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COVID-19 vaccination as condition of deployment: Q & A

8 October 2021

Introduction§

From 11 November 2021, anyone working or volunteering in a care home will need to be fully vaccinated against coronavirus (COVID-19), unless they are exempt under the regulations.

Temporary self-certification arrangements were introduced in September 2021. On a temporary basis people working or volunteering in care homes who have a medical reason why they are unable to have a COVID-19 vaccine will be able to self-certify that they meet the medical exemption criteria. These temporary arrangements will run out on 24 December 2021 (12 weeks after the formal system became available).

The formal guidance on how to apply for medical exemptions was announced on 30 September and published on 1 October 2021.

This Q&A is based on Care Provider Alliance (CPA) webinars held in August and September 2021, and publicly available Government documents.

The answers provided here are based on CQC and NHSE responses and do not necessarily reflect the Care Provider Alliance’s position.

This document will be updated as we receive more detailed information. Please return to our website pages on COVID vaccination as a condition of deployment on a regular basis.

Consultation on extending requirements§

Government is currently consulting on whether or not the government should extend the requirement to other health and care settings, as a condition of deployment, and in addition, whether to introduce a statutory requirement to be vaccinated against the flu as a condition of deployment, as a means to protect vulnerable people. This consultation is due to close on 22 October 2021 and is NOT the focus of this Q&A. 

The CPA advises all care services to respond to the consultation by 22 October 2021.

Disclaimer§

The CPA assumes no responsibility or liability for any errors or omissions in the publication of this communication. The information contained in this update is provided on an “as is” basis with no guarantees of completeness, accuracy, usefulness or timeliness. It does not constitute legal advice.

Questions§

Timing of changes, including self-certification§

1. What happens on 11 November 2021?

The regulations go into force on 11 November 2021 and if someone has not been fully vaccinated and does not have a temporary or permanent exemption after that date, they will not be able to work in a care home.

If someone has a temporary, self-certified exemption, this runs out on 24 December 2021. They must be fully vaccinated OR be medically exempt based on the formal, permanent system by 24 December 2021. If not, they cannot enter the care home.

2. What are the temporary arrangements for self-certification?

On 15 September 2021, a grace period was put in place to ensure staff who had not yet been vaccinated could take up the vaccine before the regulations come into force on 11 November 2021. Guidance and forms are available here.

The 12-week grace period runs from 1 October to 24 December 2021.

During this period, staff can self-certify that they are exempt from having the COVID-19 vaccine. Care homes can accept self-certifications as evidence of exemption up to 24 December 2021. Self-certifications run out on 24 December 2021 and can no longer be accepted as evidence of exemption from that date.

The 12 weeks between 1 October and 24 December 2021 are to give employees the time to undertake the permanent process for exemptions, or be fully vaccinated if they are not eligible for an exemption based on the permanent process.

However, please note that 11 November 2021 remains the date the regulations go into force and if someone does not have a temporary or permanent exemption after that date, they will not be able to work in the care home.

This means that some care home staff will no longer be able to enter the care home from 24/25 December 2021.

The Care Provider Alliance and our members are aware that the timing of these arrangements is concerning as care homes are exceptionally busy, with major pressures on the workforce, at Christmas time. As of 1 October 2021, members are requesting an immediate review of these arrangements and an extension of at least another month for self-certification of care home staff.

Further details, and related self-certification forms are available on the Gov.UK website. The temporary arrangements are summarised below:

Temporary self-certification arrangements use the same exemption criteria as permanent arrangements.

Care providers should accept self-certification and are not required to make any kind of clinical assessment. The form requests that the person clarifies that they meet the medical exemption criteria – it does not require the person to disclose a particular condition that they might have.

Self-certification will be considered sufficient evidence for exemption from 1 October to 24 December 2021. This is to enable people to:

    1. apply via the formal system,
    2. get a result and choose whether or not they want to get vaccinated
    3. get both vaccines.

Workers who have self-certified will not be required to be redeployed by 11 November but they will need to complete the formal process by 24 December 2021 to either secure a medical exemption or take up vaccination.

The temporary self-certification system and the permanent system use the same criteria for exemptions.

The temporary, self-certification does not need clinical approval.

The permanent system is subject to assessment by clinicians.

Anyone who has been vaccinated overseas will need to self-certify as exempt using the forms published on gov.uk. (See below for further details)

3. What support is being given to ensure care staff get their vaccines – including boosters?

Additional funding on COVID-19 was announced on 20 September 2021. This includes £25 million to support care workers to access COVID-19 and flu vaccines over the winter months. This will ensure social care staff who need to travel to receive their COVID-19 or flu vaccinations are paid their usual wages to do so and can be supported with travel costs.

Application to care settings§

4. Which services are covered by mandatory COVID-19 vaccination?

The duty will only apply to services registered with CQC to provide the Regulated Activity: Accommodation for persons who require nursing or personal care.

Further consultation is underway about potentially extending the requirement to other health and care settings. Closing date for consultation is 22 October 2021. Access the consultation here. All care providers are strongly advised to respond to this consultation.

5. What roles are covered by the vaccination as a condition of deployment in care homes requirements?

The requirement only applies in respect of persons entering the inside of the care home premises and it will be up to the registered person (or those acting on behalf of the registered person) to identify the most appropriate procedures to check vaccination status. (See Appendix 1 for a summary).

It includes roles such as care home staff, health care professionals, CQC inspectors, tradespeople, hairdressers and beauticians.

Essential Care Givers and visitors do not have to show proof of vaccination or exemption. Essential Care Givers do, however, need to follow the same IPC guidance as staff.

6. Will office-based staff employed by a home care agency be covered by the new proposals currently being considered?

No. The government is consulting on whether vaccination should become a condition of deployment in wider care settings, such as domiciliary care, but this only covers staff who “undertake direct treatment or personal care as part of a CQC regulated activity”.

How does this regulation apply in respite settings which are registered and regulated as a care home, but people are not permanently residing there?

The duty applies as respite settings provide accommodation for persons who require nursing or personal care.

7. What about volunteers coming into the home who provide an activity service to the residents in their rooms or communal areas?

All volunteers who enter the care residence will need to show proof of vaccination or exemption, unless they are under 18.

8. Is there an example template available for a covid vaccination policy for care home providers?

Yes – see examples via CPA website

Recording evidence of vaccination or exemption§

9. What details need to be recorded for an employer to confirm they have seen evidence of vaccination status or exemption status?

Registered persons will not be required to show a record of the evidence itself to inspectors, but they will need to be able to provide reassurance that systems and processes are in place to ensure individuals who enter the premises are fully vaccinated.

Registered persons may choose to make a record of the evidence they have seen for their own internal staff employment record keeping.

If the evidence is collected and recorded, all personal data must be handled in accordance with UK GDPR. This includes providing individuals with privacy information at the stage their data is being collected.

Please refer to the guidance from the Information Commissioner’s Office to ensure you have the appropriate lawful basis, technical and security measures in place to protect personal data.

10. Are care providers obliged to keep a hard copy of staff vaccine evidence, or can they just record the information on their matrix once seen by a manager?

The DHSC guidance makes it clear you don’t need to keep a copy of the evidence you’ve seen – just a record to confirm that you’ve seen that evidence.

It may be that you want to keep a more detailed record of the evidence you’ve seen for your own employed/deployed staff (e.g., the info on the NHS App: brand, date of vaccinations) but for visiting professionals you simply tick a column in the visitor log to say that you have seen it.

11. What form of evidence of vaccination is acceptable? Can someone use their vaccination card?

Individuals that have been vaccinated by the NHS in England may demonstrate their vaccination status using the NHS COVID Pass service via the following 3 routes:

  • the NHS App
  • the NHS website – NHS.uk
  • the NHS COVID Pass letter

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

12. What form of evidence of exemption is acceptable?

Self-certification is acceptable on a temporary basis from 1 October to 24 December 2021. Providers should accept self-certification and are not required to make any kind of clinical assessment. The self-certification form available on GOV.UK requests that the person clarifies that they meet the medical exemption criteria – it does not require the person to disclose a particular condition that they might have. Forms and guidance on self-certification are available on GOV.UK.

