authority level

• flu vaccination for the 2021 to 2022 flu season in adult social care settings at national, regional and local authority level

This report also includes previously published statistics on uptake of first, second and booster doses uptake of COVID-19 vaccinations in adult social care settings.

For more information and links to other published sources of adult social care data please see the ‘About this data’ section below.

Publication updates

Data is now available for the proportion of social care staff and residents who have received a booster dose of the COVID-19 vaccine. Data is available from 28 September 2021 onwards.

The next publication will be published on 13 January 2021. Dates for future publications will be pre-announced on the GOV.UK publication release calendar.

COVID-19 vaccination in adult social care settings

How the data can be used

This data can be used for:

• comparing vaccination rates across local authorities and regions in England as self-reported by care providers for the:

  • first, second and booster doses of the COVID-19 vaccine
  • flu vaccinations for the 2021 to 2022 season

• monitoring vaccination rates over time for the:

  • first, second and booster doses of the COVID-19 vaccine
  • flu vaccinations for the 2021 to 2022 season

This data cannot be used for:

• estimating the number of social care staff or residents who have not been vaccinated
• estimating the number of social care staff or residents who have been vaccinated abroad
• comparing with vaccination rates in other countries of the UK
• directly comparing vaccination take up rates between different types of care home staff (directly employed and agency staff)
• estimating the number of vaccinations delivered each day

Data is now available for the proportion of social care staff and residents who have received a booster dose of the COVID-19 vaccine. These rates do not distinguish between those who are eligible for a booster, given the recommended gap between second and booster doses.

The total number of staff and residents for each social care setting as well as the number reported to be vaccinated for COVID-19 and flu are self-reported by the care provider and local authorities. As a result, the rates in this publication refer to the percentage of staff and residents reported to be vaccinated by care providers. This means that the number of individuals who have not received the vaccine cannot be directly derived from data published in these statistics as there is a number of individuals for whom the vaccination status is unknown to the care provider.

The dates in this section refer to the dates vaccinations were reported by care providers as opposed to the date vaccinations were administered.

Some care providers have reported the total number of staff or residents but not the numbers vaccinated. As a result of this, vaccination rates are affected by response rates. This is particularly prominent for vaccination rates for second doses in staff employed in other settings and boosters and flu for all staff and resident groups. This is because these groups have a lower response rate and as a result, second dose vaccination rates may be underestimated.

For data relating to 9 November 2021 and before, response rates may have been underestimated, particularly for boosters and flu vaccination. This is because the default value in the underlying data is set to zero, so any zero values submitted will appear to be non-responses. From 9 November 2021 onwards, care providers are required to select that they have reviewed their responses to confirm the data submitted is accurate, therefore increasing the accuracy of response rates.

Among care home staff, there is a substantial difference in reported vaccination rates for COVID-19 and flu vaccinations between staff directly employed by care homes and staff employed by agencies operating within care homes. This could be due to, for example but not exclusively, different uptake rates, vaccination status not being known to the care provider or the nature of employment and information available to the care homes.

For data relating to 31 August 2021 onwards, a small number of social care staff who had their vaccination outside of the UK are excluded from the numbers vaccinated.

For more information, please see the background quality and methodology note.

COVID-19 vaccinations

Adult social care groups covered in this publication by JCVI priority group for COVID-19 vaccination

This is a summary of the priority groups for different social care staff and residents.

JCVI priority group 1:

• residents in older adult care homes

• staff directly employed by older adult care homes

• agency staff working in older adult care homes

JCVI priority group 2:

• staff directly employed by younger adult care homes

• agency staff working in younger adult care homes

• domiciliary care staff registered to independent Care Quality Commission (CQC) providers

• social care staff working in other settings (including non-registered providers and local authority employed)

Not in a specific JCVI priority group:

• residents of younger adult care homes

The NHS started administering vaccinations for COVID-19 in England on 8 December 2020. Social care staff and residents of care homes were prioritised for the vaccine according to the Joint Committee on Vaccination and Immunisation (JCVI) recommendation. For more information see Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI.

From 11 November 2021, all people working or volunteering in care homes are required to have received 2 doses of the COVID-19 vaccine as a condition of their deployment in a care home, unless exempt. This report contains data relating up to 23 November 2021. The final date for staff to receive their first dose of the vaccination so they were fully vaccinated in time for the regulation to come into force was 16 September 2021, based on the assumption of an 8-week interval between first and second doses. More details can be found on Vaccination of people working or deployed in care homes: operational guidance.

Adult social care staff and residents are now eligible for a COVID-19 booster vaccination after receiving their second dose. More details can be found at COVID-19 vaccination: a guide to booster vaccination.

