Last reviewed 16 November 2020

The Department of Health and Social Care (DHSC) is seeking views on plans to minimise the risk of Covid-19 infections by making residential and nursing care home providers restrict the movement of care staff.

The findings of a study on the impact of Covid-19 in care homes in England showed one of the common factors in care homes with higher levels of infection among staff was the extent to which those homes employed staff who worked across multiple sites.

In response, the Government's Adult Social Care: Our COVID-19 Winter Plan 2020 to 2021 committed to creating new, time limited regulations to limit staff movement between care homes, and between care homes and other health and care settings. The Government is now consulting on temporarily modifying Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which covers staffing. It means residential and nursing care home providers in England have to restrict the movement of staff providing personal care or nursing care in their services.

The changes mean registered care home providers of nursing or residential care cannot deploy people to provide nursing care or personal care if those people are also being deployed, or have been deployed within the previous 14 days, to provide a regulated activity in another health or social care setting.

There are some limited exceptions to the requirement, including where complying with the new requirement would mean that a provider did not have sufficient staff to provide a safe service. This only applies for the period reasonably necessary to allow that provider to make arrangements to allow it to find enough staff who are not working elsewhere to enable it to comply with the new requirement. For this exception to apply, the provider will need to be able to demonstrate that:

  • it has adequately planned its staffing requirements in accordance with Care Quality Commission (CQC) Fundamental Standards

  • it is actively taking steps to address any resourcing needs

  • it is still unable to ensure sufficient staff are available to care for service users safely

  • so far as reasonably practical, all staff used in this situation have had a test for Covid-19 within the previous 7 days and have received a negative result from it.

The accompanying Code of Practice (CoP) states that where a provider intends to use people to provide care who are also attending a job in another health or social care setting it must have a risk assessment in place, in accordance with criterion 1 of the CoP. The person being deployed should be asked to confirm they have had a negative test for Covid-19 in the last seven days, and the provider must be satisfied the individual has had training in infection prevention and control.

All staff deployed by the provider on this basis should be tested as part of the provider's routine weekly testing programme. Where an individual is working in a care home, they should always have had a test within the last seven days.

Where the exceptions apply and a provider uses agency or other temporary staff, the provider should seek to engage them on a block-booking or placement basis and take all reasonable steps to ensure those staff are not attending other settings.

Providers will only be allowed to deploy people using the exceptions for as long as is needed for them to resolve any staffing issues. They will be expected to demonstrate to the CQC the steps they have taken to meet the requirements and why they have still been unable to do so, and the steps they are actively taking, or have taken, to ensure compliance.

Where one provider makes use of this exception, the second provider will not be in breach of the regulations.

The consultation is open until 23 November 2020 and is available at: