Guidance

Adult social care in England statistics: background quality and methodology (May 2021 to August 2022)

Updated 1 September 2022

Applies to England

This document sets out information on the context, sources, quality and coverage of the monthly statistics on adult social care in England reports from May 2021 to August 2022 only. This document will no longer be updated.

See the current background quality and methodology.

About these statistics

These statistics are badged as experimental statistics and are undergoing development and further assessment of quality. Data is being published to provide insight into how COVID-19 has impacted the social care sector and its response to the pandemic.

These statistics will be assessed regularly and any improvements in quality will be incorporated accordingly at the next available opportunity. The scope of the data included in this publication will also be assessed to ensure the value of these statistics is maintained.

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

Introduction

The Department of Health and Social Care (DHSC) publishes monthly statistics on COVID-19 in adult social care settings. This document primarily sets out information on the data sources and methodology used to generate the statistics. These statistics currently cover:

• first, second and first booster COVID-19 vaccinations in social care settings for staff and residents

• selected infection prevention and control (IPC) measures in care settings at national, regional and local authority level, which include visiting in care homes and personal protective equipment (PPE) availability in care homes and domiciliary care

• staffing levels in care homes

• COVID-19 related absence rates in care homes and domiciliary care settings

• COVID-19 testing for staff, residents and visitors of care homes

Up until the May 2022 release, these statistics also covered:

• additional IPC measures, including staff movement across different social care settings and payment of full wages when care home staff were isolating due to COVID-19
• flu vaccinations for the 2021 to 2022 season for social care staff and residents

The data collection for these statistics ceased on 4 April 2022. These metrics appear in the data tables up to the May 2022 release but have been removed from the data tables from June 2022 onwards. References to staff pay, staff movement and flu are still included throughout this methodology document in order to provide the necessary information to users referring to releases prior to May 2022, which include these metrics.

Throughout this document, if the user refers to data from December 2020 to April 2022, all references to IPC data include data on:

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

From 4 April 2022, IPC data references only relate to visitation in care homes.

Data sources and collection

COVID-19 vaccination, IPC, PPE availability, staff absence rates and staffing level data in the publication is taken from management information submitted by care providers in England to a data collection and insight tool called Capacity Tracker.

Capacity Tracker was 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.

Capacity Tracker was identified as a suitable tool for COVID-19 data collection from care providers. Its re-purposing was announced via the government’s action plan (15 April 2020) and joint letter (17 April 2020) from DHSC and NHS England and Improvement (NHSEI) together with the Care Quality Commission (CQC) and the Care Provider Alliance.

Data items collected in Capacity Tracker underwent a review in line with the publication of the new infection prevention and control guidance on 31 March 2022 and the conclusion of the Adult Social Care Infection Control and Testing Fund (ICTF). Data items directly related to the ICTF, with the exception of care home visitation, were removed on 4 April 2022, including items covered in the infection prevention and control measures in care settings section of this publication.

The Health and Care Act 2022 received Royal Assent in April 2022. It includes a provision to mandate Capacity Tracker data collections which came into place on 31 July 2022, and a provision to make enforcement regulations which will come into effect in November 2022. The guidance on the mandatory data collection was published on 14 July 2022. From 31 July 2022, providers will, where possible, be given 3 months’ notice before new data fields become mandatory.

Since 31 July 2022, providers are mandated to submit a core subset of the data which they have already been submitting through the 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 must be no more than a week out of date – that is, data must be submitted between the 8th and 14th day of each month. The data in the August 2022 publication goes up to 26 July 2022 so is not affected by this change. The publication will be adapted in September 2022 to reflect this change.

Changes to Capacity Tracker will be reflected in this publication as and when they occur.

COVID-19 and flu vaccination

The Capacity Tracker data collection on first and second doses of the COVID-19 vaccination began in December 2020 for care homes, and in February 2021 for independent CQC-registered domiciliary care providers and for other settings including non-registered providers and local authority employed. Providers self-report their total number of staff and residents and the number of staff and residents who have received the COVID-19 vaccination.

Data collection on first booster doses for the COVID-19 vaccine began in September 2021 and the data has been reported in this publication since November 2021. Data collection on second boosters began in April 2022 and was published in August 2022 for the first time.

Data collection for flu vaccination for the 2021 to 2022 season began in September 2021 and data has been published since November 2021 but collection was ceased in April 2022. As a result, the timeseries for flu vaccination ended on 29 March 2022 and the data tables feature in the May 2022 publication but do not feature in subsequent publications.

