Guidance

[Withdrawn] Guidance for those who provide unpaid care to friends or family

Updated 15 February 2022

This guidance was withdrawn on 1 April 2022

The information in this guidance has been superseded by Infection prevention and control in adult social care: COVID-19 supplement.

Applies to England

• Publication for Northern Ireland
• Publication for Scotland
• Publication for Wales

Applies to: England (see information for Wales, Scotland and Northern Ireland)

Guidance section	Overview of changes
General advice	The guidance has been updated to reflect the changes made to coronavirus restrictions from 27 January 2022. These changes include face coverings, PPE and testing. The guidance has been updated to reflect the changes made to coronavirus restrictions following the announcement of Plan B. Included a new section on face coverings following face coverings being required by law in most indoor settings.
Getting vaccinated	Updated the section in line with current advice from the Joint Committee on Vaccination and Immunisation (JCVI).
If you or the person you care for has symptoms, a positive test or is a close contact of someone with a positive test	Updated ‘Making alternative arrangements for care’ section to reflect the advice given to contacts of someone with COVID-19 who are not required to self-isolate.

The government announced on 19 January 2022 that measures in England put in place under Plan B in response to the risks of the Omicron variant were being lifted on 26 January 2022. Find out what you must do to help prevent the spread.

Who this guidance is for

This guidance is for anyone in England who cares for someone, unpaid. The person could be a friend or family member who, due to a lifelong condition, illness, disability, serious injury, a mental health condition or an addiction, cannot cope without the carer’s support.

It builds on other guidance published on GOV.UK, including guidance for households with possible coronavirus infection.

There is additional advice on providing unpaid care to adults with learning disabilities and autistic adults.

Young carers and young adult carers

You are a young carer if you are under the age of 18 and look after or care for someone who needs support with daily life. A friend or family member (parent, brother, sister, grandparent or other relative) might need support because of illness, disability, serious injury, mental health condition or an addiction.

If you are over 16 but under 25 and look after or have caring responsibilities for someone else, you are a young adult carer. You may or may not live with those you care for.

The information and advice provided to young carers in this guidance is designed to help them understand the changes they need to make and signposts the help available during the coronavirus (COVID-19) pandemic.

General advice

Face coverings

Since 27 January 2022, there is no longer a legal requirement to wear a face covering. The government suggests that you continue to wear a face covering in crowded and enclosed spaces where you may come into contact with other people you do not normally meet.

See Face coverings: when to wear one, exemptions and what makes a good one for more information, including the full list of settings where face coverings are required or not.

Protecting yourself and the person you care for

If you have, or the person you care for has, no symptoms then please follow the guidance to stay safe and help prevent the spread and guidance on avoiding catching and spreading coronavirus on the NHS website. This says:

Do:

• get vaccinated against COVID-19 – find out how to book your COVID-19 vaccine

• meet people outside if possible

• open doors and windows to let in fresh air if meeting people inside

• limit the number of people you meet and avoid crowded places

• wear a face covering when it’s hard to stay away from other people – particularly indoors or in crowded places

• wash your hands with soap and water or use hand sanitiser regularly throughout the day

Do not:

• touch your eyes, nose or mouth if your hands are not clean

In addition:

• get access to regular rapid lateral flow testing if you have no symptoms

• if you do have symptoms of COVID-19, please order a polymerase chain reaction (PCR) test

Getting vaccinated

COVID-19 vaccine

All adult unpaid carers are eligible for the COVID-19 vaccine ‘Evergreen’ offer. Unpaid carers aged 16 and over can book a COVID-19 vaccine via the National Booking Service online, calling 119 or by attending a walk-in centre. Children aged 12 to 15 can now access COVID-19 vaccinations in line with the Joint Committee on Vaccination and Immunisation (JCVI) guidance released on 3 September 2021. Young carers can now access vaccinations as part of this approach.

There is specific guidance for vaccine preferences for people aged under 40 and under 18. There is additional advice for 16 and 17 year olds who are in an at risk group and should receive 2 doses of the Pfizer vaccine.

The JCVI advised on 14 December 2021 that adult carers should be offered the COVID-19 booster vaccine as one of the 9 priority cohorts for booster roll-out.

Following updated JCVI advice, booster vaccines will be offered to all UK adults (18 or over) before the new year and no sooner than 3 months after receiving a second dose of the vaccine.

