Official Statistics

Adult social care monthly statistics, England: September 2022

Published 1 September 2022

Applies to England

Main points

Coronavirus (COVID-19) testing in care homes

In the week ending 16 August 2022:

• there were 3,326 positive lateral flow test results among staff which is a substantial decrease compared with 10,842 positive tests recorded in the week ending 12 July 2022
• there were 425 positive lateral flow test results among residents, which is substantially lower than the 1,170 positive tests recorded in the week ending 12 July 2022

The total number of lateral flow and PCR tests conducted has decreased since mid-July 2022, following a period of increase in June and early July 2022.

COVID-19 vaccination in social care settings

As of week ending 16 August 2022, the proportions of care home residents who had received a second booster dose of the COVID-19 vaccine were:

• 73.3% of total residents of older adult care homes
• 23.7% of total residents of younger adult care homes

Visiting in care homes

In the week ending 15 August 2022, 97.4% 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 15 August 2022, 0.6% of care homes staff and 0.9% of domiciliary care staff were absent due to COVID-19 related reasons. These proportions decreased in the last month, compared to the week ending 19 July 2022 when 1.1% of care homes staff and 1.8% 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 first, second and booster doses of COVID-19 vaccinations in adult social care settings at national, regional and local authority level

• visiting in care homes

• staffing levels 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 this month’s report

Since 31 July 2022, all registered social care providers have been mandated to complete a subset of the data in Capacity Tracker on a monthly basis. Providers are required to update their data by the end of the 14th day of each month, or the next working day where the 14th falls on a weekend or public holiday. Data submitted must be no more than a week out of date. To align with these changes to the collection, the following changes have been made to this month’s publication:

• the publication is released on the first Thursday of the month rather than the second Thursday of the month, to better align with the timing of the monthly mandatory window for completion of the Capacity Tracker. In line with this change in release date, the latest weekly data point presented in the vaccination tables is now the third Tuesday of the month rather than the fourth Tuesday of the month
• the publication provides monthly data points, instead of weekly data points, for statistics on visiting in care homes and staff absences. This is because providers will only be required to update this data on a monthly basis, instead of weekly
• this publication continues to provide weekly data points for vaccination. This is because providers will still be encouraged, although not mandated, to update this information weekly. Providers are mandated to update this information at least once a month
• this publication no longer includes data on PPE shortages in care settings as this data field is not part of the mandated subset of data. Statistics on PPE distribution to social care settings are published as part of the quarterly PPE distribution statistical release

This publication also no longer includes data on staffing levels because this question was removed from Capacity Tracker on 3 August 2022. The full timeseries up to 26 July 2022 for both PPE and staffing levels can be found in the ‘Infection control, PPE and workforce statistics, August 2022: data tables’ on the Adult social care in England, monthly statistics: August 2022 page.

More information on Capacity Tracker, the adult social care COVID-19 data collection tool, can be found in the background quality and methodology note.

Updates on future reports

The next publication will be released on 6 October 2022. Dates for future publications will be pre-announced on the GOV.UK publication release calendar.

On 1 September 2022, the questions on vaccination were changed in Capacity Tracker. Providers will be asked to submit the numbers of residents and staff who have received a full primary course of the COVID-19 vaccination and the numbers who have received an autumn booster (defined as any booster delivered under the autumn booster campaign). 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. Providers will no longer be asked about first and second doses, vaccination abroad and first and second booster doses. These changes will be reflected in the October 2022 publication.

Data on vaccination in other settings will no longer be collected via Capacity Tracker from September 2022 so these tables will be removed from the publication from October 2022 onwards.

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

• monitoring vaccination rates over time for the first, second and booster doses of the COVID-19 vaccine

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

Restrictions on data collection do not allow us to identify eligibility for a booster based on the recommended gap between second dose and first booster dose. Hence booster rates are not adjusted by eligibility.

The total number of staff and residents for each social care setting as well as the number reported to be vaccinated for COVID-19 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 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. This is particularly prominent for vaccination rates for second doses in staff employed in other settings and first boosters 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.

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.

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.

From 31 July 2022, providers are mandated to complete Capacity Tracker on a monthly basis, by the end of the 14th day of each month, or the next working day where the 14th 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 vaccination statistics, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 2022 page.

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.

From 11 November 2021 until 15 March 2022, all people working or volunteering in care homes were required to be fully vaccinated against COVID-19, unless exempt. As Omicron, which is intrinsically less severe, replaced Delta as the dominant variant, DHSC consulted on revoking this requirement. Over 90,000 responses were received and 90% supported the removal of vaccination as a condition of deployment. Following the publication of this consultation, the Secretary of State for Health and Social Care announced in a written ministerial statement the revocation of the legislation to take effect from 15 March 2022.