The permanent process for exemptions is also live. All exemptions will be confirmed by a doctor, specialist clinician or midwife. If approved, the NHS COVID Pass can then be used to prove someone’s status.

The domestic NHS COVID Pass will look and work the same for people with medical exemptions as it will for people who are fully vaccinated. The pass won’t show that someone has a medical exemption, just that they have the NHS COVID Pass.

Staff can show their NHS COVID Pass digitally – on the NHS app or the NHS website. They can also download it as a pdf. The paper version of the pass will be available soon.

13. Can we retain a copy of the vaccine evidence on a staff file in addition to recording or would this be a breach of GDPR?

Registered persons may choose to make a record of the evidence they have seen for their own internal staff employment record keeping.

If the evidence is collected and recorded, all personal data must be handled in accordance with UK GDPR. This includes providing individuals with privacy information at the stage their data is being collected.

Please refer to the guidance from the Information Commissioner’s Office to ensure you have the appropriate lawful basis, technical and security measures in place to protect personal data.

14. Presumably, employers need to keep a record of vaccine dose details for their staff? As a minimum, evidence of 2 doses and the date the doses were given? And presumably, less detail is needed for anyone else crossing the threshold?

Registered persons will not be required to show a record of the evidence itself to inspectors but will need to be able to provide reassurance that systems and processes are in place to ensure individuals who enter the premises are fully vaccinated.

Registered persons may choose to make a record of the evidence they have seen for their own internal staff employment record keeping.

If the evidence is collected and recorded, all personal data must be handled in accordance with UK GDPR. This includes providing individuals with privacy information at the stage their data is being collected.

Please refer to the guidance from the Information Commissioner’s Office to ensure you have the appropriate lawful basis, technical and security measures in place to protect personal data.

15. How will the Capacity Tracker be used in monitoring compliance?

The following questions are being added to Capacity Tracker:

  • Number of staff self-certifying as medically exempt.
  • Number of staff in receipt of NHS COVID Pass medical exemption.
  • Number of staff self-certifying as being vaccinated abroad.

It is important to note that Capacity Tracker is an NHS system. CQC do receive location level data from this. This data is used as part of the normal ongoing monitoring processes. If Capacity Tracker data indicates a low level of vaccine uptake amongst staff, depending on other information available to the inspector, it may trigger (for example) a call to the registered manager or an inspection.

16. How will CQC ensure that all inspectors apply the same approach in terms of evidencing the application of the regulation? Can we be assured they will not want to see the physical copy of the vaccine evidence?

Registered persons will not be required to show a record of the evidence itself to inspectors but will need to be able to provide reassurance that systems and processes are in place to ensure individuals who enter the premises are fully vaccinated.

Registered persons may choose to make a record of the evidence they have seen for their own internal staff employment record keeping.

If the evidence is collected and recorded, all personal data must be handled in accordance with UK GDPR. This includes providing individuals with privacy information at the stage their data is being collected.

Please refer to the guidance from the Information Commissioner’s Office to ensure you have the appropriate lawful basis, technical and security measures in place to protect personal data.

Booster vaccinations§

17. What is the situation regarding booster doses – are they mandatory for staff in care homes?

Booster doses are not currently included in the regulations, but managers are strongly advised to encourage workers to take up booster vaccines if eligible. At this stage no decision has been taken regarding adding provision for booster vaccines to the regulations in the future.

18. Given that it is highly likely that boosters will become the official advice of the JCVI, how much notice will we get of boosters being added to the regs?

This is not known at the moment. Regulations would need to be changed to include it.

HR and contract of employment questions§

Please refer to the Government guidance on vaccination as a condition of deployment. In particular, see Annex A on Good employment practice.