Prior to September 2021, providers were expected to review and submit the number of individuals who are reported as ‘vaccinated’, ‘not vaccinated’ or whose vaccination status is ‘unknown’ on a daily basis. A vaccination status declared as ‘unknown’ includes those situations in which the status is not known to the care provider or has not been disclosed. From September 2021, providers are only asked to review and submit the number of individuals who are reported to be ‘vaccinated’.

As a result, the rates in this publication refer to the percentage of staff/residents reported to be vaccinated by care providers. This means that the number of individuals who have not received the vaccine cannot be directly derived from data published in these statistics as there may be a number of individuals whose vaccination status is unknown to the care provider.

Vaccination rates among care home staff vary substantially between those who are directly employed by the care homes and those employed by agencies operating within care homes. This could be due to different uptake rates of the vaccine as well as different proportions of staff whose vaccination status is unknown. Therefore, directly comparing the vaccination rate of directly employed staff to agency staff should be done with caution as the 2 groups are likely to have different percentages of staff whose vaccination status is unknown. Care homes are less likely to know the vaccination status of their agency staff due to the nature of their employment.

From 31 July 2022, vaccination data is part of the subset of data which providers are mandated to submit on a monthly basis.

Infection prevention and control

The adult social care Infection Control and Testing Fund (ICTF) was first introduced in May 2020. The purpose of this fund was to support adult social care providers, including those with whom the local authority does not have a contract, to reduce the rate of COVID-19 transmission within and between care settings, in particular by helping to reduce the need for staff movement between sites.

Up until 31 March 2022, the ICTF provided funding from local authorities to ensure that infection prevention and control (IPC) measures were in place to curb the spread of COVID-19. To support the monitoring of the fund, questions tracking the adult social care sector’s implementation of IPC measures was collected. Providers self-report their responses and are expected to submit on a weekly basis.

This publication provided data on how providers were complying with the following measures, up until 29 March 2022:

• limitation of staff movement across different social care settings

• accommodating COVID-safe visitation in care homes in line with government guidance

• payment of full wages when staff are isolating due to COVID-19 in care homes

On 21 February 2022, DHSC published new guidance on Living with COVID-19, which outlines the government’s plan for removing the remaining legal restrictions while protecting people most vulnerable to COVID-19 and maintaining resilience. On 31 March 2022, DHSC published new infection prevention and control guidance on managing specific infections and a COVID-19 supplement to reduce the spread of COVID-19 in adult social care settings in England, which both apply from 4 April 2022.

On 31 March 2022, the government ceased funding for COVID-19 positive social care staff to stay away from work and the staff movement restrictions were lifted, allowing pressure on workforce to be alleviated.

As a result, among other data collected about infection prevention and control measures, the data on staff pay and staff movement ceased to be collected from 4 April 2022 and therefore the last data point in the timeseries for these 2 metrics is 29 March 2022. The timeseries for these two metrics are included in data tables up until the May 2022 release, but these tables do not feature in subsequent publications.

The question on COVID-safe visitation in care homes remains, and this publication will continue to present this data. On 4 July 2022, the visiting questions changed in Capacity Tracker, which now asks about whether care homes have been able to accommodate visiting in the past month rather than in the last 7 days.

From 31 July 2022, visiting data is part of the subset of data which providers are mandated to submit on a monthly basis.

Workforce pressures

The Capacity Tracker data collection on staff absences related to COVID-19 started in December 2020 for care homes and independent CQC-registered domiciliary care providers.

Care home providers self-report their total number of staff in the establishment (nurses, care workers and non-care workers) and the number of staff absent due to COVID-19 related reasons.

Independent CQC-registered domiciliary care providers self-report the total number of staff who have face-to-face contact with care recipients and the number who are not working because of COVID-19.

In December 2021, an additional workforce report providing more information on the pressures faced by the adult social care workforce was published. This information was received through an ad hoc survey and can be found on the collection page. The survey covers more detailed insight into current workforce pressures faced compared to 6 months previously. This includes issues relating to recruitment, retention, staff morale and use of agency staff. See the adult social care workforce survey: December 2021 report.

From 31 July 2022, staff absence data is part of the subset of data which providers are mandated to submit on a monthly basis.

PPE availability

Data is collected on PPE availability in care homes and domiciliary care providers. Before 4 July 2022, data was collected on the supply of the following items of PPE:

• aprons
• eye protection
• gloves
• hand sanitiser
• face masks

On 4 July 2022, the question changed in Capacity Tracker to ask whether providers have a shortage of any PPE, rather than asking about each item individually.