Although it is no longer a legal requirement for staff in adult social care to be vaccinated to be deployed, adult social care staff and residents are still encouraged to get their COVID-19 booster vaccination after receiving their second dose.

More details can be found at COVID-19 vaccination: a guide to booster vaccination.

On 21 February 2022, the JCVI issued advice on an additional COVID-19 spring booster dose, around 6 months after the last vaccine dose, for:

• adults aged 75 years and over
• residents in a care home for older adults
• individuals aged 12 years and over who are immunosuppressed, as defined in the COVID-19 healthcare guidance Green Book

The spring booster programme began on Monday 21 March 2022. Between 4 April 2022 and 31 August 2022, providers were asked to record second booster vaccinations in the Capacity Tracker for their residents. This data was published for the first time in the August 2022 edition of this publication. From 1 September 2022, providers will start to report booster vaccinations under the autumn 2022 campaign.

COVID-19 vaccinations in older adult care homes

99.5% of older adult care homes have provided data on the number of staff and residents who received a first COVID-19 booster dose and 99.0% on the number who received a second COVID-19 booster dose, as of week ending 16 August 2022. This means the first and second dose rates, and the number of staff and residents receiving booster doses may be underestimated compared with the true value.

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

Residents of older adult care homes

As of week ending 16 August 2022, in older adult care homes:

• 94.6% of residents have been reported to have received 2 doses
• 91.4% of residents have been reported to have received their first booster dose
• 73.3% of residents have been reported to have received their second booster dose

Second booster vaccination rates increased steeply between April 2022 and mid-July 2022 but have increased less rapidly since the end of July 2022.

There is some variation in reported second booster doses administered regionally. London had the lowest uptake of second booster doses with 67.9% of residents vaccinated, while the South West had the highest uptake with 78.0%.

Staff of older adult care homes

As of week ending 16 August 2022, in older adult care homes:

• 93.1% of staff have been reported to have received 2 doses
• 56.5% of staff have been reported to have received their first booster dose

Reported booster vaccination rates stabilised after early April 2022, following a continued period of increase between January 2022 and March 2022. There is a large regional variation in rates, with the South West having the highest uptake with 62.1%, and London having the lowest at 45.0%.

Vaccination as a condition of deployment (VCOD) required individuals to be fully vaccinated against COVID-19 with a primary course (2 doses). Boosters were not required in order to comply with the regulations, but all staff were and continue to be encouraged to take up their offer of a booster dose.

Figure 1: cumulative percentage of staff and residents of older adult care homes who have received their first and second COVID-19 booster vaccination, England, 15 December 2020 to 16 August 2022

Reported first booster vaccination rates have stabilised for residents and staff in older adult care homes. Second booster resident vaccinations increased steeply between April 2022 and mid-July 2022.

Source: Capacity Tracker

Figure 2: percentage of older adult care home residents who have received their second booster dose of the COVID-19 vaccination by local authority, England, as of 16 August 2022

Over half of all local authorities have a reported second booster vaccination rate over 70% for residents in older adult care homes.

Source: Capacity Tracker

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

Notes:

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

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

Data for staff working in other settings (including non-registered providers and local authority employed) after August 2021 does not include Surrey as this data is no longer collected by the local authority.

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 16 August 2022:

• 91.8% of staff have been reported to have received 2 doses
• 52.1% of staff have been reported to have received their first booster dose

For domiciliary care staff as of week ending 16 August 2022:

• 85.1% of staff have been reported to have received 2 doses
• 49.6% of staff have been reported to have received their first booster dose

Among staff working in other settings as of week ending 17 August 2022:

• 34.7% of staff have been reported to have received 2 doses
• 4.9% of staff have been reported to have received their first 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 16 August 2022

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 (as of 17 August)
Provided data on second dose	99.3	96.1	63.8
Provided data on first booster dose	99.3	95.4	26.3

Notes:

• 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 vaccination response rates, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 2022 page
• there is regional variation for all staff groups – see table 2 for further details

Figure 3: percentage of staff in younger adult care homes, domiciliary care settings and other care settings who have been vaccinated against COVID-19, England, as of 16 August 2022 (17 August 2022 for other care settings)

Around half of staff are reported to have received their booster vaccination dose in both younger adult care homes and domiciliary care settings.

Source: Capacity Tracker

This data can be found in tables 6, 9 and 10 of the accompanying ‘COVID-19 vaccination statistics, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 2022 page, in addition to data by region and local authority.