COVID-19 vaccinations in JCVI priority group 1

96.7% older care homes have provided data on the number of staff and residents who received a COVID-19 booster dose, as of 23 November 2021. This means the first and second dose rates and the number of staff and residents receiving a booster dose may be underestimated compared to the true value. For full response rates please see the accompanying ‘COVID-19 vaccination response rates, December 2021: data tables’.

The figures used in this report differ to the reported 81.7% of eligible residents reported on 5 November 2021 in the news article NHS offers residents in every eligible care home a COVID booster jab, as a different methodology was used.

Going forward we recommend users use the rates in this report and the weekly NHSEI weekly COVID-19 vaccination statistics, which use the total number of residents for consistency purposes. Please note it does not distinguish those who are eligible for a booster dose. Please see the accompanying background quality and methodology document for more details.

Residents of older care homes

As of 23 November 2021, in older adult care homes:

• 96.3% of residents have been reported to have received their first dose
• 95.1% of residents have been reported to have received their second dose
• 70.8% of residents have been reported to have received their booster dose

The reported first dose vaccination rate rapidly increased between January and February 2021 for residents and has since continued to increase but at a much slower pace as more of the population receive the first dose.

For second doses the reported rate increased steeply between April and June 2021 and has continued to increase but at a slower rate since then.

There is little regional variation in the reported second dose vaccination rate among residents in older adult care homes. London continues to show the lowest uptake, with 93.1% of residents reported to have received both doses.

There is large variation in booster doses administered regionally, with the North East region having the largest uptake with 75.0% of residents vaccinated, compared to the lowest uptake in the East Midlands with 63.5%.

Staff of older adult care homes

As of 23 November 2021, in older adult care homes:

• 95.7% of staff have been reported to have received their first dose
• 93.8% of staff have been reported to have received their second dose
• 29.4% of staff have been reported to have received their booster dose

The reported first dose vaccination rate rapidly increased between January and February 2021 for staff and has continued to increase each week.

Similarly, for second doses the reported rate increased steeply between April and June 2021 and has continued to steadily increase since July 2021.

There is little variation between regions among staff of older adult care homes who have been reported to have received their second dose.Out of all regions, London has shown the quickest increase in second dose vaccination since the end of August 2021, increasing from 78.2% to 94.9% in the week ending 23 November 2021. The West Midlands currently has the highest second dose take up rate, reporting 95.1% as of 23 November 2021.

For booster doses, there is large regional variation, with the North East region having the highest uptake with 34.5%, and London having the lowest at 20.7%.

Figure 1: percentage of staff and residents of older adult care homes who have received the first, second and booster doses of the COVID-19 vaccination, cumulative rate, 15 December 2020 to 23 November 2021, England

Reported booster vaccination rates steeply increases for both staff and residents of older adult care homes.

Source: Capacity Tracker

Figure 2: percentage of older adult care home staff who have received their second dose of the COVID-19 vaccination by local authority as of 23 November 2021, England

A majority of local authorities have reached a 90% reported dose 2 vaccination rate for staff in older adult care homes.

Data for figures 1 and 2 can be found in tables 1 and 2 of the accompanying ‘COVID-19 vaccination statistics’ tables in addition to data by region and local authority.

Notes:

• data is reported from care providers
• based on date of reporting rather than date of vaccination

COVID-19 vaccinations in JCVI priority group 2

Data for staff working in other settings (including non-registered providers and local authority employed) is not available for dates after 17 August 2021 for national, South East region, and Surrey local authority. This is due to a data quality issue that is being investigated. As a result, data in this report refers to the week ending 17 August 2021 rather than 23 November 2021.

The following proportions of social care staff in JVCI priority group 2 have been reported to have received their COVID-19 vaccination doses:

In younger adult care homes as of 23 November 2021:

• 94.5% of staff have been reported to have received their first dose
• 91.8% of staff have been reported to have received their second dose
• 24.8% of staff have been reported to have received their booster dose

For domiciliary care staff as of 23 November 2021:

• 84.6% of staff have been reported to have received their first dose
• 76.8% of staff have been reported to have received their second dose
• 15.3% of staff have been reported to have received their booster dose

Among staff working in other settings as of 17 August 2021:

• 77.0% of staff have been reported to have received their first dose
• 32.9% of staff have been reported to have received their second dose

As data is self-reported by care providers, COVID-19 vaccination rates are affected by response rates. An overview of response rates is in the table below.