Adult unpaid carers who have not already been called for or received their booster can book a COVID-19 booster via the National Booking Service online, calling 119 or by attending a walk-in centre. Advance bookings can be made 2 months after the second COVID-19 vaccine dose so that individuals can receive their vaccination once 3 months have passed.

Unpaid carers continue to have priority access to vaccines, and at vaccination centres may access priority queuing, where available. To ensure this, the Department for Health and Social Care has developed a letter for unpaid carers and frontline social care workers to take to any vaccination site.

We also encourage all unpaid carers who do not have a ‘carer’s flag’ on their primary care record to make themselves known to GP practices as this provides a sustainable approach for identifying unpaid carers for any future vaccinations.

For further information, please see the standard operating procedure for COVID-19 vaccination deployment for unpaid carers and guidance about COVID-19 on GOV.UK.

Flu vaccine

Unpaid carers may also be eligible for a flu vaccine free on the NHS. The flu vaccine is given free on the NHS to people who:

• are 50 and over (including those who’ll be 50 by 31 March 2022)

• have certain health conditions

• are pregnant

• are in long-stay residential care

• receive a carer’s allowance, or are the main carer for an older or disabled person who may be at risk if you get sick

• live with someone who is more likely to get infections (such as someone who has HIV, has had a transplant or is having certain treatments for cancer, lupus or rheumatoid arthritis)

• frontline health or social care workers

Individuals can have the NHS flu vaccine at their GP surgery, a pharmacy offering the service, a midwifery service if pregnant or a hospital appointment.

Testing for unpaid carers

If you or anyone you care for are showing symptoms of COVID-19, you should order a PCR test and self-isolate immediately.

Free rapid COVID-19 tests are available for everyone in England without symptoms.

Unpaid carers should access twice-weekly asymptomatic rapid lateral flow tests. This will be crucial in detecting people that are infectious and to help maintain the safety of everyone with caring responsibilities and those being cared for. Where appropriate, regular testing of people you are caring for may also be helpful.

Rapid lateral flow tests are available for home delivery, for collection at participating pharmacies and local sites and at local asymptomatic test sites. Carers should access these tests through any of these routes and test twice weekly (every 3 to 4 days). Unpaid carers can order rapid lateral flow tests online or pick up tests from a local pharmacy or collection point.

You should report all lateral flow test results – whether positive, negative or void. If you receive a positive result, but do not have any of the main symptoms of COVID-19, you should still report your result and self-isolate.

Anyone who has a positive lateral flow test or PCR test should not take another PCR test within 90 days of this result unless:

• you develop any new main symptoms of COVID-19
• you are required to take a PCR test upon entry into the UK
• you have a positive lateral flow test result and need to take a PCR test in order to claim the Test and Trace Support Payment

If you have a positive test result within 90 days of a previous positive lateral flow test or PCR test result you must stay at home, self-isolate, and follow the stay at home guidance.

Emergency planning

We advise all carers to create an emergency plan with the person they care for, to use in circumstances where help from other people to deliver care may be needed. Depending on the circumstances, this could be help from family or friends, or a care provider.

To create an emergency plan that fits the needs of the person you care for, you will need to set out:

• the name and address and any other contact details of the person you look after
• who you and the person you look after would like to be contacted in an emergency
• details of any medication the person you look after is taking
• details of any ongoing treatment they need
• details of any medical appointments they need to keep

You should also ensure that it is in a format that can readily be shared with other people who will need to discuss the plan with the person you care for.

Further information can be found at Carers UK.

You may be able to arrange help and support from family and friends, but it can be reassuring to have the involvement of your local authority or healthcare provider in case informal arrangements fall through. It may also be helpful to contact your local carers support organisation who can help with contingency planning. You can find out about local carer organisations at Carers UK.

You can also find information about local services on the Carers Trust website.

If you are a young carer, talk to your family and the person you care for about what you might do if someone becomes ill. Write this plan down and make sure everyone knows where to find it. You could leave it somewhere everyone can see, like on the fridge door.

You may find information on the Children Society’s young carers services website helpful.

Caring for someone who was previously considered to be clinically extremely vulnerable

Following expert clinical advice and the successful rollout of the COVID-19 vaccine programme, people previously considered to be clinically extremely vulnerable (CEV) will not be advised to shield again. If you were previously identified as CEV, you are advised to continue to follow the guidance to stay safe and help prevent the spread. Individuals should consider advice from their health professional on whether additional precautions are right for them.