Table 2: percentage of younger adult care home and domiciliary care staff reported to have received a first booster dose of the COVID-19 vaccine by region, England, up to 16 August 2022

Region	Younger adult care home staff	Domiciliary care staff	Staff working in other settings
East Midlands	51.7	50.1	12.1
East of England	52.4	54.1	0.8
London	48.6	36.8	0.7
North East	65.3	5.99	8.9
North West	50.3	48.0	5.5
South East	51.0	53.0	3.5
South West	52.2	56.9	1.8
West Midlands	52.2	47.6	3.9
Yorkshire and the Humber	52.0	51.9	13.5

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. First booster dose rollout, however, is dependent on the recommended time gap between second dose and booster dose rather than specific priority groups.

As of week ending 16 August 2022, in younger adult care homes:

• 91.5% of residents have been reported to have received 2 doses
• 82.6% of residents have been reported to have received their first booster dose
• 23.7% of residents have been reported to have received their second booster dose

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 will be suspended, however this change does not yet affect the data presented in this publication.

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 This change does not affect the data presented in this publication
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 September 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 15 August 2022:

• 97.4% 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 been increasing steadily since April 2022
• a further 1.2% were able to accommodate visits in exceptional circumstances. This figure has broadly declined since April 2022. 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 98.2% of care homes accommodating visiting in Yorkshire and the Humber compared to 95.8% in London in the week ending 15 August 2022

Figure 4: percentage of care homes accommodating or limiting visits for residents, England, 15 December 2020 to 15 August 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, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 2022 page, in addition to data by region and local authority.

Until last month, this publication also included data on PPE availability in care settings in the section on infection prevention control measures. This publication no longer includes PPE data as this data field is not part of the mandated subset of data in Capacity Tracker. Statistics on PPE distribution to social care settings are published as part of the quarterly PPE distribution statistical release. The full timeseries up to 26 July 2022 for PPE can be found in the ‘Infection control, PPE and workforce statistics, August 2022: data tables’ on the Adult social care in England, monthly statistics: August 2022 page.

Adult social care workforce

This publication no longer includes data on staffing levels because this question was removed from Capacity Tracker on 3 August 2022. The full timeseries for staffing levels up to 26 July 2022 can be found in the ‘Infection control, PPE and workforce statistics, August 2022: data tables’ on the Adult social care in England, monthly statistics: August 2022 page.

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 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 since the end of July, following a period of increase between early June and mid-July 2022. In the week ending 15 August 2022, 0.6% of care home staff were absent because of COVID-19 related reasons.

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 15 August 2022, there was little regional variations, with COVID-19 related staff absence rates ranging from 0.6% to 0.7% across all regions, apart from London. In London, since January 2022, care home staff COVID-19 related absence rates have remained consistently lower than in other regions. In the week ending 15 August 2022, 0.3% of care home staff were absent because of COVID-19 related reasons in London.

Data on absences and response rates can be found in tables 2 and 5, respectively, of the accompanying ‘Visiting and workforce statistics, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 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 0.9% in the week ending 15 August 2022, compared with 1.8% in the week ending 19 July 2022.

There has been some variation across regions, throughout the timeseries, especially during periods of high absences. London had consistently been an outlier and shown substantially higher COVID-19 related absence rates compared with other regions. This was partly explained by substantially lower response rates in the London region compared with other regions, which might result in biased data.

However, since the start of mandatory data provision from 31 July 2022, response rates in London increased substantially, resulting in more accurate and representative data since August 2022. In the week ending 15 August 2022, 1.8% of staff in London were absent due to COVID-19 related reasons, while the North West had the lowest COVID-19 related absence rate at 0.6%. In August 2022, absence rates decreased in all regions except the East Midlands, where they remained stable.

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

Figure 5: percentage of staff absent due to COVID-19 related reasons, England, 1 January 2022 to 15 August 2022

Absence rates due to COVID-19 related reasons decreased since mid-July 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 represents 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, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 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 ‘About this data’ section below
• testing kits used, see the ‘Terminology’ section below

In the August publication, we were only able to present data up to the 12 July 2022 due to a technical data access issue. This issue has now been resolved and this publication includes complete data up to 16 August 2022.

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

The overall number of rapid lateral flow tests and the number of positive results returned for both care home residents and staff increased from early June 2022 to mid-July 2022, following a period of decline since the end of March 2022. The overall number of tests and the number of positive PCR tests also increased since early June, for both residents and staff.

As of the week ending 16 August 2022, which is the latest data point included in this publication, the regular testing regime in place was as follows:

Care home staff testing:

• 2 rapid lateral flow tests a week
• 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 testing:

• no testing is recommended, unless visitor providing personal care

Visiting professionals to care homes:

• NHS professionals should provide proof of a negative test taken 72 hours in advance of the visit
• CQC inspectors regularly take weekly PCR tests but should additionally take rapid lateral flow test on the day of visiting a care home
• other professionals should be tested with a rapid lateral flow test on arrival

On 24 August 2022, DHSC announced the temporary suspension of asymptomatic testing in care settings from 31 August 2022. These changes do not impact the data published this month as the time series only includes data up to the week ending 16 August 2022. However, this change in guidance will impact data in future publications. The COVID-19 testing in adult social care guidance and the COVID-19 supplement have been updated to reflect this latest change.