19. Can a member of staff keep working right up to the 11th of November if they do not want to get the vaccine?

Staff who are not fully vaccinated and who have not provided a temporary self-certification form indicating that they are exempt can remain at work until 10th November. They will not be able to enter a care home from 11th November. If they have not served their full notice period, they can be put on paid leave.

Workers who have self-certified will not be required to be redeployed by 11 November 2021 but they will need to complete the permanent process by 24 December 2021. This will give them time to either secure a medical exemption or take up vaccination. If they do not, they cannot enter the care home from 24 December 2021.

20. Are we legally allowed to ask all our staff for evidence of having had both vaccinations?

Yes. Registered persons are ultimately responsible for ensuring that everyone who enters the care home is vaccinated or exempt. They do not need to show information about the reason for the exemption – just that they are formally exempt (or for a limited period, self-certified as exempt).

21. If on maternity/long term sick/sabbatical, are you only required to provide proof of vaccine before you re-enter the service? Or is it still required by 11th Nov despite not being on-site?

People who are on maternity or long-term sick leave or on sabbatical do not have to be vaccinated by 11 November 2021, but they must have had both doses of the vaccine by the time they return to work, or have a medical exemption.

22. Are care providers obliged to respond to template letters that employees have sent to them, but have been produced by other organisations?

We are aware that several workforce organisations have produced standard letters which care workers are sending on to their employers.

Care providers should consider these carefully. They may be raising a compliant, grievance or whistleblowing concern – even if they do not refer to a specific employee.

You should explain that while the regulations regarding vaccination or exemption are in place, as an employer you have a legal duty to obey those regulations.

You also need to demonstrate that you are following a fair process, otherwise you may be at risk of an Employment Tribunal.

23. Can you include information about vaccination as a condition of deployment on recruitment adverts?

Yes you can. Remember the requirement is either to be fully vaccinated, or have a medical exemption.

24. What do you say to people about why you are dismissing them?

You must have a ‘fair reason’ to dismiss someone. There are five fair reasons in law and three of them are most likely to apply in this instance:

  • Illegality – you would be contravening an enactment if you continue to employ someone in a care home who is not fully vaccinated or has an exemption
  • Other substantial reason – for example this might include protecting health and safety of colleagues and people you support
  • Capability – you cannot employ someone who does not have the capability to carry out role.

Some legal advisors recommend including a number of ‘fair reasons’ for the dismissal. These reasons should be outlined in meetings, and in writing to the employee.

Ultimately it will be the courts that decide what is fair.

25. What constitutes a ‘fair process’?

Employers must follow a fair process when managing dismissals. This is likely to include consultation with individuals, talking to them about the vaccination – ensuring that they understand the issues and implications of not getting vaccinated, and not being medically exempt.

Discuss what they are considering doing. For example, if they plan to sign on with a care agency, they will face the same requirements and not be able to work in a care home.

Give them the opportunity to have the vaccination. If they still refuse and do not have an exemption (temporary self-certification to 24 December 2021 or permanent), you can then hold another meeting to terminate their employment.

26. What process do I need to follow in order to dismiss someone due to vaccination status?

You must follow your standard dismal process – including meetings, correspondence, notice period, ACAS meetings etc. Some legal advisers are recommending that care providers give conditional notice based on not taking up the vaccine or proving that they are medically exempt by 10 November 2021. If they do then get fully vaccinated by 10 November, the notice is no longer valid and they can continue to work.

You also need to give adequate notice to terminate the contract, which is subject to the statutory notice period – which is one week to every year of service, to a maximum of 12 weeks.

If a staff member is working their notice period and this goes beyond 11 November 2021, you can still redeploy them if that is feasible, or you can put them on paid leave and not come into the care home, or pay them in lieu of notice.

Care providers need to consider the costs this will incur.

Please refer to the Government guidance on vaccination as a condition of deployment. In particular, see Annex A on Good employment practice.

27. If a care worker is not exempt and wants to get the vaccine, but they can’t be fully vaccinated with double dose by 11 November, what can they do?