If the person you care for is concerned about their usual paid carer coming in and out of their home and the risk of infection

Care for vulnerable and disabled people can continue. The government has issued the coronavirus (COVID-19): provision of home care guidance to ensure that appropriate levels of hygiene are achieved to reduce the risk of infection. Speak to the care provider about the processes they are following to maintain good hygiene if you have any concerns or questions.

Personal protective equipment (PPE)

We are currently offering free PPE for COVID-19 needs to unpaid carers who do not live with the person or people they care for. This will be available until the end of March 2023 and can be accessed through local authorities and local resilience forums (LRFs).

See personal protective equipment (PPE): local contacts for providers for details of local authorities and LRFs who are making PPE available to unpaid carers. You can contact them to request PPE.

This offer is available to cover needs for PPE that have arisen due to COVID-19. If you would normally use PPE because of the nature of the care you provide, you should continue to access it through your normal routes.

If you live with the person or people you care for, you do not need to wear PPE unless advised to do so by a healthcare professional, like a GP or nurse.

If you are a young carer talk to your family and the person you care for if you are unsure what to do.

Recommended PPE for unpaid carers who do not live with the person or people they care for

If you do not live with the person or people you care for, it is recommended that you wear PPE when delivering care.

PPE must be worn correctly in order to reduce the risk of transmission. PPE should be put on and removed at least 2 metres away from the person you are caring for. You should also always clean your hands before putting on and after taking off your PPE.

See guidance on how to put on and take off PPE correctly and an accompanying illustrative PPE guide on what PPE to wear and when.

The type of PPE you should wear will depend on the type of care you provide. The type of surgical mask (Type II or Type IIR) you have been given will be clearly stated on the box.

Scenario	Type of care being given	PPE recommended
1	When you are within 2 metres of the person you are caring for who has COVID-19 or flu like symptoms such as coughing, high temperature or loss of taste or smell	- apron (disposable plastic) - mask (single use fluid-repellent surgical mask Type IIR) - eye protection, either a visor or goggles, can be used (prescription glasses are not eye protection) - gloves (disposable)
2	When providing personal care to someone with no COVID-19 or flu symptoms but involving potential contact with blood or body fluids. For example, helping a person to wash or use the toilet If the person you are caring for has any symptoms of infection such as a cough or high temperature or has tested positive for COVID-19 follow example 1	- apron (disposable plastic) - mask (fluid-repellent surgical mask Type IIR) - eye protection (if there is a risk of splash into your face with blood or body fluids) - gloves (disposable)
3	When you are within 2 metres of a person you are caring for and contact with blood or bodily fluids is not likely. For example, providing a meal or companionship If the person you are caring for has any symptoms of infection such as a cough or high temperature or has tested positive for COVID-19 follow example 1	- Type I, Type II or Type IIR surgical mask - no apron or gloves required (unless you would normally use them for the task you are doing)
4	When you are more than 2 metres from the person you are caring for and undertaking domestic duties	- Type I, Type II or Type IIR surgical mask - depending on the task this is contact with cleaning solutions, cleaning toilet, gloves and aprons would also need to be worn - eye protection if there is a risk of splash in to your face with blood or body fluids or cleaning solutions. Prescription glasses are not eye protection. If you do wear glasses a visor is the best eye protection to use)

See this illustrative guide for more detailed guidance on how to wear your PPE, when to change it and procedures that should be followed.

If you are a young carer, talk to your family and the person you care for if you are unsure what to do. You could also talk to your social worker (if you have one) about approaching your local authority to understand what is possible and suitable for you.

If the person you care for is in a care home

If you have no symptoms, you should keep in contact with the care home to understand any local arrangement to keep in touch with residents and follow the guidance from the care home when visiting.

Do not visit if you have any symptoms of illness, for example:

• cough
• temperature
• loss of taste and/or smell
• diarrhoea
• vomiting

Please let the care home know if you are unwell.

Maintaining your own health while you’re looking after others

It’s important that you look after your own mental health and wellbeing as well as supporting others you care for, particularly given the potential for additional stresses at the current time.

The Every Mind Matters website includes tips and expert advice to help you look after your mental health and wellbeing during the pandemic and beyond. This includes practical steps on dealing with stress and anxiety, boosting your mood and sleeping better. You can also use the Hub of Hope to find local sources of mental health support and services, both from the NHS and from other organisations close to you.