PPE data does not feature in the subset of data which providers are mandated to submit. Providers are still encouraged to provide the data, but on a voluntary basis. PPE data will be removed from the publication in September 2022.

COVID-19 testing

This data is collected from management information generated during the operation of the NHS Test and Trace service. For more information see NHS Test and Trace statistics (England): methodology.

The adult social care Rapid Testing Fund was first announced on 23 December 2020 to support the rollout of rapid lateral flow testing in care homes. The funding was extended over 2021 to 2022 until the end of March 2022, to support additional testing of staff in care homes, and enable indoors, close contact visiting where possible. No further specific testing funding will be provided in 2022 to 2023.

From 4 April 2022, the government continues to provide tests to the sector to help manage the spread of COVID-19, prioritising groups most at risk of infection, and reducing testing requirements where possible to ease the additional burden testing places on care services. At the time of publication, the adult social care settings outlined in the COVID-19 testing in adult social care guidance continue to have access to free testing to support asymptomatic, symptomatic and outbreak testing.

Data coverage

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

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

Infection prevention and control, PPE availability, staff absences and staffing levels

Data is self-reported by care homes and providers are expected to submit IPC data on a weekly basis while staffing level, COVID-19 related absences and PPE availability data was expected to be submitted on a daily basis, until April 2022. Any care home that has not submitted data within the last 7 days is excluded from the relevant analysis for the associated time period where no response was received. This is to avoid skewing the data. This means that the total number of care homes and staff varies over time and between tables. The full response rates for all data points are available in the accompanying tables. From 4 April 2022, the expectation for all data fields changed to weekly, to reduce the burden on providers.

Infection control data for each reporting week refers to data up to 2pm on the date stated as the ‘week ending’ and the 7 days prior. For PPE, staffing levels and COVID-19 related absences, data relates up to 11:59pm on the date stated as the ‘week ending’. Until 4 April 2022, the reporting week usually ends on a Tuesday but occasionally no data is available for this date. In these situations the ‘week ending’ date will be the nearest available date.

From 4 April 2022 to 31 July 2022, in line with the expectation for providers to submit data on a weekly basis instead of daily, the Capacity Tracker data was downloaded from the data portal on a weekly basis, instead of daily. This change did not affect the data on PPE availability, staff absences and staffing levels in this publication, but affected data on visiting in care homes, presented in table 1 of the accompanying tables ‘Infection control, PPE and workforce statistics’. From 4 April 2022 to 31 July 2022, for visiting statistics, the reporting week ends on a Wednesday instead of a Tuesday for this table. For other tables, the reporting week continued to end on a Tuesday.

From 31 July 2022, providers are required to submit a core subset of the data which they have already been submitting through the Capacity Tracker, on a monthly basis instead of weekly on a voluntary basis. This includes data on visiting and staff absences, but data on PPE availability is not mandatory. After 31 July 2022, data tables for visiting and staff absence will present a monthly data point which will cover the mandation window (approximately between the 8th and 14th day of the month), instead of weekly data points.

PPE availability

From April 2022 onwards, the data on availability of PPE in domiciliary care settings is only presented from week ending 6 July 2021, when the wording of the question in the collection tool was changed. This change resulted in the incomparability of the data between London and other regions from July 2021 onwards. For a number of providers in London, responses are collected via the London Association of Directors of Adult Social Services (ADASS) before being uploaded to Capacity Tracker in bulk. Due to differences in the interpretation of the wording of the questions asked by ADASS about specific items of PPE stock, the data collected via this channel is not comparable to the data collected directly via Capacity Tracker. As a result, from April 2022 onwards, the national figure on availability of PPE does not include the data from providers in the London region and therefore is not a complete picture of the national situation. Local figures for the London region and London local authorities have also been suppressed from the data tables.

Work is currently being done to harmonise the data across regions. Data prior to July 2021 can be found in previous editions of the publication, but are not comparable to the data from July 2021 onwards. The last edition to present data prior to July 2021 is the Adult social care in England, monthly statistics: March 2022.

Payment of full wages when staff are isolating

For data relating to the payment of full wages when care home staff are isolating due to COVID-19, the proportion of care homes paying staff full wages while self-isolating relates to care homes which had staff required to self isolate in the relevant week. This means care homes who had no staff needing to self-isolate are excluded from the rates for the relevant week. The data collection for this metric ceased on 4 April 2022, and the last data point available is for the week ending 29 March 2022, which is presented in the May 2022 release.