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 1 September 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 This change does not affect the data presented in this publication
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 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 guidance and the Infection prevention and control in adult social care settings.

Care home staff

Rapid lateral flow tests

In the week ending 16 August 2022, there were 3,326 positive tests returned from rapid lateral flow test kits in care home staff. This number has decreased substantially since the week ending 12 July 2022, when it reached a peak of 10,842. This peak remained lower than the January 2022 and March 2022 peaks.

This decrease coincides with a decrease in the number of lateral flow tests conducted (which includes positive, negative and void tests) since mid-July. In the week ending 16 August 2022 there were 257,628 tests conducted compared with 345,021 in the week ending 12 July 2022.

PCR tests

The overall number of PCR tests conducted (including positive, negative and void tests) in care home staff decreased from mid-July to 16 August 2022. This follows a period of increase in June and early July 2022.

There were 19,166 PCR tests conducted in the week ending 16 August 2022, which is a substantial decrease compared with 43,522 in the week ending 12 July 2022. This follows a period of increase in June and early July 2022. Due to changes in testing guidance for care home staff at the start of April 2022 requiring symptomatic staff to take rapid lateral flow test instead of 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

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, see the ‘About this data’ section.

Rapid lateral flow tests

In the week ending 16 August 2022, there were 425 positive tests returned from rapid lateral flow test kits in care home residents. The number of positive rapid lateral flow tests returned decreased from mid-July to mid-August, from 1,170 in the week ending 12 July 2022, following a period of increase throughout June and early July.

The overall number of rapid lateral flow tests conducted in care home residents, which includes positive, negative and void tests, has also decreased since mid-July 2022. In the week ending 16 August 2022 there were 9,334 tests conducted, which is around half of the 18,797 tests recorded in the week ending 12 July 2022.

PCR tests

The number of PCR tests conducted (including positive, negative and void tests) in care home residents has also decreased from mid-July to mid-August 2022, following a period of increase in June and early July 2022.

There were 25,904 tests conducted in the week ending 16 August 2022, which is less than half the 55,327 tests recorded in the week ending 19 July 2022.

Figure 6: number of tests conducted in care home staff and residents, England, December 2021 to August 2022

The number of tests conducted among staff and residents has been decreasing since mid-July 2022.

Source: NHS Test and Trace

Note: the dotted lines in this chart represent the implementation of the 4 most recent changes in care home testing guidance as at 16 August 2022:

• A: from 15 December 2021, staff are required to take weekly PCR and 3 rapid lateral flow tests per week
• B: from 11 January 2022, for staff and residents, confirmatory PCR test following a positive rapid lateral flow test is no longer required
• C: from 16 February 2022, staff are required to take pre-shift rapid lateral flow tests
• D: from 4 April 2022, staff are required to take 2 rapid lateral flow tests per week, instead of pre-shift tests, and resident asymptomatic testing is removed

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, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 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, December 2021 to August 2022

The number of positive test results returned in care home staff and residents has been decreasing since mid-July 2022.

Source: NHS Test and Trace

Note: the dotted lines in this chart represent the implementation of the 4 most recent changes in care home testing guidance as at 16 August 2022:

• A: from 15 December 2021, staff are required to take weekly PCR and 3 rapid lateral flow tests per week
• B: from 11 January 2022, for staff and residents, confirmatory PCR test following a positive rapid lateral flow test is no longer required
• C: from 16 February 2022, staff are required to take pre-shift rapid lateral flow tests
• D: from 4 April 2022, staff are required to take 2 rapid lateral flow tests per week, instead of pre-shift tests, and resident asymptomatic testing is removed

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, September 2022: data tables’ on the Adult social care in England, monthly statistics: September 2022 page, 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 positive tests returned in both care home visitors and visiting professionals decreased from mid-July 2022.

In the week ending 16 August 2022 there were:

• 24 positive rapid lateral flow tests returned in care home visitors
• 38 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 continued to decrease throughout July and August 2022. In the week ending 16 August 2022, there were 680 rapid lateral flow tests conducted among visitors compared with 20,472 in the week ending 12 July 2022. Additionally, there were 3,111 rapid lateral flow tests conducted among visiting professionals to care homes in the week ending 16 August 2022. The number of rapid lateral flow tests conducted among visiting professionals has decreased slightly throughout July and August 2022, from 3,854 in the week ending 5 July 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.

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 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.

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].