Daily physical activity is important for health and wellbeing, including managing stress and encouraging positive feelings and sleep. You can look for ideas of exercises you can do at home.

Draw on support you might have through your friends, family and other networks during this time. Try to stay in touch with those around you and do not be afraid to ask how someone is doing. Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing and you may find it helpful to talk to them about how you are feeling. Remember it is OK to share your concerns with others you trust and in doing so you may end up providing support to them too.

If you, or someone you know, needs help for a mental health crisis or emergency, you should get immediate expert advice and assessment. You can find your local NHS urgent mental health helpline. Helplines are open 24/7 to support people of all ages.

It may also be helpful to contact your local carers support organisation who can help with contingency planning. Carers UK has information about local carer organisations and an online forum.

Every Mind Matters has tips and support on looking after the mental wellbeing of children and young people. Young carers and young adult carers may also find helpful information on the Children’s Society website.

Young carers

If you are a young carer, you can collect medicines with permission from the person you are caring for. Some pharmacists might refuse to give you the medicines if they think it is not appropriate.

If you normally collect prescriptions for the person you care for and you are self-isolating, you should look to make alternative arrangements. You should try and seek support from friends and family to assist if possible.

Schools and education

Attending school or college

All children are expected to attend school or college, including vulnerable children and the children of critical workers, and their attendance continues to be monitored. Read the latest guidance for parents and carers, students and university students, teachers and educational setting leaders.

Since 27 January 2022, face coverings are no longer advised for staff and pupils in communal areas of secondary schools, nor for staff in communal areas of primaries.

If at any time you do not feel comfortable attending school or college, or have concerns about the health of someone in your household or those you provide care for, you should discuss this with your school or college and social worker (if you have one).

Support from your school or college

Your school, college or social worker (if you have one) may be able to offer you support with your education, for example, by giving you extra time for work or putting you in touch with local young carers’ services.

If you are not sure whether your school or college knows you are a young carer, you can talk to a teacher, school nurse or someone you trust and tell them you think you need extra support.

School nurses have a duty of confidentiality to all those who receive their care. This means they will ask you for your consent to share confidential health information with others, including your parents and teachers unless they think your personal safety is at risk. If they think this might be the case, they will discuss this with you first before taking any action.

You might not want your school or college to know you’re caring for someone. But if they do know, they will understand that things are sometimes hard for you. It is a good idea to let at least one teacher or school nurse you trust know that you are a carer. A young carer support worker can also help.

If you think you are eligible for free school or college meals but were not accessing them before, schools, colleges and local authorities are continuing to accept school and college meal applications. See the eligibility criteria to apply for free school meals (for schools), or free meals in further education funded institutions (for colleges). You can also speak to your college or further education institution who will be able to offer advice.

Further support can be found on the NHS support for young carers page.

Support from your university

Universities are independent and the support they provide will differ. You should speak to someone you trust at your institution about any support that may be available to you.

Read the latest guidance for university students. You can also find information on universities, including latest announcements, on the Education in the Media blog.

Further sources of support

If you or someone in your family has a social worker, you can contact them to say you think you might need more help if someone becomes unwell.

You could ask friends, family or use online services like the NHS volunteer responders to see if they could help drop off shopping or support you in other ways.

If you can’t think of anyone who can help you, or if nobody else knows you are a young carer, you can contact a local young carers service and tell them you think you are a young carer and you would like some help. You can find a local support group or get in touch with the Children’s Society’s young carers’ services.

Helplines

If you would like to speak to someone anonymously, you can call helplines or visit one of the websites below:

Childline provides a confidential telephone counselling service for any young person with a problem. It comforts, advises and protects. You can:

• call free on 0800 1111 any time

• have an online chat with a counsellor

• check out the message boards

Websites

Further support can be found on the NHS support for young carers page.

The Children’s Society has information for young people and professionals about COVID-19 which includes links to tools, resources and activities as well as wellbeing tips for young carers.

Carers Trust has information for young people about coronavirus.

Support for carers

Support from volunteers

You can also get help from NHS volunteer responders who can help with things like collecting medication or shopping. There is information here about what support the NHS volunteer responders can offer.

You can also call 0808 196 3646 between 8am and 8pm.

Carer’s assessment

If you need support with caring, you can contact your local authority for a carer’s assessment. You do not have to live with the person you care for and it is free. It is separate from the needs assessment the person you care for might have, but you can ask to have them both done at the same time.