Table 1: percentage of providers that have provided data on the number of staff vaccinated at least once as of 23 November 2021

Dose	Younger adult care home providers on behalf of their staff	Domiciliary care providers on behalf of their staff	Local authorities on behalf of staff working in other settings
Provided data on first dose	98.6	95.7	98.0
Provided data on second dose	98.4	93.1	63.8
Provided data on the booster dose	93.7	84.5	21.7

Due to these response rates, the number of staff and residents, particularly for boosters, will be underestimated compared to the true value. For full response rates please see the accompanying ‘COVID-19 vaccination response rates, December 2021: data tables’.

There is regional variation for all staff groups in JCVI priority group 2, please see table 1 for further details.

Figure 3: percentage of younger adult care home and domiciliary care staff who have received the first, second and booster dose of the COVID-19 vaccination, cumulative rate, 15 December 2020 to 23 November 2021, England

Reported booster vaccination rates for staff steeply increases.

Source: Capacity Tracker

This data can be found in tables 6, 9 and 10 of the accompanying ‘COVID-19 vaccination statistics’ tables in addition to data by region and local authority.

Notes:

• data collection for the second dose began on 20 April 2021
• data is self-reported from care providers
• based on date of reporting rather than date of vaccination

Table 2: percentage of younger adult care home and domiciliary care staff reported to have received the first, second, and booster doses of the COVID-19 vaccine, up to 23 November 2021 by region, England

Region	Younger adult care home staff: dose 2	Younger adult care home staff: booster	Domiciliary care staff: dose 2	Domiciliary care home staff: booster
East Midlands	89.4	20.2	78.6	15.4
East of England	90.5	25.7	79.6	17.7
London	94.5	24.5	63.9	2.6
North East	95.5	36.3	82.5	21.7
North West	92.0	23.8	77.5	15.1
South East	90.0	20.7	79.8	18.4
South West	92.5	28.4	81.0	19.9
West Midlands	92.1	25.7	73.6	14.7
Yorkshire and the Humber	93.4	26.5	81.6	18.8

Note: data is not presented for other settings staff due to a data quality issue affecting data after 17 August.

COVID-19 vaccinations for residents of younger adult care homes

Residents of younger adult care homes are not part of a single priority group for the COVID-19 vaccine. However, the conditions for which they reside in care homes are likely to make them more vulnerable to COVID-19 and they are therefore likely to be part of priority groups 3 to 9.

As of 23 November 2021, in younger adult care homes:

• 93.7% of residents have reported to have received their first dose
• 91.3% of residents have reported to have received their second dose
• 52.5% of residents have reported to have received their booster dose

Flu vaccination in adult social care settings

The national influenza (flu) immunisation programme aims to provide direct protection to those who are at higher risk of influenza associated morbidity and mortality. Groups eligible for NHS influenza vaccination are based on the advice of the JCVI. More details can be found in the National flu immunisation programme 2021 to 2022 letter.

This report covers cumulative flu vaccination rates for the 2021 to 2022 season in the below adult social care groups:

• residents in older adult care homes
• staff directly employed by older adult care homes
• agency staff working in older adult care homes
• staff directly employed by younger adult care homes
• agency staff working in younger adult care homes
• domiciliary care staff registered to independent CQC providers
• social care staff working in other settings (including non-registered providers and local authority employed)
• residents of younger adult care homes

Guidance on flu vaccination for social care workers was updated on 9 September 2021. For more information, please see the background quality and methodology note.

Data is self-reported by care providers and local authorities, who may submit their resident and staff numbers but not the number receiving the flu vaccination, resulting in a lower reported percentage vaccinated. An overview of response rates for the numbers vaccinated is in the table below.

Table 3: percentage of providers that have provided data on the number of staff or residents who received a flu vaccination for the 2021 to 2022 season, as of 23 November 2021

	Older adult care home providers on behalf of their staff	Younger adult care home providers on behalf of their staff	Domiciliary care providers on behalf of their staff	Local authorities on behalf of staff working in other settings
Percentage who provided flu data at least once	96.6	93.8	84.4	17.8

For full response rates please see the accompanying ‘COVID-19 vaccination response rates, November 2021: data tables’.

Older adult care homes

As of 23 November 2021, the proportions of those who have received a flu vaccination in older adult care homes were:

• 70.7% of residents
• 18.9% of all staff

Younger adult care homes

As of 23 November 2021, the proportions of those who have received a flu vaccination in younger adult care homes were:

• 54.9% of residents
• 16.8% of all staff

Domiciliary care staff and staff working in other settings

As of 23 November 2021, the proportions of staff who work in domiciliary care and other settings who have received a flu vaccination were:

• 9.5% of domiciliary care staff
• 0.8% of staff working in other settings

Figure 4: percentage of social care staff and residents who have received the flu vaccination, cumulative rate, 23 November 2021, England

The reported flu vaccination rates are highest among older adult care home residents.