The care home worker would not be able to enter the care home from 11 November. The care home should aim to redeploy them for the period until they are fully vaccinated.

JCVI advice is that there should be a minimum of 8 weeks between vaccines. GPs should not be agreeing to provide second doses in a shorter period of time. CQC have followed up with GPs who have done this.

28. If a care worker has had one vaccine but declines to have the second, what happens?

Staff must be fully vaccinated – so they must have had both vaccines. So unless they are medically exempt, they must be deployed elsewhere or their employment will be terminated.

29. If a care worker gets their second vaccination on 10 November, can they continue to be deployed?

Technically yes. They don’t have to wait for the two weeks after the second vaccination. However, we recognise that there may be a delay in their NHS COVID Pass being updated with this information. You would be therefore taking your staff member on trust. Consider if you can redeploy them or put them on leave until their COVID Pass is updated.

Exemptions including pregnant staff§

30. What are considered medical exemptions for not getting the vaccine?

Some individuals are unable to be vaccinated and/or tested for medical reasons. They can apply for proof that they have a medical reason why they should not be vaccinated and/or tested.

According to Government guidance issued on 1 October 2021, the possible reasons for exemptions are limited. Examples that might be reasons for a medical exemption are:

  • people receiving end of life care where vaccination is not in the person’s best interests
  • people with learning disabilities or autistic individuals, or people with a combination of impairments where vaccination cannot be provided through reasonable adjustments
  • a person with severe allergies to all currently available vaccines
  • those who have had an adverse reaction to the first dose (for example, myocarditis).

Other medical conditions could also allow someone to get a medical exemption.

Short-term exemptions will also be available for those with short-term medical conditions and as an option that some pregnant women may choose to take. Exemptions for pregnant women will expire 16 weeks post-partum, in order to allow them to become fully vaccinated after birth.

Pregnant women can alternatively use MAT B1 certificates to show their COVID status, if they choose to use a medical exemption. Pregnant women do not need to apply for a medical exemption NHS COVID Pass if they have a MAT B1 certificate. For pregnant women who use the MAT B1 form to show their exemption, the exemption will expire 16 weeks post-partum. This will allow them to become fully vaccinated after birth.

31. What is the process for proving that you are medically exempt?

On 1 October 2021, the Government published guidance on proving you are unable to get vaccinated.

If someone gets this proof of medical exemption they will be able to use the NHS COVID Pass wherever they need to prove their COVID-19 status within England.

All exemptions will be confirmed by a doctor, specialist clinician or midwife. If approved, the NHS COVID Pass can then be used to prove someone’s status.

The domestic NHS COVID Pass will look and work the same for people with medical exemptions as it will for people who are fully vaccinated. The pass will not show that someone has a medical exemption.

To apply for an exemption, people must phone the NHS COVID Pass service on 119 to ask for an NHS COVID Pass medical exemptions application form, and follow their process.

32. Is it correct that that self-exemption is all that is required and that care providers cannot request that staff provide medical evidence of exemption?

Self-certification of exemption is only acceptable on a temporary basis up to 24 December 2021 (12 weeks from the formal arrangements being available – which was announced on 1 October 2021) in order to give staff time to get vaccinated or go through the permanent exemption arrangements.

Care providers should accept self-certification on a temporary basis and are not required to make any kind of clinical assessment. The form requests that the person clarifies that they meet the medical exemption criteria – it does not require the person to disclose a particular condition that they might have.

Self-certification will be considered sufficient evidence for exemption until 12 weeks from the date that the permanent arrangements are put in place. The 12 week period is to enable people to:

  1. apply via the formal system,
  2. get a result and choose whether or not they want to get vaccinated
  3. get both vaccines.

So that is 12 weeks from new system going live (ie from 1 October 2021). NOT 12 weeks from 11 November 2021.

With the formal process and the self-certification process, there is no requirement for registered persons to record the clinical reason behind the exemption - they should only record whether a person is medically exempt or not (or self-certified during the temporary arrangements).