Staff absences due to COVID-19

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. Absence rates might be affected by provider response rates.

Absence data started to be reported by care providers in Capacity Tracker from December 2020. However, in the first few months of collection, due to low response rates, 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 their staff, due to high levels of absences. As such, 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 positivity rates. This is because absences related to COVID-19 can cover a wide range of reasons, including but not restricted to:

• testing positive to COVID-19

• isolating

• caring for someone who has tested positive to COVID-19

• suffering from illness related to COVID-19

The total number of staff reported in these tables will be lower than the total care workforce because only care homes who have filled in the relevant section of Capacity Tracker in the last 7 days are included in the staff counts each week. If a care home has not recently responded to this question, their staff count will not be included. A count of all staff, for all care homes who have responded to Capacity Tracker at least once, can be found in the vaccination tables. This is because the vaccination rates are cumulative and therefore include all care homes, whether they have replied recently or not.

COVID-19 and flu vaccination

Data on the proportion of social care staff and residents who have received a booster dose of the COVID-19 vaccine is available since the December 2021 report. These rates do not distinguish between those who are eligible for a booster, given the recommended gap between second and booster doses. Data on the proportion of residents who have received a second booster dose of the COVID-19 is available from the August 2022 report.

Response rates

Data on total number of staff and residents as well as those vaccinated is self-reported by care providers and local authorities. Providers were expected to update their vaccination data on a daily basis. From 4 April 2022, the expectation changed to weekly, to reduce the burden on providers. From 31 July 2022, providers are mandated to update this data monthly, within a specific time window but are still encouraged to update it weekly. We will therefore continue to provide weekly data point. There may be a time lag between individuals receiving the vaccine and the reporting week they are included in the statistics when providers have not provided a recent response. The dates in this section refer to the date vaccinations were reported by care providers as opposed to the date vaccinations were administered.

The methodology used to calculate response rates has been updated several times to improve accuracy. These changes affected the response rates, but not the vaccination rates. The following summarises the methodology used over time.

May 2021 publication to August 2021 publication

No vaccination response rates were reported.

September 2021 publication to November 2021 publication

A time series of response rates was added in the accompanying spreadsheet ‘COVID-19 vaccination response rates: data tables’ for the relevant month. Response rates were calculated by counting any non-zero values as responses. During this time period, response rates may have been underestimated because the default value in the underlying data is set to zero, so any zero values submitted will appear to be non-responses. This would have particularly affected response rates for boosters and flu vaccination.

December 2021 publication to June 2022 publication

From 8 November 2021, care providers were required to select that they have reviewed their responses to confirm the data submitted is accurate, meaning zero values were no longer counted as non-responses if the provider had confirmed the data entry. The response rate methodology was therefore updated to include this new feature, which increased the accuracy of the reported response rates for dates after 8 November 2021.

July 2022 publication onwards

For care homes and domiciliary care providers, the response rate methodology has been updated in preparation of the addition of new data on second booster vaccinations to the publication and for consistency with the NHSEI weekly vaccination publication.

The previous method is no longer relevant for second booster vaccinations because the Capacity Tracker user interface does not make it possible to check whether a zero value in the second booster data field is a non-response or a true value, even if the provider has confirmed the entry. We have therefore updated the methodology for second booster data, which was published for the first time in August 2022. For consistency, we have updated the methodology for all doses.

Under the new methodology, a provider is counted as having responded for each vaccination dose if the date of their last update on Capacity Tracker (which is recorded automatically when they access the system) is after the date at which the data field relating to that dose was added to the collection. However, providers with zero in every vaccination data field are still counted as non-responses.

This updated methodology has been backdated to the start of the time series, so response rates for dates before June 2022 may be higher than response rates published in previous reports, especially at the beginning of each dose timeseries. The updated methodology does not apply to Other Settings.

Timeliness of the data

Data for care homes and domiciliary care relates up to 11:59pm on the day reported as the ‘week ending’. For other settings this relates up to 8:00am on the day reported as the ‘week ending’. Until 4 April 2022, the reporting week usually ends on a Tuesday but occasionally no data is available for this date, in these situations the ‘week ending’ date will be the nearest available date.

Between 4 April 2022 and 31 July 2022, in line with the expectation for providers to submit data on a weekly basis instead of daily, the Capacity Tracker data were downloaded on a weekly basis, instead of daily. This did not affect data on care homes and domiciliary care but did affect data on ‘other social care settings’ (including Non-Registered Providers and Local Authority Employed), presented in table 10 of the accompanying tables ‘COVID-19 vaccination statistics’. From 4 April 2022, the reporting week ends on a Wednesday instead of a Tuesday for this table. For other tables, the reporting week still ends on a Tuesday.

