Official Statistics

Adult social care monthly statistics, England: December 2022

Published 1 December 2022

Applies to England

Main points

Coronavirus (COVID-19) testing in care homes

In the week ending 13 November 2022:

• there were 1,395 positive lateral flow test results among care home staff, which is around a third of the 4,015 recorded in the week ending 16 October 2022.This has been decreasing since mid-October, following a period of increase from early September 2022
• there were 245 positive lateral flow test results among care home residents, which is a third of the 716 positive tests recorded in the week ending 16 October 2022

The total number of lateral flow tests conducted among care home staff and residents has decreased since mid-October 2022.

COVID-19 and flu vaccination in social care settings

As of week ending 13 November 2022, the proportions who had received an autumn booster dose of the COVID-19 vaccine were:

• 62.8% of total residents and 13.3% of total staff of older adult care homes
• 49.0% of total residents of younger adult care homes
• 11.0% of total staff of younger adult care homes and 10.8% of total domiciliary care staff

As of week ending 13 November 2022, the proportions who had received their flu vaccination for the 2022 to 2023 season were:

• 52.4% of total residents and 9.5% of total staff of older adult care homes
• 41.0% of residents of total younger adult care homes
• 7.6% of total staff of younger adult care homes and 7.7% of total domiciliary care staff

Visiting in care homes

In the week ending 14 November 2022, 98.5% of care homes in England were able to accommodate residents receiving visitors. This figure has broadly increased since the end of January 2022.

Staff absences due to COVID-19

In the week ending 14 November 2022, 0.5% of care homes staff and 0.6% of domiciliary care staff were absent due to COVID-19 related reasons. These proportions decreased in the last month, compared to the week ending 14 October 2022 when 0.7% of care homes staff and 1.0% of domiciliary care staff were absent due to COVID-19 related reasons.

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 information on:

• uptake of full primary course and autumn 2022 booster doses of COVID-19 vaccinations and flu vaccinations for the 2022 to 2023 season in adult social care settings at national, regional and local authority level
• visiting in care homes at national, regional and local authority level
• staff absence rates due to COVID-19 in care home and domiciliary care at national, regional and local authority level
• testing for COVID-19 in care homes at national, regional and local authority level

Data used in this publication is taken from Capacity Tracker and the NHS Test and Trace service. Capacity Tracker is a web-based digital insight tool originally developed by NHS England and the Better Care Fund to enable the system to better manage hospital discharges by identifying available capacity in care homes. It enables care homes to share their vacancies in real-time, meaning hospital discharge teams and other health professionals can rapidly search availability throughout England. Since spring 2020 the tool has also been used by DHSC to gather COVID-19 related data to help monitor the sector’s response to the pandemic.

For more information on data sources, on the data previously published as part of this report and on other published sources of adult social care data, see the background quality and methodology note.

Publication updates

Updates on future reports

The next publication will be pushed back by a week due to the holiday period and released on 12 January 2023 – the second Thursday of the month instead of the first Thursday of the month. Dates for future publications will be pre-announced on the GOV.UK publication release calendar.

COVID-19 and flu 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 full primary course and autumn 2022 booster doses of the COVID-19 vaccine
  • flu vaccinations for the 2022 to 2023 season
• monitoring vaccination rates over time for:
  • the full primary course and autumn 2022 booster doses of the COVID-19 vaccine
  • flu vaccinations for the 2022 to 2023 season

This data cannot be used for:

• estimating the number of social care staff or residents who have not been vaccinated
• 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

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 a vaccine cannot be directly derived from the data published in these statistics as the vaccination status of some individuals may be unknown to the care provider.

The dates in this section refer to the dates on which vaccinations were reported by care providers rather than the dates on which 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 and may be underestimated.

Among care home staff, there is a substantial difference in reported vaccination rates for COVID-19 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.

From 31 July 2022, providers were mandated to complete Capacity Tracker on a monthly basis. Providers are required to update Capacity Tracker with the required data within a designated 7-day reporting window. This window will open at the start of the 8th day of each month and run until the end of the 14th day of each month, or the next working day where the 14th day falls on a weekend or public holiday.