There is regional variation in reported flu vaccination uptake among each of the adult social care groups. The variation is most pronounced among residents of older and younger adult care homes. Regional variation among all groups is summarised in table 4.

Table 4: percentage of each social care group reported to have received a flu vaccination up to 23 November 2021 by region, England

Region	Older adult care home staff	Older adult care home residents	Younger adult care home staff	Younger adult care home residents	Domiciliary care staff	Other settings staff
East Midlands	17.7	65.1	13.2	47.3	9.4	1.7
East of England	16.8	71.9	17.0	55.4	9.8	0.2
London	14.0	73.1	17.7	61.8	2.1	0.1
North East	20.4	75.0	26.3	59.8	12.9	2.8
North West	20.7	73.1	18.1	56.2	9.7	1.2
South East	17.9	67.7	13.9	52.9	12.0	0.4
South West	21.6	72.5	16.4	50.6	11.3	0.1
West Midlands	19.7	68.3	18.1	56.9	10.3	1.1
Yorkshire and the Humber	20.3	72.7	18.1	57.5	11.3	1.0

Infection prevention control measures

How the data can be used

This data can be used for:

• estimating the number and proportion of care homes that indicate they:
  • are accommodating COVID-safe visits within the care homes in line with government guidance
  • are paying full wages to the majority of their self-isolating staff
  • restrict staff movement across settings
• monitoring trends over time
• comparisons across local authorities and regions in England

This data cannot be used for:

• estimating the number of visitors in care homes and their infection or vaccination status
• comparing with other countries of the UK
• linking staff movement across settings to positivity rates

The Adult Social Care Infection Control and Testing Fund provides funding from local authorities to ensure that infection prevention control (IPC) measures are in place to curb the spread of COVID-19. This publication provides data on how providers are implementing the following measures:

• limitation of staff movement across different social care settings
• accommodating COVID-19 safe visitation in care homes in line with government guidance
• payment of full wages when care home staff are isolating due to COVID-19

More details on the data collection, coverage and quality of this data can be found in the ‘About this data’ section below.

Accommodating COVID-safe visitation in care homes

The guidance on allowing care home residents to have visitors has changed since December 2020 which is summarised in the table below.

Table 5: visiting guidance since December 2020

Date	Guidance
19 July 2021 to present	No limits on the number of named visitors, with testing and guidance to support safe visiting in place
17 May 2021 to 18 July 2021	Residents are permitted to have 5 named visitors for regular visits with testing in place
12 April 2021 to 16 May 2021	Residents are permitted to have 2 named visitors for regular visits with testing in place
8 March 2021 to 11 April 2021	Residents are permitted to have 1 named visitor for indoor visits with testing in place
6 January 2021 to 7 March 2021	No indoor visits permitted due to the national lockdown
1 December 2020 to 5 January 2021	Indoor visits permitted with testing in place (from 19 December 2020 – no indoor visits permitted in tier 4 areas)

More information can be found in the guidance on care home visiting. This report covers care homes that are accommodating visitation in line with this guidance. This could cover visitation in the care homes premises, either indoors or outdoors, or also visits off premises, either for the day or overnight.

In the week ending 23 November 2021:

• 93.0% of care homes in England were able to accommodate residents receiving visitors within care homes in all circumstances. This proportion has remained broadly consistent since late July 2021
• a further 3.5% were able to accommodate visits in exceptional circumstances. Exceptional circumstances are individually defined by each care home but are generally thought to be considered when residents are palliative
• there is regional variation with 94.6% of care homes accommodating visitors in the South East in comparison to 89.7% in the South West

Figure 5: percentage of care homes accommodating or limiting visits for residents, 15 December 2020 to 23 November 2021, England

The proportion of care homes accommodating visiting for residents has remained stable since the end of July.

Source: Capacity Tracker

This data can be found in table 1 of the accompanying ‘Infection control, PPE and staffing level statistics’ tables in addition to data by region and local authority.

Payment of care home directly employed staff while self-isolating due to COVID-19

The infection control funds can be used to ensure staff who are self-isolating along with government guidance are paid their full wages. This includes:

• staff isolating while waiting for a test

• isolating after having tested positive or after a positive test in their household

• staff required to quarantine prior to receiving certain NHS procedures

For more information see stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection.

Employers who do not pay their staff their full wages while self-isolating must pay their staff at least Statutory Sick Pay (SSP) when the employee meets the following criteria:

• is classed as an employee and has done some work for their employer
• earns an average of at least £120 per week
• has been ill or is self-isolating for at least 4 days in a row (including non-working days)

Care home staff who do not meet the criteria may not be eligible and as a result not paid to self-isolate. For more information, please see guidance on Statutory Sick Pay.