From 31 July 2022, providers are mandated to update their vaccination data once a month but are encouraged to update it on a weekly basis. From September 2022, we will continue to provide weekly data points in the vaccination tables, in order to include those providers who update their data more regularly. Response rates outside the mandation window are likely to be lower than in the mandation window as not all providers will update their data on a weekly basis. However, this will not result in lower vaccination rates as these are cumulative rates.

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

Older adult care homes are defined as care homes serving any older people (aged 65) as identified from the latest CQC data on care homes in the ‘older people’ service user band. Some residents in these care homes may be aged under 65. The remainder of the care homes are classed as younger adult care homes. Staff refers to both those directly employed by the care provider and agency staff.

The total numbers of residents and staff may include individuals who did not receive the vaccine for valid medical reasons or where consent to receive the vaccination was not received.

From the October 2021 report onwards, the number of eligible residents and staff, which excluded those who have tested positive for COVID-19 in the last 28 days is no longer published.

COVID-19 testing

The number of tests conducted in this report includes care homes staff, residents and visitors tested by:

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

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

The figures in this report are only deduplicated to report on the number of individual tests taken, not the number of people tested. As individuals can have more than one test, the data should not be compared with prevalence or case positivity rates. Therefore, this report only includes the total number of tests and the number of tests with a positive result and not positivity rates.

The number of tests conducted in care home staff also includes staff who additionally work across other care settings such as domiciliary care. It may also include some staff who solely work in another social care setting other than a care home but are unable to be distinguished due to the way occupation is identified in the data.

An update to the methodology was implemented to the testing for COVID-19 in care homes data, from the ‘Adult social care in England, monthly statistics: July 2021’ publication onwards. Prior to that, it included tests where someone had identified their occupation as any of:

• care worker or home carer
• residential, day or domiciliary care manager or proprietor
• senior care worker

Tests where someone has identified their occupation as one of the above and the test is associated with testing kits sent to domiciliary care providers are now removed from the counts. However, tests where someone has identified their occupation as one of the above but the test is not associated with testing kits sent to domiciliary care providers, have not been excluded.

The timeseries in the ‘Adult social care in England, monthly statistics: July 2021’ publication and all subsequent publications have been backdated with the new methodology which has resulted in the removal of a substantial number of tests compared to past publications.

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

The number of tests conducted is reported by type of test and by the individual role (staff, resident, visitor and visiting professional) which is captured when the test is registered. For some tests a limited amount of information is available therefore the individual role cannot be determined. These tests are reported separately in the data tables.

The requirement for care home staff to register negative rapid lateral flow test results was suspended between 31 December 2020 and 15 January 2021 inclusive, following a change in guidance issued on 23 December 2020 to increase testing in care home staff. As a result, a proportion of rapid lateral flow tests conducted on care home staff will not be included for these dates.

Other changes in testing guidance in social care settings have affected trends in the data. These changes are listed below.

Changes in guidance

From 4 April 2022

Staff:

• asymptomatic testing: 2 rapid lateral flow tests per week

• symptomatic testing: 2 rapid lateral flow tests taken 48 hours apart

Residents:

• asymptomatic testing: no testing

• symptomatic testing: 2 rapid lateral flow tests taken 48 hours apart

Visitors:

• no requirement to test, unless providing personal care

16 February 2022 to 3 April 2022

Staff: 

• pre shift rapid lateral flow tests

Care homes were able to transition to the new testing regime any time between the announcement on 27 January 2022 and 16 February 2022, which means this change could have affected trends before 16 February 2022.

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

Visitors:

• required to take rapid lateral flow test before each visit (tests are free)

PCR tests for staff and residents if symptomatic.

Data quality

This section measures the adult social care statistics against the dimensions of quality set out by the Government Statistical Service for statistical outputs.

Any feedback on these statistics is welcome and can be sent to asc.statistics@dhsc.gov.uk.

Relevance

These are monthly statistics by 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.

These statistics are published to provide an overview of how COVID-19 has impacted the adult social care sector and provide transparency on how the care sector is utilising government funds such as the adult social care Infection Control and Testing Fund. This fund ended on 31 March 2022 but there is still a need to provide an insight into how the care sector is adapting to living with COVID-19. This publication aims to improve access to various data on adult social care, especially in relation to COVID-19, by providing a comprehensive, easily accessible bulletin.

These statistics are being badged as experimental statistics while DHSC scopes out user and stakeholder needs for these statistics. Feedback from user and stakeholders will be incorporated on an ongoing basis.

Accuracy and reliability

Accuracy

COVID-19 and flu vaccination

Coverage is limited to care providers registered and providing data to Capacity Tracker. As data is self-reported by care providers for their staff and residents, trends in the data must consider response rates as some care providers report the total number of staff or residents but not the number vaccinated.

Additionally, a proportion of staff and residents will have an unknown vaccination status. This will impact on the deviation from the true value for all care providers. More details can be found in the ‘data coverage’ section above.

Response rates may be underestimated, particularly for boosters and exemptions. This is because the default value in Capacity Tracker is set to zero, so any zero values submitted will appear to be non-responses.

The methodology for classifying older and younger adult care homes has been revised for the September 2021 report onwards. Prior to September 2021, care homes that are newly active since the publication of the latest CQC care directory were classed as a younger adult care home until the next monthly publication of the CQC list, when some may be reclassed as older adult care homes. From September 2021 onwards, newly active care homes are classified according to the CQC data available through their application programming interface (API). This data can be found on Using CQC data.

The time series in the September 2021 report has been backdated with the new methodology. This has had no impact on the vaccination rates but has resulted in minor differences in the number of staff or residents in older and younger adult care homes. As a result, counts for the number of staff or residents in younger adult care homes have been revised downwards by between 0 to 4% for each reporting week while counts for the number of staff or residents in older adult care homes have been revised upwards by less than 1% for each reporting week.

In the October 2021 report some data relating to dates before 11 May 2021 has been revised from previous publications due to some instances of implausible data being found. This relates to instances where the counts of staff or residents vaccinated is higher than the number of staff or residents. Implausible data has now been suppressed from the underlying data and removed from aggregated counts and rate calculations.

The time series in the October 2021 report has been backdated with the new methodology. The methodology update has resulted in slight changes in terms of counts and vaccination rates for some areas for dates relating to before 11 May 2021.

Validation checks are now implemented by the data supplier to ensure the number of staff or residents vaccinated entered by care providers can’t be higher than the number of staff residents.

Infection control, staffing levels, staff absences and PPE

Coverage is limited to care providers registered and providing data to Capacity Tracker. Data is self-reported by care providers and can be influenced by response rates. More details on response rates can be found in the ‘data coverage’ section above.

For the ‘payment of care-home staff while self-isolating’ metric, there may be several care providers who may use a combination of payment options for staff wages. In these situations, providers should report the option they use for the majority of their staff. Questions are not always exhaustive as not all provider circumstances can be considered. Regular work is ongoing to review and adapt questions based on feedback in conjunction with stakeholders.

COVID-19 testing

Data is collected from management information generated during the operation of the NHS Test and Trace service. This report will only include tests which were registered through the National Testing Programme digital infrastructure.

Reliability

The data tables for this publication are produced by a Reproducible Analytical Pipeline (RAP) using the statistical software ‘R’. This reduces the likelihood of certain processing errors by minimising the amount of manual processing or compiling of data. All stages in this pipeline are quality assured by a professional analyst.

COVID-19 testing

From the February 2022 report, there has been a change in the data processing platform used by DHSC analysts to compile these statistics. This change allows better transparency and flexibility of the data processing pipelines, meaning errors can be fixed more efficiently and in a shorter timeframe. Before the transition, extensive work was undertaken to ensure the new pipelines were reliable and produced similar estimates.

Ongoing work is taking place to improve the data processing further.

From the February 2022 report onwards, testing data up to 21 December 2021 is computed using a frozen data set processed by the former platform. Testing data after that date is computed via the new platform. From the February 2022 report onwards, data from approximately 2 months before the cut-off date will be updated each time.

Timeliness and punctuality

These statistics are updated on a monthly basis and the data in each publication relates up to 2 weeks prior to the publication date. The lag is to allow time for data to be collected and ensure quality assurances processes can be carried out.

From 31 July 2022, a subset of Capacity Tracker will be mandated on a monthly basis, meaning providers are required to update it every month, within a specific window – the 7 days prior to the 14th day of each month, or the next working day where the 14th falls on a weekend or public holiday. In order to reduce the lag between the time the data is submitted and the time the data is published, from September 2022, this publication will be released on the first Thursday of each month, instead of the second Thursday of each month.

The frequency of these publications will be evaluated while DHSC continues to scope out the needs of users and stakeholders.

More timely data on COVID-19 vaccinations and testing in adult social care in England is available through other sources. More details on this can be found in the ‘data sources and collection’ section above.

Comparability and coherence

COVID-19 vaccination, infection control, staffing levels, staff absences and PPE

Data is self-reported from care providers and comparability over time is influenced by response rates. The latest response rates and how they influence the time series can be found in the ‘data coverage’ section above.

COVID-19 vaccination

NHSEI also publish data on vaccinations in adult social care settings as part of their broader statistical release on COVID-19 vaccination. The figures in these statistics use the same source and are broadly in line with the NHSEI figures. More details on the differences can be found in the ‘other sources of adult social care COVID-19 data’ section below.

The figures used in this report differ from the reported 81.7% of eligible residents reported on 5 November 2021 in the news article ‘NHS offers residents in every eligible care home a COVID booster jab’, as a different methodology was used. The denominator in the figure of 81.7% of eligible residents was the number of older adult care home residents who were reported as having received a first dose vaccination in Capacity Tracker on 9 March 2021 (around 265,000), as an approximation for the number of residents who would currently be eligible for a booster. The number of booster vaccinations used in the calculation is a combination of 178,364 residents reported as having received a booster in Capacity Tracker as at 3 November 2021 (by 7,021 older adult care homes) and an additional 38,175 booster vaccinations reported in the NHS Foundry system from a further 1,681 care homes. This figure is an estimate only as care home populations change over time and it is not possible to derive the exact number of residents currently eligible for a booster from Capacity Tracker.

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

Outputs are also compared against internal analysis carried out by other professional analysts in the department.

Workforce statistics

In December 2021, an additional workforce report providing more information on the pressures faced by the adult social care workforce has been published as part of this data collection. This information was received through an ad hoc survey and has been published as part of this collection as a one-time event. The survey covers more detailed insight into current workforce pressures faced compared to 6 months previously. This includes issues relating to recruitment, retention, staff morale and use of agency staff. See the adult social care workforce survey: December 2021 report.

The monthly reports include data on care home staffing levels. In order to measure the workforce pressures on providers during the pandemic, each provider is asked to assess their workforce pressures based on their agreed staffing ratios.

The workforce survey complements the regular collection by providing the opportunity to have a deeper exploration of workforce issues, which is possible in an ad hoc survey but would be too burdensome for the regular collection. The workforce survey collected information from both care homes and domiciliary care providers.

From February 2022, care home staffing levels are accompanied by data on care work absences due to COVID-19 related reasons. Care home providers are asked to report the total number of staff in the establishment (nurses, care workers and non-care workers) and the number of staff absent due to COVID-19 related reasons.

Independent CQC-registered domiciliary care providers are asked to report the total number of staff who have face-to-face contact with care recipients, and the number who are not working because of COVID-19 related reasons.

Skills for Care publishes yearly and monthly estimates of the number of adult social care filled posts as a measurement of the size of the adult social care workforce, as well as monthly estimates of the average number of days lost due to sickness. Differences in data sources and methodology mean that these statistics are not comparable to those published in this publication. More details on the differences can be found in the ‘other sources of adult social care COVID-19 data’ section below.

COVID-19 testing

Data is from management information collected during the Test and Trace process. The level of testing and guidance on how frequently those in the adult social care sector should be tested has changed over time and as a result comparison between certain time periods should be made with caution. More information on the testing rollout in care homes is available in the ‘data coverage’ section above.

DHSC also published care home testing data in the weekly NHS Test and Trace statistics (England) at national level. This publication was discontinued from 23 June 2022. Trends in these reports are broadly similar to these statistics and differences can be accounted for by variances in methodology. More details on the differences can be found in the ‘other sources of adult social care COVID-19 data’ section below.

Accessibility and clarity

These statistics are freely available on the GOV.UK website with all documents published in an accessible format. The statistical reports and ‘Background quality and methodology’ documents are published in HTML and accompanying data tables are published in Open Document Spreadsheet (ODS) format.

This ‘Background quality and methodology’ document is published to ensure users have sufficient information on how these statistics can be used.

The commentary is written with the aim of being clear and impartial. DHSC will continue to scope user and stakeholder needs to ensure the commentary sufficiently meets their needs.