This means that response rates are likely to be higher during the mandation window and may be lower in other weeks of the month. Therefore, weeks which coincide with the mandation window may see a bigger increase in vaccination rates, due to higher response rates in those weeks. These data points are flagged in the accompanying ‘COVID-19 and flu vaccination statistics, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page.

From 9 October 2022, the weekly data points for COVID-19 and flu vaccination refer to weeks ending on a Sunday rather than weeks ending on a Tuesday. This change means that the data point for the week ending 9 October only covers 5 days rather than 7, so there are a lower number of additional vaccinations reported for that data point due to the shorter time period.

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

COVID-19 vaccinations

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.

On 12 September 2022, the JCVI issued advice and formally launched the latest COVID-19 booster vaccination campaign, for autumn 2022, for the following individuals:

• residents in a care home for older adults and staff working in care homes for older adults
• frontline health and social care workers
• all adults aged 50 years and over
• persons aged 5 to 49 years in a clinical risk group, who are household contacts of people with immunosuppression, or who are carers

NHS vaccination teams started visiting care homes to administer the vaccine on 5 September 2022, a week before the formal launch of the campaign.

From 1 September 2022, providers are mandated to submit data on the numbers of residents and staff who have received a full primary course and are no longer asked about first and second doses separately. A full primary course does not include COVID-19 boosters. For most people, a full primary course is defined as 2 doses of COVID-19 vaccination. For a small number of people, however, including people who were vaccinated abroad, people who have received a single-dose vaccination such as Janssen, or people who are severely immunosuppressed, a full primary course may mean a different number of doses.

From 1 September 2022, providers were also encouraged to submit data on individuals who have received their autumn 2022 COVID-19 booster vaccine. An autumn booster is defined as any booster delivered under the autumn booster campaign which started on 5 September 2022. Data on autumn 2022 boosters is available from week ending 13 September 2022. It became mandatory for providers to submit data on autumn booster vaccinations from the October reporting window.

The full timeseries for first and second doses and first and second booster doses of COVID-19 vaccination up to 31 August 2022 (including vaccination in other care settings) can be found in the accompanying ‘COVID-19 vaccination statistics, up to 31 August 2022: data tables’ on the Adult social care in England, monthly statistics: October 2022 page.

COVID-19 vaccinations in older adult care homes

97.7% of older adult care homes have provided data on the number of staff and residents who received an autumn booster dose, as of week ending 13 November 2022. This means the number of staff and residents receiving autumn booster doses may be slightly underestimated compared with the true value.

For full response rates, see the accompanying ‘COVID-19 and flu vaccination response rates, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page.

Residents of older adult care homes

As of week ending 13 November 2022, in older adult care homes:

• 94.0% of residents have been reported to have received a full primary course
• 62.8% of residents have been reported to have received their autumn booster dose

There is some variation in reported autumn booster doses administered regionally. London had the lowest uptake of autumn booster doses with 57.0% of residents vaccinated, while the South West had the highest uptake with 69.1%.

Staff of older adult care homes

As of week ending 13 November 2022, in older adult care homes:

• 91.8% of staff have been reported to have received a full primary course
• 13.3% of staff have been reported to have received their autumn booster dose

There is some regional variation in reported autumn booster doses, with the South West having the highest uptake with 17.8% of staff vaccinated, and London having the lowest at 9.8%.

COVID-19 vaccinations in staff working in domiciliary care, younger adult care homes and other settings

The following proportions of social care staff have been reported to have received their COVID-19 vaccination doses.