You will be entitled to an assessment regardless of the amount or type of care you provide, your financial means or your level of need for support. You do not necessarily have to be caring full-time to have an assessment.

If you have not been offered one, you can contact your local authority. Find your local social services team.

Young carers can also request a young carer’s needs assessment. You can speak to your support worker. If you don’t have a support worker, you can speak to your social worker or local authority about getting one.

Carer’s Allowance

You may be eligible for Carer’s Allowance if you, and the person you care for, meet certain criteria. You need to spend at least 35 hours a week caring for someone who receives a particular disability benefit. The care you provide can include:

• help with washing and cooking

• help with preparing or eating meals

• help with personal care and hygiene – bathing, grooming and so on

• help with dressing and undressing

• help to manage medicines or treatments, or to take the person cared for to a doctor’s or hospital appointment

• help with household tasks such as shopping, managing bills or making decisions about money

• help with moving around or leaving the house and engaging with others

• ‘keeping an eye’ on the person – for example, preventing them or others from coming to harm

• time taken doing practical tasks, even if not done in the presence of the person cared for (for instance, time spent preparing for the visit of the cared-for person or cleaning up afterwards if you look after someone who visits you regularly for the care they need)

See information about eligibility and how to apply for Carer’s Allowance.

If you are a young adult carer who is aged 16 or over and you are caring for someone for at least 35 hours a week you may also qualify for Carer’s Allowance. You can find out about financial support on the Children’s Society website.

Further sources of support

For further sources of information or support, you may find information on your local authority’s website or you could contact your local authority.

You can also look on the Carers UK and Carers Trust websites.

If you or the person you care for has symptoms, a positive test or is a close contact of someone with a positive test

If you have symptoms of coronavirus

The guidance has recently been updated in response to the risks of the Omicron variant. See the stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection for more information on isolation periods and what you must and must not do if you have symptoms of coronavirus, a positive test or are a close contact of someone who has tested positive.

Anyone with COVID-19 symptoms or a positive test result should stay at home and self-isolate immediately. This is because you could pass the infection on to others, even if you don’t have symptoms.

You could be fined if you do not self-isolate following a notification by NHS Test and Trace. You may be entitled to a one-off payment of £500 through the NHS Test and Trace Support Payment scheme if you are required to stay at home and self-isolate or you are the parent or guardian of a child who has been told to self-isolate.

This guidance still applies even if you have received one or more doses of COVID-19 vaccine.

It may be difficult for some people to separate themselves from others in their household. Not all these measures will be possible if you are living with children or have caring responsibilities, but follow this guidance to the best of your ability in these circumstances.

Making alternative arrangements for care

You should seek to make alternative arrangements for the provision of care in the following circumstances:

• you and the person you care for do not live together and either of you get symptoms or a notification of a positive test

• you and the person you care for do not live together and either of you has been notified by Test and Trace as a close contact of a person with a positive COVID-19 test and you are legally required to self-isolate

For contacts who are not legally required to self-isolate:

• if the person you are caring for is at higher risk of severe illness from COVID-19 you may together decide to make alternative arrangements

• if you are at higher risk of severe illness from COVID-19 you may also want to make alternative arrangements if the person you care for is identified as a contact

See the guidance for households with possible or confirmed coronavirus (COVID-19) infection and the guidance for contacts of people with confirmed coronavirus (COVID-19) infection who do not live with the person for more information.

Collecting prescriptions when self-isolating

If you normally collect prescriptions for the person you care for and you are self-isolating, you should look to make alternative arrangements. You should try and seek support from friends and family to assist if possible.

Most pharmacies provide a home delivery service. Telephone them to see if this is available or if there is another scheme running locally to help you access prescriptions.

You can also get help from NHS volunteer responders who can help with things like collecting medication or shopping. Call 0808 196 3646 between 8am and 8pm. There is information about what support the NHS volunteer responders can offer.

Pharmacy delivery services may be under pressure at the moment, so it is important that you order your repeat prescriptions in good time to avoid delays in dispensing. Information on repeat prescriptions and delivery services may also be available via your GP practice website.

If it is not possible to arrange an alternative collection, it is possible for someone self-isolating to leave home where necessary to obtain medical supplies for someone in the same household.

If the person you care for does not live with you and is self-isolating, then provided you are not self-isolating you can enter their household to drop off a prescription if reasonably necessary. You should distance yourself from the person with symptoms or a positive test as much as possible and follow the guidance.