The figures in this report refer to care homes which had staff required to self-isolate in the relevant week. This means care homes who had no staff needing to self-isolate will be excluded from the rates for the relevant week. There may be several care providers who may use a combination of payment options for staff wages. In these situations, providers should report the option they use for the majority of their staff.

In the week ending 23 November 2021:

• 82.6% of care homes who had directly employed staff needing to self-isolate paid staff their full wages. This proportion has remained consistent since mid-December
• there is substantial regional variation with 87.9% of providers in the North West paying their staff full wages compared to 76.4% in the East Midlands

Figure 6: percentage of care homes with staff self-isolating by wages paid, week ending 23 November 2021, England

More than 8 in 10 care homes were reporting to pay their staff full wages when self-isolating.

Source: Capacity Tracker

This data can be found in table 2 of the accompanying ‘Infection control, PPE and staffing level statistics’ tables in addition to data by region and local authority.

Limiting staff movement between care settings

Infection control funding can be used to reduce the need for staff movement between social care settings to limit the spread of infection, for example they can be used to recruit additional staff to enable staff to only work across one care home.

In the week ending 23 November 2021:

• 70.6% of care homes had no staff members working in another social care setting, this proportion has been steadily declining since late April 2021 when this proportion was 78.2%
• 7.5% of care homes had some staff additionally working in another health or social care setting
• a further 22.0% of care homes had some staff additionally working in another health or social care setting due to exceptional circumstances. This number has been increasing steadily since mid-May. Exceptional circumstances are defined as the care home having exhausted all other reasonable steps to ensure there are sufficient staffing levels
• there is substantial regional variation with 80.8% of providers in the North East having no staff working in another health or social care setting in the week ending 23 November 2021, in comparison to 65.9% in both the South East and South West

Figure 7: percentage of care homes by staff working across additional health or social care settings, week ending 23 November 2021, England

Seven in 10 care homes reported having no staff working across another health or social care setting.

Source: Capacity Tracker

This data can be found in table 3 of the accompanying ‘Infection control, PPE and staffing level statistics’ tables in addition to data by region and local authority.

Care home staffing levels

How the data can be used

This data can be used for:

• estimating the number and proportion of care homes that indicate they are operating within their agreed staffing ratios
• monitoring trends over time
• comparisons across local authorities and regions in England

This data cannot be used for:

• identifying the reasons for care home staff shortages and absences
• linking staff shortages and the number of positive cases among care home staff
• comparing with other countries of the UK

In order to measure the workforce pressures on providers during the pandemic, each provider is asked to assess their workforce pressures based on their agreed staffing ratios More details on how staffing ratios are agreed can be found within the CQC guidance on staffing.

In the week ending 23 November 2021:

• 0.4% of providers flagged that their agreed staffing ratios had been breached
• 4.6% flagged that they were operating within the agreed staffing ratios but there is a significant risk of escalation in the coming days
• 95.0% were operating within their agreed staffing ratios. This has remained broadly consistent since mid-December 2020

If a care home’s staffing ratio has been breached, then business continuity measures may be put in place.

Figure 8: percentage of care homes operating within agreed staffing ratios, week ending 23 November 2021, England

More than 9 in 10 care homes report operating within their agreed staffing ratios.

Source: Capacity Tracker

This data can be found in table 4 of the accompanying ‘Infection control, PPE and staffing level statistics’ tables in addition to data by region and local authority.

PPE availability in care settings

How the data can be used

This data can be used for:

• estimating the number and proportion of care homes and domiciliary care providers who are experiencing PPE shortages in the next 48 hours, and comparing across local authorities and regions in England

• monitoring trends over time

This data cannot be used for:

• predicting PPE shortages in the coming weeks
• comparing with other countries of the UK
• linking PPE shortage to positivity rates

All care homes and domiciliary care providers are responsible for ensuring safe systems of work and have duties concerning the provision and use of PPE in the workplace.

This publication covers the availability of the following 5 items of PPE:

• aprons

• eye protection

• gloves

• hand sanitiser

• face masks

In care homes

Guidance on what PPE should be used in various circumstances is available from personal protective equipment (PPE): resource for care workers working in care homes during sustained COVID-19 transmission in England. Despite most legal restrictions being lifted on 19 July 2021, PPE and other infection prevention and control measures are expected to continue to be practised in care homes.