In younger adult care homes as of week ending 13 November 2022:

• 84.7% of staff have been reported to have received a full primary course
• 11.0% of staff have been reported to have received their autumn booster dose

For domiciliary care staff as of week ending 13 November 2022:

• 83.9% of staff have been reported to have received a full primary course
• 10.8% of staff have been reported to have received their autumn booster 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 13 November 2022

Dose	Younger adult care home providers on behalf of their staff	Domiciliary care providers on behalf of their staff
Provided data on full primary course	99.4	96.3
Provided data on autumn booster dose	97.2	89.5

Note: due to these response rates, the number of staff and residents, particularly for boosters, will be underestimated compared with the true value. For full response rates see the accompanying ‘COVID-19 and flu vaccination response rates, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page.

COVID-19 vaccinations for residents of younger adult care homes

Residents of younger adult care homes were 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 were therefore likely to be part of priority groups 3 to 9.

As of week ending 13 November 2022, in younger adult care homes:

• 89.0% of residents have been reported to have received the full primary course
• 49.0% of residents have been reported to have received their autumn 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, from 1 September 2022, are based on the advice of the JCVI. More details can be found in the national flu immunisation programme 2022 to 2023 letter.

This year, frontline social care workers, carers and everyone over the age of 50 is eligible for a flu vaccine. Social care workers who are in direct contact with people who receive care and support services should have the flu vaccine provided by their employer. However, there are circumstances where frontline staff, who are employed by specific social care providers without access to employer led occupational health schemes, can access the vaccine through the NHS free-of-charge.

This report covers cumulative flu vaccination rates for the 2022 to 2023 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
• residents of younger adult care homes

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.

Data on flu vaccination rates for the 2022 to 2023 season is available from 13 September 2022.

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

Table 2: percentage of providers that have provided data on the number of staff or residents who received a flu vaccination for the 2022 to 2023 season, as of 13 November 2022

	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
Percentage who provided flu data at least once	97.7	97.3	89.7

For full response rates please see the accompanying ‘COVID-19 and flu vaccination response rates, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page.

As of week ending 13 November 2022, the proportions of those who had received a flu vaccination in care settings were:

• 52.4% of residents in older adult care homes
• 9.5% of all staff in older adult care homes
• 41.0% of residents in younger adult care homes
• 7.6% of all staff in younger adult care homes
• 7.7% of staff who work in domiciliary care settings

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 younger adult care homes.

Figure 1: percentage of staff and residents of older adult care homes who have received their autumn 2022 COVID-19 booster vaccination and 2022 to 2023 flu vaccine, England, as of 13 November 2022

Reported COVID-19 autumn 2022 booster vaccination rates and 2022 to 2023 flu vaccination rates are highest among residents in older adult care homes.

Source: Capacity Tracker

Figure 2: percentage of older adult care home residents who have received their autumn booster dose of the COVID-19 vaccination by local authority, England, as of 13 November 2022

The majority of local authorities have a reported autumn booster vaccination rate of over 60% for residents in older adult care homes.

Source: Capacity Tracker

Figure 3: percentage of staff in younger adult care homes and domiciliary care settings who have received their autumn 2022 COVID-19 booster vaccination and 2022 to 2023 flu vaccine, England, as of 13 November 2022

Reported COVID-19 autumn 2022 booster vaccination rates and 2022 to 2023 flu vaccination rates are similar among staff working in younger adult care homes and domiciliary care settings.

Source: Capacity Tracker

This data can be found in the accompanying ‘COVID-19 and flu vaccination statistics, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page, in addition to data by region and local authority.

Accommodating COVID-safe visitation in care homes

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
• 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
• estimating rates of compliance with the mandatory provision of certain data items as set out in the adult social care provider information provisions. Response rates for visiting questions during the reporting window as set out in the adult social care provider information provisions are not equivalent to compliance rates because there may be extenuating circumstances in which a provider has not responded for legitimate reasons

Visiting guidance and data trends

There are currently no restrictions on visiting in care homes under normal circumstances. However, during periods of outbreak or when a resident is COVID-positive, visits may need to be limited to one visitor at a time for each resident. From 4 April 2022, visitors are no longer required to test before the visit, unless they are providing personal care. From 31 August, testing for visitors providing personal care was suspended.