33. What is the position regarding pregnant workers and the vaccine? Do they still form part of the exemption list?

According to guidance published on 1 October 2021, short-term exemptions will also be available for those with short-term medical conditions and as an option that some pregnant women may choose to take. Exemptions for pregnant women will expire 16 weeks post-partum, in order to allow them to become fully vaccinated after birth.

Pregnant women can alternatively use MAT B1 certificates to show their COVID status, if they choose to use a medical exemption. Pregnant women do not need to apply for a medical exemption NHS COVID Pass if they have a MAT B1 certificate. For pregnant women who use the MAT B1 form to show their exemption, the exemption will expire 16 weeks post-partum. This will allow them to become fully vaccinated after birth.

Tradespeople and training§

34. Is there an exemption for all tradespeople?

Tradespeople can use the same temporary self-certification arrangements up to 24 December 2021, as outlined above. Self-certification of exemption is only acceptable on a temporary basis while they go through the permanent exemption arrangements.

After 24 December 2021, tradespeople carrying out non-urgent maintenance work must be either fully vaccinated OR be medically exempt under the permanent arrangements.

Government guidance says:

“We expect urgent maintenance assistance to only apply where there is a significant impact on the quality of care of residents or risk to life.

“Exemptions to the requirement can only apply for a person to provide urgent maintenance or emergency assistance with respect to the care home. It is for the registered manager of the care home to make that decision.”

35. Does this also affect staff attending training, if the trainer is not vaccinated?

Anyone who enters a care home as part of their professional responsibilities will need to show proof of vaccination unless they are exempt. This includes trainers.

Trainers can use the same temporary self-certification arrangements up to 24 December 2021, as outlined above. Self-certification of exemption is only acceptable on a temporary basis while they go through the permanent exemption arrangements.

After 24 December 2021, trainers must be either fully vaccinated OR be medically exempt under the permanent arrangements.

36. Do entertainers/ music therapists have to be double vaccinated?

Anyone who enters a care home as part of their professional responsibilities will need to show proof of vaccination unless they are exempt. This includes entertainers or therapists.

They can use the same temporary self-certification arrangements up to 24 December 2021, as outlined above. Self-certification of exemption is only acceptable on a temporary basis while they go through the permanent exemption arrangements.

After 24 December 2021, they must be either fully vaccinated OR be medically exempt under the permanent arrangements.

Vaccinated overseas§

37. What should care home staff who are vaccinated in another country do?

Individuals that have received a COVID-19 vaccination abroad can use the temporary arrangements to self-certify as medically exempt. This is because it is not clinically appropriate for them to be vaccinated in the UK if they have already received a partial or full course of vaccination overseas.

The Department of Health and Social Care is working on a permanent solution to this and will provide further guidance as soon as possible.

Keeping services safe§

38. What is the role of the Care Quality Commission in relation to this requirement?

The requirement forms part of the fundamental standards and will be monitored and enforced in appropriate cases, by the Care Quality Commission (CQC).

CQC will not begin monitoring this until it becomes a duty in November. They will continue to use their existing assessment and enforcement policies and take a proportionate approach. CQC has published a statement on their website outlining their approach to:

  • registration
  • ongoing monitoring and inspection

39. What if a care home has not been able to collate all of the data about their staff’s vaccination status and CQC come to inspect them?

Technically they have not provided evidence then technically they shouldn’t be working in the service, and the provider would be in breach. CQC will be asking what systems and processes do you have in place to demonstrate compliance, and we sample. 

40. If managers have seen staff getting vaccinated is this adequate evidence of that staff members’ vaccination?

No. Individuals that have been vaccinated by the NHS in England may demonstrate their vaccination status using the NHS COVID Pass service via the following 3 routes:

  • the NHS App
  • the NHS website – NHS.uk
  • the NHS COVID Pass letter

41. What exceptions will CQC allow where services have to work below safe numbers due to this?

The way the regulation is worded means that compliance with it is pretty binary – either you are meeting it or you aren’t.

If CQC identify a breach of regulation, they say they will be reasonable and proportionate in the action we take, using our normal enforcement and judgement frameworks.