In the week ending 23 November 2021:

• 0.3% of care homes in England had either no supply or were expecting to experience a shortage in the next 48 hours of at least one item of PPE
• this gradually decreased from late September 2020 when 1.1% of care homes were experiencing a shortage and has remained relatively unchanged since March 2021

In domiciliary care

Data on PPE availability in domiciliary care has not been updated for the London region for dates after 29 June 2021 due to a data quality issue which is being investigated. National figures for England are also not presented due to the effects of this issue on the national rate. Data for other regions and local authorities outside of London are available in the accompanying data tables.

COVID-19 testing in adult care homes

How the data can be used

This data can be used for:

• estimating the number of PCR and LFD tests taken and positive results returned in care homes, and comparing across local authorities and regions in England
• estimating trends in prevalence and positivity rates for COVID-19 in care homes based on trends in positive tests

This data cannot be used for:

• calculating positivity rates for COVID-19 in care homes due to routine and repeat testing of individuals
• linking positivity rates in care homes to lower vaccination rates in care homes
• estimating the number of people tested and positive cases in care homes as people can take more than one test

For more information on:

• the rollout of the testing programme in care homes, please see ‘About this data’ section below.
• testing kits used, please see the ‘Terminology’ section below

Given that anyone who tests positive with a PCR test is exempt from regular testing for 90 days, the number of tests conducted with both PCR and LFD kits can fluctuate slightly in relation to COVID-19 prevalence.

Number of tests conducted and positive tests returned in adult care homes

The number of positive tests returned in care home staff and residents decreased in November compared to October where an upward trend was seen throughout the month.

Previously the number of positive tests had been increasing between mid-September 2021 and mid-October 2021. The trend in positive tests has fluctuated since late July 2021 for staff and late August 2021 for residents. Prior to that positive tests had been increasing from mid-June 2021 to July 2021 but the number of positive tests remained substantially lower than levels seen in January 2021.

Throughout October, the number of tests conducted has slightly decreased for care home staff compared to levels seen in September but have remained broadly consistent in care home residents.

Care home staff

PCR tests

In the week ending 23 November 2021 there were:

• 2,061 positive tests returned from PCR kits in care home staff
• 19% fewer positive tests compared to the week ending 26 October 2021 and 42% fewer compared to the week ending 20 July 2021

The number of PCR tests conducted in care home staff has broadly decreased between the end of July and the end of November.

LFD tests

In the week ending 23 November 2021 there were:

• 818 positive tests returned from LFD kits in care home staff
• 12% fewer positive tests compared to the week ending 26 October 2021

There has also been a gradual decline in the number of LFD tests conducted in care home staff since late July.

Care home residents

The testing regime for staff is more frequent than for residents. As a result, the total number of staff tests is higher than the total number of resident tests. For more information please see the ‘About this data’ section below.

PCR tests

In the week ending 23 November 2021 there were:

• 515 positive tests returned from PCR kits in care home residents
• 44% fewer positive tests compared to the week ending 26 October 2021

The number of PCR tests conducted among care home residents has been broadly consistent between August 2021 and the end of November 2021. Previously the number of tests had gradually increased between mid-May and the beginning of August.

LFD tests

In the week ending 23 November 2021 there were:

• 46 positive tests returned from LFD kits in care home residents
• the number of positive LFD tests has decreased throughout November with 73% fewer the number of positive tests in the week ending 23 November compared to the week ending 26 October 2021

There has been a decline in the number of LFD tests conducted in the week ending 23 November 2021 compared to the end of October 2021.

Figure 9: number of tests conducted in care home staff and residents, 15 December 2020 to 23 November 2021, England

The number of tests conducted in care home staff has declined compared to late July.

Source: NHS Test and Trace

This data can be found in tables 1 and 2 of the accompanying ‘COVID-19 testing’ tables in addition to data by region and local authority.

Figure 10: number of positive test results in care home staff and residents, 2 September 2020 to 23 November 2021, England

The number of positive test results returned in care home staff have slightly increased, and for residents have remained stable during October.

Source: NHS Test and Trace

This data can be found in tables 1 and 2 of the accompanying ‘COVID-19 testing’ tables in addition to data by region and local authority.

Staff and residents have different testing regimes as outlined in the ‘About this data’ section below. As a result, the number of positive test results returned are expected to be of a different scale between staff and residents.

Visitors

The number of LFD tests conducted among visitors to care homes has been broadly consistent since the end of June with 94,810 tests conducted in the week ending 23 November.

Following the change in guidance for residents receiving visitors in early March, LFD tests conducted among visitors to residents of care homes increased substantially throughout the month, then continued to gradually increase until the end of June 2021.