Until 31 March 2022, the Adult Social Care Infection Control and Testing Fund provided funding from local authorities to ensure that infection prevention control (IPC) measures were in place to curb the spread of COVID-19, including accommodating COVID-19 safe visitation in care homes in line with government guidance. To support the monitoring of the fund, data tracking the adult social care sector’s implementation of IPC measures was collected. The fund ended on 31 March 2022 and the majority of the IPC related questions were removed from the collection tool on 4 April 2022.

The question on COVID-safe visitation in care homes is still included in the data collection but was updated in early May 2022 to remove the reference to government guidance since restrictions on visiting in care homes have been removed. This wording change has had no substantial impact on reporting. In July 2022, the question changed from asking care homes whether residents had been allowed visits in the last 7 days to whether residents had been allowed visits in the last month.

Since 31 July 2022, this question is part of the subset of data which providers are mandated to submit on a monthly basis. For more information, see the background quality and methodology note.

The table below summarises the changes in guidance on allowing care home residents to have visitors since December 2020.

Table 3: changes in visiting guidance since December 2020

Date	Guidance
From 31 August 2022	Visitors providing personal care no longer need to test before a visit
From 4 April 2022 to 30 August 2022	No restrictions on visitation in care homes. Every care home resident should have one visitor who can visit in all circumstances (including during periods of isolation and outbreak) Visitors are not required to test before a visit, unless providing personal care Visitors providing personal care do not need to test more than twice a week
From 31 January 2022 to 3 April 2022	No limits on the number of named visitors, with testing and guidance to support safe visiting in place
From 15 December 2021 to 30 January 2022	Residents are permitted to have 3 named visitors for regular visits with testing in place
19 July 2021 to 14 December 2021	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)

Note: timelines for guidance are accurate as of 1 December 2022.

More information on the current visiting guidance can be found in the COVID-19 supplement, which accompanies the infection prevention and control in adult social care settings.

In the week ending 14 November 2022:

• 98.5% of care homes in England were able to accommodate visits in or out of the care home for residents in all circumstances during the last month. This proportion has broadly increased since the end of January 2022
• a further 0.8% were able to accommodate visits in exceptional circumstances, which is a decrease compared to the week ending 14 October 2022. This figure has broadly declined since April 2022 with the exception of a slight increase between September and October. Exceptional circumstances are individually defined by each care home but are generally thought to be considered when residents are palliative
• there is little variation across regions, with 99.1% of care homes accommodating visiting in Yorkshire and the Humber compared to 97.4% in London in the week ending 14 November 2022

Figure 4: percentage of care homes accommodating or limiting visits for residents, England, 4 January 2022 to 14 November 2022

The proportion of care homes accommodating visiting for residents has broadly increased since mid-January.

Source: Capacity Tracker

Note: the dotted lines in this chart represent the implementation of the changes in care home visiting guidance or changes to the visiting question in Capacity Tracker:

• A: from 31 January 2022, no limits on the number of named visitors, with testing and guidance to support safe visiting in place
• B: from 4 April 2022, no restrictions on visitation in care homes. Every care home resident should have one visitor who can visit in all circumstances (including during periods of isolation and outbreak)
• C: from 4 July 2022, the visiting questions in Capacity Tracker changed so care homes were asked whether residents had been allowed visits in or out of the care home in the last month, instead of in the last 7 days
• D: from 31 July 2022, providers are mandated to submit data on visiting on a monthly basis. From August 2022 onwards the data points in this graph are monthly instead of weekly

This data can be found in table 1 of the accompanying ‘Visiting and workforce statistics, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page, in addition to data by region and local authority.