If they find a provider is in breach of the regulation, they say they will look at things in the round. This means for example if there is a short-term tension between deploying staff who have been vaccinated against having sufficient staff to provide safe care and treatment, then we would reflect that in the action we take (for example perhaps issuing a requirement notice, or warning notice rather than more significant enforcement action).

42. Is a lack of staff classed as an emergency?

It is the registered person’s responsibility to use their professional judgement to determine whether a situation is an emergency in line with the guidance set out below. Registered persons will be expected to keep a log of all emergency situations, including details of the circumstances, during which people entered the home without showing proof of vaccination or exemption.

An emergency situation could include (but is not limited to):

  • members of the public assisting in the event of flood or fire
  • social workers responding to immediate safeguarding concerns

43. How does it work where a business contingency plan requires staff not in care roles to be deployed into a care home where staffing levels become unsafe? Presumably this effectively means all those staff would be expected to be vaccinated even though their main role does not specifically require it?

The regulation states that registered persons (registered managers, registered providers) will need to ensure that they do not allow anyone entry into a care home unless they have had a complete course of an authorised vaccine or fall into one of the groups exempt from being vaccinated.

The way the regulation is worded means that compliance with it is pretty binary – either you are meeting it or you are not.

If CQC identifies a breach of regulation, they say they will be reasonable and proportionate in the action we take, using our normal enforcement and judgement frameworks.

If CQC finds a provider is in breach of the regulation, they will look at things in the round. This means for example if there is a short-term tension between deploying staff who have been vaccinated against having sufficient staff to provide safe care and treatment, then CQC would reflect that in the action they take (for example perhaps issuing a requirement notice, or warning notice rather than more significant enforcement action).

44. Where one part of a building is a CQC registered care home (separate from the rest of the building) does the vaccination requirement apply to the care home zone only?

The regulations apply to anyone entering the inside of a care home. If a care home shares its premises with another business or home, then the requirement should not apply to these businesses/ homes as long as no one enters or passes through a care home to access them.

As a registered person, you know your service better than anyone else. We want to support and enable you to comply with these regulations in the way which will work best for you and your team. This means you should make a decision about where you want to have vaccine checkpoints. We suggest you treat this as a risk assessment process. Talk to your team and to regular visiting professionals. Decide how you want to make this work in practice, keep a record of your discussion and review the actions you are taking regularly, making changes as necessary.

45. What support will be provided to commissioners/ASC providers to help enable recruitment to meet any shortfall in staffing levels as a result of the regulation changes?

The DHSC is looking at this issue and will talk to regional assurance teams to understand how different regions will be affected. They will be looking at providing support according to local need.

46. What happens if funeral directors of the person's choice are not vaccinated - do we go against the person's/family’s wishes?

Funeral directors and their staff will have to show proof of vaccination or exemption when entering the care home.

47. If a person is not vaccinated or exempt will this stop them gaining their registration? What about current registered managers - are they expected to be vaccinated, and if they refuse could they lose their registration?

People who apply to be registered manager in a care home will need to be either vaccinated or exempt.

The requirement to be either vaccinated or exempt from vaccination also applies to existing registered managers. The registered provider would need to decide on the appropriate course of action in the event of an existing RM failing to meet this requirement. Annex A of the DHSC guidance provides information about sources of advice around employment law and practices.

Further information§

CPA COVID-19 vaccination - information and webinars

Coronavirus (COVID-19) vaccination of people working or deployed in care homes: operational guidance

Vaccinations for NHS staff entering care homes letter and FAQ

Covid-19 medical exemptions: proving you are unable to get vaccinated

Temporary medical exemptions for Covid-19 vaccination for people working or deployed in care homes

NHS Covid Pass

DHSC Webinar 21 May 2021: Your Questions Answered on the COVID-19 vaccine.

Appendix 1 – Crossing the threshold of a care home§

National Care Forum infographic illustrating when full vaccination is required, and when it is not required. Download a PDF.