Additionally, there were 8,050 LFD tests conducted among visiting professionals to care homes in the week ending 23 November 2021. This declined steadily since mid-June up until the end of August but has since remained fairly stable with an average of around 8,160 tests per week from beginning of September to the end of November 2021.

In the week ending 23 November 2021 there were:

• 50 positive PCR tests returned in care home visitors and 74 LFD positive results
• 6 positive LFD tests returned among visiting professionals to care homes

Terminology

Care home: facilities providing residential care. The data in this bulletin refers to Care Quality Commission (CQC) registered care homes.

Older adult care homes: care homes serving any older people (aged 65 and over) as identified from the latest CQC data on care homes in the ‘older people service’ user band. A small number of residents within care homes serving older people may be aged under 65.

Younger adult care homes: care homes not serving any older people (aged 65 and over) as identified from the latest CQC data on care homes in the ‘older people service’ user band.

Domiciliary care: services providing personal care for people living in their own homes. The data in this bulletin refers to domiciliary staff employed by independent CQC registered providers.

Staff: unless specified, staff can refer to staff directly employed by a provider and/or through an agency.

Staff employed by other settings: this includes non-registered providers and local authority employed: all other eligible frontline social care staff working in close and personal contact with people clinically vulnerable to COVID-19 (as defined by the Joint Committee on Vaccination and Immunisation (JCVI) priority groups) who need care and support irrespective of where they work or who they are employed by, for example, local government, NHS, private sector or third sector.

Agreed staffing ratios: the agreed number of residents for any given member of staff. This is determined by individual providers to ensure there is safe levels of staffing for care to be delivered. This can be subject to inspection by the CQC. See Regulation of staffing for more information.

PCR (polymerase chain reaction) tests: PCR tests check for the genetic material of the coronavirus in the sample, which is taken using a swab and is processed in a lab via a polymerase chain reaction (PCR). These are predominantly used in care homes for people who experience symptoms, and for routine asymptomatic testing for staff and residents.

LFD (lateral flow device): often referred to as ‘rapid tests’, these test for the presence of proteins called ‘antigens’ which are produced by the virus. They are swab tests that give results in 30 minutes or less, without the need for processing in a laboratory. These tests are primarily used in care homes for routine asymptomatic testing for staff, residents and visitors.

PPE (personal protective equipment): equipment worn by staff, visitors or essential care-givers in care homes to reduce transmission of COVID-19. This publication refers to supplies of aprons, eye protection, gloves, hand sanitiser and face masks in care homes.

About this data

These statistics are being published as a part of a wider landscape of statistics on adult social care. The Government Statistical Service (GSS) compiles a UK adult social care database of official statistics on adult social care across the 4 nations of the UK. This is updated on a monthly basis.

The UK Statistics Authority (UKSA) conducted a review of adult social care statistics in England which called for:

• better leadership and collaboration across different organisations publishing official statistics. This publication has been produced in collaboration with other statistics providers of COVID-19 adult social care data and DHSC will endeavour to work with various stakeholders as more data is published through this publication

• addressing of gaps in available data, particularly in privately funded care. This bulletin aims to plug some of that gap by including data on residents privately funding their care in addition to those funded by local authorities

• improving existing official statistics. These statistics are being badged as experimental statistics and more data will be added iteratively based on user needs

Other sources of adult social care COVID-19 data

COVID-19 vaccinations

NHS England and Improvement (NHSEI) also publish data on vaccinations in adult social care settings as part of their broader statistical release on COVID-19 vaccination, using the same methodology and the same data source as this publication but there are differences in the:

• reporting period; data in this publication reports data collected up to 11:59pm on a Tuesday whereas NHSEI use data collected up to 11:59pm on a Sunday

• a small amount of data may be collected after the respective reporting periods

• regional breakdowns; data in this publication uses the administrative regions of England and NHSEI use NHS regions

COVID-19 testing

DHSC also publishes care home testing data in the weekly NHS Test and Trace statistics (England) at national level. This publication uses the same data source but has a different methodology for presenting testing in care homes and differences in the figures will occur due to the following reasons:

• differences in which tests from different routes are included. Both methodologies include the number of tests registered from kits sent directly to care homes, but this publication additionally includes care home staff or residents tested via other routes such as regional or local test sites. As a result, figures in this report will be substantially higher for PCR tests conducted in care home staff due to the current guidance recommending staff with symptoms to be tested outside of the care home (see coronavirus (COVID-19) testing in adult care homes for more information)

• different reporting periods. This publication uses the start time of the test in comparison to the Test and Trace statistics which use the date on which the test result was received by the individual taking the test

• different times of extracting the data

For more details on the NHS Test and Trace programme and the statistics please see the NHS Test and Trace methodology document.