Adult social care workforce

Staff absence rates

How the data can be used

This data can be used for:

• estimating the number and percentage of staff absent because of COVID-19-related reasons
• monitoring trends over time
• comparisons across local authorities and regions in England

This data cannot be used:

• as a sole indicator of all workforce pressures faced by the social care sector, since they only cover COVID-19-related absence
• to directly compare absence rates related to COVID-19 between domiciliary care and care home staff
• for comparing with other countries of the UK
• for linking COVID-19-related absence rates with test positivity rates
• for inferring trends about staff headcounts as these are partly driven by response rates

Absence rates related to COVID-19 are calculated using the reported number of staff employed and the reported number of staff out of work that day because of COVID-19 related reasons. Both the number of total staff employed, and the number of staff absent might be affected by provider response rates as only numbers reported by providers in the last 7 days (or during the mandatory reporting window where this is longer than 7 days) are included in the total counts.

Absence data started to be reported by care providers in Capacity Tracker from December 2020. However, low response rates in the first few months of collection mean that the workforce data is incomplete, which affects the accuracy of the absence data during that period.

Providers who are the least likely to respond are likely to be those experiencing the most pressures on delivery due to high levels of staff absence. For this reason, data from December 2020 to the start of February 2021 for care homes, and from December 2020 to the start of March 2021 for domiciliary care providers, are not presented in this publication.

COVID-19-related absences cannot be directly linked to staff test positivity rates. This is because absences related to COVID-19 can cover a wide range of reasons, including but not restricted to staff:

• testing positive to COVID-19
• self-isolating
• caring for someone who has tested positive to COVID-19
• suffering from illness related to COVID-19

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

Absence rate statistics presented in this section were added for the first time in February 2022, following growing general interest in workforce pressures from various sources.

From 31 July 2022, workforce absence data is part of the subset of data which providers are mandated to submit on a monthly basis. Only data submitted during the monthly mandation window are included in these statistics.

COVID-19-related absence rate statistics alone are not sufficient to give a full picture of workforce pressures faced by the sector – however, they may provide some insight on some of the challenges. Additional statistics, such as general absences, retention or recruitment could provide a more complete picture.

In care homes

Data on care home staff absences related to COVID-19 is available from 9 February 2021.

Absence rates in care homes have decreased slightly over the last month. In the week ending 14 November 2022, 0.5% of care home staff were absent because of COVID-19 related reasons, compared with 0.7% in the week ending 14 October 2022.

Care home staff absence related to COVID-19 reached a peak of 2.9% in the week ending 11 January 2022 and has remained below this level since.

In the week ending 14 November 2022, there was little regional variation, with COVID-19 related staff absence rates ranging between 0.4% and 0.5% across all regions.

Data on absences and response rates can be found in tables 2 and 5, respectively, of the accompanying ‘Visiting and workforce statistics, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page.

In domiciliary care

Data on domiciliary care staff COVID-19 related absences is available from 2 March 2021. Absence rates in domiciliary care settings are not directly comparable with those in residential care homes.

Domiciliary staff COVID-19 related absence rates decreased over the last month, to 0.6% in the week ending 14 November 2022, compared with 1.0% in the week ending 14 October 2022.

In the week ending 14 November 2022, there was little regional variation, with all regions reporting absence rates between 0.5% and 0.7%. Absence rates decreased in all regions this month.

Data on absences and response rates can be found in tables 3 and 6 of the accompanying ‘Visiting and workforce statistics December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page.

Figure 5: percentage of staff absent due to COVID-19 related reasons, England, 1 January 2022 to 14 November 2022

Absence rates due to COVID-19 related reasons decreased since mid-October 2022.

Source: Capacity Tracker

Notes:

• the proportion of staff absent due to COVID-19-related reasons is not comparable across care settings
• the dotted lines in this chart represent the move to monthly reporting after the start of the mandatory data provision implemented on 31 July 2022. From August 2022 onwards the data points in this graph are monthly instead of weekly

This data can be found in tables 2 and 3 of the accompanying ‘Visiting and workforce statistics, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page, in addition to data by region and local authority.

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 rapid lateral flow 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, see the background quality and methodology note
• testing kits used, see the ‘Terminology’ section below

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

The total number of rapid lateral flow tests conducted among staff was 46,025 in the week ending 13 November 2022, which is a decrease of almost half compared to 86,432 tests conducted in the week ending 16 October 2022. This decrease follows a period of slight increase between mid-September and mid-October 2022.