Cost and burden

COVID-19 vaccination, infection control, staffing levels, staff absences and PPE

The burden associated with providing data through Capacity Tracker varies among questions and in line with provider resources. This publication covers different types of questions. Until April 2022, some of these were to be reported daily (COVID-19 vaccinations, PPE, staffing levels, staff absences) and some weekly (infection control). From April 2022, all questions are expected to be reported weekly, to reduce the burden on providers. From 31 July 2022, instead of a voluntary weekly update, providers are mandated to update Capacity Tracker monthly, which will further reduce the burden on providers. See guidance and impact assessment on the adult social care information provisions under the Health and Care Act 2022 for more information.

From 31 March 2022 to 31 July 2022, care providers were expected to provide data regularly to Capacity Tracker as a condition of receiving Infection Control and Testing Funding. See adult social care Infection Control and Testing Fund: round 3 for more details. The funding ceased in April 2022 but providers are still expected to provide weekly data. Questions on staff pay during isolation and staff movement across settings, among other infection prevention and control questions, were removed on 4 April 2022.

From 31 July 2022, providers are mandated to submit data monthly, but are still encouraged to submit it more regularly.

A high burden on providers to supply data might impact the quality of the data in terms of accuracy, coverage, and consistency. Responses that have been submitted less frequently than weekly are also excluded as part of the analysis for the infection control, PPE, staffing level and absence data for these statistics.

To improve coverage, the relevance of questions is regularly reviewed in collaboration with care providers and stakeholders and questions which no longer provide value are adjusted or removed.

Revisions

Any revisions to past publications will be in line with DHSC’s revision policy. Any unscheduled or substantial revisions that do not fit into the scheduled revisions criteria will be highlighted accordingly.

COVID-19 vaccination, infection prevention and control, PPE availability, staffing levels and staff absences

Some data may be collected after the initial publication period and therefore may need to be revised over time.

COVID-19 testing

Some data may be collected after the initial publication period and therefore may need to be revised over time. From the February 2022 report onwards, figures from approximately 2 months before the cut-off date are updated each time. Before February 2022, all figures were routinely revised each month.

Other sources of adult social care COVID-19 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.

COVID-19 vaccinations

NHSEI also publish data on vaccinations in adult social care settings as part of their broader statistical release on COVID-19 vaccination.

Both publications follow the same methodology and use the same data source but there are some differences, such as:

• reporting period prior to April 2022, when data in this publication reports data collected up to 11:59pm on a Tuesday whereas NHSEI used data collected up to 11:59pm on a Sunday. However, since April 2022 NHSEI also use data collected up to 11:59pm on a Tuesday

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

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

COVID-19 testing

DHSC also publishes care home testing data at national level in the NHS Test and Trace statistics release. The frequency of this publication and accompanying data tables was reduced from weekly publications to fortnightly publications of weekly data from 14 April 2022, before the publication was discontinued altogether from 23 June 2022. Up to June 2022, this publication used the same data source but had a different methodology for presenting testing in care homes. Differences in the figures occurred due to the following reasons:

• differences in which tests from different routes are included. Both methodologies include the number of tests registered from kits sent directly to care homes, but this publication additionally includes care home staff or residents tested via other routes such as regional or local test sites. As a result, figures in this report will be substantially higher for PCR tests conducted in care home staff due to the current guidance recommending staff with symptoms to be tested outside of the care home (see coronavirus (COVID-19) testing in adult care homes for more information). Since 11 January 2022, due to recent high prevalence, confirmatory PCR tests after a positive LFD result are no longer required for the wider population, including the care home population. This could result in a lower number of PCR tests taken inside and outside care homes reported in this monthly report. The number reported in the weekly NHS Test and Trace statistics, will also be affected by this change in guidance, but to a lower extent as it does not include tests taken outside the care home

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

• different times of extracting the data

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

Adult social care workforce size and absence statistics

Skills for Care publishes yearly and monthly estimates of the number of adult social care filled posts as a measurement of the size of the adult social care workforce. Differences in data sources and methodology mean that these statistics are not comparable to those published in this report.

Skills for Care’s monthly tracking data on staffing is based on the unweighted responses of a relatively small cohort of providers who have updated records in the Adult Social Care Workforce Data Set in each respective month. This data may not be representative of the sector as a whole and therefore may only be indicative of general trends. Skills for Care uses a wider definition of domiciliary care than is used in Capacity Tracker and includes other services delivered in the user’s own home, such as supported living and extra care housing.

Skills for Care also publishes monthly estimates of the average number of days lost due to sickness, which are not comparable to the absence rates published in this report. This is because of similar reasons explained above and due to the nature of Skills for Care’s estimate which is not specific to COVID-19 related absences.