Data sources

COVID-19 vaccination, infection prevention control (IPC), PPE availability and staffing levels

Data in this publication is taken from self-reported data submitted by care providers in England through a data collection and insight tool called Capacity Tracker.

Care providers are expected to submit data on IPC compliance on a weekly basis whilst data on vaccinations, PPE availability and staffing levels is expected to be updated on a daily basis.

Infection control data for each reporting week refers to data up to 2pm on the date stated as the ‘week ending’ and the 7 days prior. For PPE and staffing-levels data relates up to 11:59pm on the date stated as the ‘week ending’. The reporting week usually ends on a Tuesday but occasionally no data is available for this date, in these situations the ‘week ending’ date will be the nearest available date.

This bulletin presents the proportion of staff and residents vaccinated out of the total number of staff and residents as self-reported by care providers. Only individuals who have not tested positive for COVID-19 in the last 28 days are eligible to receive the vaccine. Data on the number of staff and residents of older adult care homes eligible for the vaccination over time can be found in the accompanying COVID-19 vaccination tables.

For more information, please see the ‘Data Sources’ section of the accompanying background quality and methodology note.

COVID-19 testing data

Testing data is collected from management information generated during the operation of the NHS Test and Trace service.

For more information, please see the ‘Data Sources’ section of the accompanying background quality and methodology note.

Data coverage and quality

All data in this publication refers to adult social care settings in England only.

Data submitted by providers reflects the current priorities to monitor the COVID-19 pandemic in social care settings. Data collection could be subject to change based on changes to the priorities and therefore the reporting in this publication will be adapted accordingly.

IPC, PPE availability and staffing levels

Providers are expected to submit data on IPC measures on a weekly basis while staffing levels and PPE availability data are expected to be submitted on a daily basis. Any providers who have not submitted data within the last 7 days are excluded from the relevant analysis for the associated time period where no response was received. The full response rates for all data points are available in the accompanying tables.

COVID-19 vaccinations

Data on total number of staff and residents as well as those vaccinated is self-reported by care providers and local authorities. Providers are expected to update their vaccination data on a daily basis. There may be a time lag between individuals receiving the vaccine and the week they are reported in the statistics depending on when providers have updated their vaccination data.

COVID-19 testing

This report includes the number of tests conducted on care homes residents, staff and visitors who were tested by:

• PCR and LFD kits sent directly to the care home for regular testing, which were registered through the National Testing Programme digital infrastructure

• PCR and LFD kits conducted at another testing site such as a regional or local test site or a mobile testing unit or tests that were registered

The figures in this report are only deduplicated to report on the number of individual tests taken, not the number of people tested. Because people can have more than one test, the data should not be compared with prevalence rates or case positivity rates.

This report does not contain data on those tested through pillar 1.

Data for each reporting period relates to the day an individual took their test.

The rollout of the testing program in care homes is summarised in the table 6 below.

Table 6: testing guidance in care homes

	Dates	Frequency	Test kit
Care home residents	7 June 2020 to present	Monthly In the event of an outbreak: day 1 and between days 4 to 7	PCR
Care home residents	22 February 2021 to present	In the event of an outbreak: day 1 and between days 4 to 7 at health protection team discretion	LFD
Care home staff	7 June 2020 to present	Weekly In the event of an outbreak: day 1 and between days 4 to 7	PCR
Care home staff	23 December 2020 to present	Twice a week In the event of a positive case: daily until 5 days without a positive	LFD
Care home indoor visitors	8 March 2021 to present	Weekly – essential care givers	PCR
Care home indoor visitors	8 March 2021 to present	Twice weekly – essential care givers	LFD
Care home indoor visitors	2 December 2020 to present*	On visit	LFD
Care home visiting professionals – CQC inspectors	14 December 2020 to present	Weekly	PCR
Care home visiting professionals – CQC inspectors	22 December 2020 to present	Before visit	LFD
Care home visiting professionals – all other professionals	14 December 2020 to present	On arrival, unless part of a regular testing regime and can provide proof of a negative result within 72 hours	LFD

*Close contact visits with LFD testing began on 2 December 2020 but ceased on 6 January 2021 because of the national lockdown. Throughout the period of national restrictions, visits were limited to outdoors, in visiting pods, or with a substantial screen; as well as those in exceptional circumstances such as end of life.

The figures in this report are only deduplicated to report on the number of individual tests taken, not the number of people tested. Because people can have more than one test, the data should not be compared with prevalence rates or case positivity rates.

Revisions

Any revisions to past publications will be in line with DHSC’s revision policy and highlighted in future publications accordingly.

Feedback

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