There was a substantial decrease in the number of tests conducted in early September 2022 following the release of the new testing guidance, which announced the temporary suspension of asymptomatic testing in care settings from 31 August 2022. The number of tests conducted has remained well below levels reported in August 2022.

The total number of PCR tests conducted among care home staff and residents also decreased in late October and November 2022, following a period of broad increase since mid-September 2022.

As of the week ending 13 November 2022, which is the latest data point included in this publication, the regular testing regime in place was as follows.

Care home staff testing:

• no asymptomatic testing
• if symptomatic, 2 rapid lateral flow tests taken 48 hours apart

Care home residents testing:

• no asymptomatic testing
• if symptomatic, 2 rapid lateral flow tests taken 48 hours apart
• as soon as they join a care home, if they are new, with a PCR test

Care home visitors and visiting professionals testing:

• no testing is required

The COVID-19 testing in adult social care guidance and the COVID-19 supplement have been updated to reflect the latest changes in testing guidance.

Different testing regimes apply when there is an outbreak of COVID-19 in a care home. See the COVID-19 testing in adult social care guidance for more details.

Changes to testing guidance have affected the trends in the number of PCR and rapid lateral flow tests conducted among staff and residents. An overview of the changes to the testing guidance in care homes since June 2020 is presented in table 4 below.

Table 4: changes in testing guidance in care homes since June 2020, as of 13 November 2022

Date	Changes in guidance
From 31 August 2022	No asymptomatic testing for staff, residents or visitors If symptomatic 2 rapid lateral flow tests taken 48 hours apart, for staff and residents
From 4 April 2022 to 30 August 2022	Staff – 2 rapid lateral flow tests per week If symptomatic 2 rapid lateral flow tests taken 48 hours apart Residents – no asymptomatic testing If symptomatic 2 rapid lateral flow tests taken 48 hours apart Visitors – no testing unless providing personal care
From 16 February 2022 to 3 April 2022	Staff – pre shift rapid lateral flow tests
From 11 January 2022	Staff and residents – removal of confirmatory PCR test following a positive rapid lateral flow test
15 December 2021 to 15 February 2022	Staff – weekly PCR and 3 rapid lateral flow tests per week
7 June 2020 to 14 December 2021	Staff – weekly PCR and 2 rapid lateral flow tests per week Residents – monthly PCR PCR tests for staff and residents if symptomatic Visitors – required to take a rapid lateral flow test before each visit (tests are free)

To see the latest testing regime guidance for care homes, see the COVID-19 testing in adult social care and infection prevention and control in adult social care settings guidance.

Care home staff

Rapid lateral flow tests

The total number of lateral flow tests conducted (which includes positive, negative and void tests) among staff decreased compared to the week ending 16 October 2022.

Following the pause in asymptomatic testing for care home staff from 31 August 2022, the number of tests conducted has broadly declined over the past 3 months, with the exception of a slight increase between mid-September and mid-October 2022.

The number of positive results also decreased in the last month. In the week ending 13 November 2022, the number of positive lateral flow tests conducted among staff was 1,395, compared to 4,015 in the week ending 16 October 2022.

PCR tests

The overall number of PCR tests conducted (including positive, negative and void tests) in care home staff decreased since mid-October 2022. In the week ending 13 November 2022, there were 14,260 PCR tests conducted among care home staff, compared to 28,161 in the week ending 16 October 2022. This follows a period of increase in the number of tests conducted in September and early October 2022.

Due to changes in testing guidance for care home staff at the start of April 2022 requiring symptomatic staff to take a rapid lateral flow test instead of a PCR test, PCR test results are now less relevant than rapid lateral flow test results in measuring COVID-19 prevalence in care homes.

Care home residents

Rapid lateral flow tests

The number of positive rapid lateral flow tests returned decreased in late October and November 2022. In the week ending 13 November 2022, there were 245 positive tests returned from lateral flow tests in care home residents, compared to 716 in the week ending 16 October 2022.

The overall number of rapid lateral flow tests conducted in care home residents (which includes positive, negative and void tests) decreased in late October and November 2022. In the week ending 13 November 2022, there were 3,935 rapid lateral flow tests conducted among care home residents, compared to 7,885 in the week ending 16 October 2022.

PCR tests

The number of PCR tests conducted in care home residents decreased in late October and November 2022. There were 18,219 tests conducted in the week ending 13 November 2022, compared to 35,622 in the week ending 16 October 2022.

Figure 6: number of tests conducted in care home staff and residents, England, April 2022 to November 2022

The number of tests conducted has decreased since mid-October.

Source: NHS Test and Trace

Note: the dotted line in this chart represents the implementation of the most recent change in care home testing guidance as of 1 December 2022:

• A: from 31 August 2022, asymptomatic testing is no longer required for staff

Note: in order to show the overall trend, all data points in this chart contain data for the past 7 days. This means that the data point for 9 October 2022 is higher than it is in the data tables because it represents data for a 7-day window rather than a 5-day window as in the data tables.

See table 4 (above) for a breakdown of prior changes to testing guidance.

This data can be found in tables 1 and 2 of the accompanying ‘COVID-19 testing statistics, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page, in addition to data by region and local authority.

Figure 7: number of positive test results in care home staff and residents, England, April 2022 to November 2022

The number of positive test results returned has decreased among both care home staff and residents since mid-October 2022, following a period of broad increase in late September and early October 2022.

Source: NHS Test and Trace

Note: the dotted line in this chart represents the implementation of the most recent change in care home testing guidance as of 1 December 2022:

• A: from 31 August 2022, asymptomatic testing is no longer required for staff

Note: in order to show the overall trend, all data points in this chart contain data for the past 7 days. This means that the data point for 9 October 2022 is higher than it is in the data tables because it represents data for a 7-day window rather than a 5-day window as in the data tables.

See table 4 (above) for a breakdown of the specific changes.

This data can be found in tables 1 and 2 of the accompanying ‘COVID-19 testing statistics, December 2022: data tables’ on the Adult social care in England, monthly statistics: December 2022 page, in addition to data by region and local authority.

Staff and residents have different testing regimes as outlined in the background quality and methodology note. 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 positive tests returned among care home visitors and visiting professionals broadly decreased in late October and November 2022.

In the week ending 13 November 2022 there were:

• 11 positive rapid lateral flow tests returned in care home visitors
• 15 positive rapid lateral flow tests returned among visiting professionals to care homes

The number of rapid lateral flow tests conducted (including positive, negative and void tests) among visitors and visiting professionals has decreased in late October and November 2022. The number of rapid lateral flow tests conducted decreased steeply in early September 2022, following the pause in asymptomatic testing for all visitors and visiting professionals on 31 August 2022.

In the week ending 13 November 2022, there were 150 rapid lateral flow tests conducted among visitors, less than half of the 390 tests conducted in the week ending 16 October 2022. There were 680 rapid lateral flow tests conducted among visiting professionals to care homes in the week ending 13 November 2022, compared to 1,120 in the week ending 16 October 2022.

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.

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.

Rapid lateral flow tests

Often referred to as ‘rapid tests’ or lateral flow device 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.

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

Data sources

Data on visiting in care homes, staff absence and vaccinations are taken from self-reported data submitted by care providers in England through a data collection and insight tool called Capacity Tracker. From 31 July 2022, these data are part of the subset of data which providers are mandated to submit on a monthly basis.

Data on testing in care settings are collected from management information generated during the operation of the NHS Test and Trace service.

More detailed information about data sources can be found in the Adult social care monthly statistics, England: background quality and methodology. This document also includes detailed information on:

• data coverage
• data quality
• relevance
• accuracy and reliability
• timeliness and punctuality
• comparability and coherence
• accessibility and clarity
• cost and burden

Revisions

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

Feedback

For feedback and any further questions, contact [email protected].