Official Statistics

Adult social care monthly statistics, England: May 2022

Published 12 May 2022

Applies to England

Main points

COVID-19 testing in care homes

ln the week ending 26 April 2022:

• there were 7,136 positive lateral flow test results among staff which is substantially lower than the number of positive tests recorded at the end of March (20,189)
• there were 1,610 positive test results among residents, which is substantially lower than the number recorded in the first week of April 2022 (3,907)

The number of positive tests returned from both lateral flow devices and PCR tests decreased for both staff and residents during April 2022, following a period of increase in March 2022. The overall number of tests conducted also decreased since the last week of March 2022.These trends are influenced by the changes to testing guidance in care homes which came into place on 4 April 2022.

COVID-19 vaccination in social care settings

As of week ending 26 April 2022, the proportions who had received a first booster dose of the COVID-19 vaccine were:

• 90.2% of total residents and 53.9% of total staff of older adult care homes
• 81.5% of total residents of younger adult care homes
• 50.3% of total staff of younger adult care homes and 46.2% of total domiciliary care staff

Visiting in care homes

In the week ending 27 April 2022:

• 91.6% of care homes in England were able to accommodate residents receiving visitors. This figure has broadly increased since the end of January 2022, despite a slight decrease at the end of March 2022

Staff absences due to COVID-19

In the week ending 26 April 2022:

• 1.1% of care homes staff and 1.5% of domiciliary care staff were absent due to COVID-19 related reasons

These proportions have been decreasing since early April 2022, following a period of increase throughout March 2022.

Introduction

This is a monthly publication by the Department of Health and Social Care (DHSC) of statistics on adult social care in England. This statistical bulletin provides an overview on a range of information on social care settings, with a focus on the impact of COVID-19.

This report provides information on:

• uptake of first, second and booster doses of COVID-19 vaccinations in adult social care settings at national, regional and local authority level

• 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 at national, regional and local authority level

• staff absence rates due to COVID-19 in care home and domiciliary care at national, regional and local authority level

• testing for COVID-19 in care homes at national, regional and local authority level

For more information and links to other published sources of adult social care data see the ‘About this data’ section below.

Publication updates

Updates on this month’s report

On 31 March 2022, DHSC published new infection prevention and control guidance on managing specific infections and a guidance supplement that sets out how to reduce the spread of COVID-19 in adult social care settings in England, effective from 4 April 2022.

In light of this new guidance and the end of the Adult Social Care Infection Control and Testing Fund (ICTF) on 31 March 2022, the department is reviewing the data items collected from providers by Capacity Tracker.

The Adult Social Care ICTF was first introduced in May 2020, to support adult social care providers in England to reduce the rate of COVID-19 transmission. It was extended in September 2021 until the end of March 2022. During this period, providers received funds to spend on infection prevention and control measures such as, for example, ensuring that staff who are isolating receive their normal wages and limiting staff movement between settings.

Since 31 March 2022, the government no longer provides funding for COVID-19 positive social care staff to stay away from work and the staff movement restrictions were lifted, allowing pressure on the workforce to be alleviated. As a result, the data collection on staff pay and staff movement ceased on 4 April 2022, and the commentary in this bulletin no longer covers these 2 metrics. However, the full timeseries (up to 29 March 2022) is presented in Tables 2 and 3 of the accompanying tables ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page. These 2 tables will be removed from June 2022 onwards, but historical data will still be available in prior editions of this publication.

The bulletin structure has been adapted to reflect these changes. Section 5 on Infection prevention control measures now covers visiting in care homes and PPE and Section 6 on Adult Social Care Workforce covers staffing levels and staff absences.

In addition, as the seasonal flu vaccination campaign ended, the data collection on flu vaccination ceased on 4 April 2022. Flu vaccination statistics are no longer covered in the commentary of this bulletin but the full timeseries (up to 29 March 2022) is presented in the accompanying ‘Flu vaccination statistics, May 2022: data tables’ on the ASC monthly statistics page. These tables will be removed from June 2022 onwards, but historical data will still be available in prior editions of this publication.

Updates on future reports

The next publication will be published on 9 June 2022. Dates for future publications will be pre-announced on the GOV.UK publication release calendar.

Since 4 April 2022, providers are asked to record spring booster vaccinations in Capacity Tracker. Data on spring booster uptake will be published in future reports.

From June 2022 onwards, this publication will no longer present data on staff pay, staff movement and flu vaccination, but historical data will still be available in prior editions of this publication.

The Capacity Tracker review is still underway, therefore further changes to this publication are likely in future reports.

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

COVID-19 vaccination in adult social care settings

How the data can be used

These data can be used for:

• comparing vaccination rates across local authorities and regions in England as self-reported by care providers for the first, second and booster doses of the COVID-19 vaccine

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

These data cannot be used for:

• estimating the number of social care staff or residents who have not been vaccinated
• estimating the number of social care staff or residents who have been vaccinated abroad
• comparing with vaccination rates in other countries of the UK
• directly comparing vaccination take up rates between different types of care home staff (directly employed and agency staff)
• estimating the number of vaccinations delivered each day

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

The total number of staff and residents for each social care setting as well as the number reported to be vaccinated for COVID-19 are self-reported by the care provider and local authorities. As a result, the rates in this publication refer to the percentage of staff and residents reported to be vaccinated by care providers. This means that the number of individuals who have not received the vaccine cannot be directly derived from the data published in these statistics as the vaccination status of some individuals may be unknown to the care provider.

The dates in this section refer to the dates on which vaccinations were reported by care providers rather than the dates on which vaccinations were administered.

Some care providers have reported the total number of staff or residents but not the numbers vaccinated. As a result of this, vaccination rates are affected by response rates. This is particularly prominent for vaccination rates for second doses in staff employed in other settings and first boosters for all staff and resident groups. This is because these groups have a lower response rate and as a result, second dose vaccination rates may be underestimated.

For data relating to 9 November 2021 and before, response rates may have been underestimated, particularly for first boosters vaccination. This is because the default value in the underlying data is set to zero, so any zero values submitted will appear to be non-responses. From 9 November 2021 onwards, care providers are required to select that they have reviewed their responses to confirm the data submitted is accurate, therefore increasing the accuracy of response rates.

Among care home staff, there is a substantial difference in reported vaccination rates for COVID-19 vaccinations between staff directly employed by care homes and staff employed by agencies operating within care homes. This could be due to, for example but not exclusively, different uptake rates, vaccination status not being known to the care provider, or the nature of employment and information available to the care homes.

For data relating to 31 August 2021 onwards, a small number of social care staff who had their vaccination outside of the UK are excluded from the numbers vaccinated.

For more information, see the background quality and methodology note.

COVID-19 vaccinations

The NHS started administering vaccinations for COVID-19 in England on 8 December 2020. Social care staff and residents of care homes were prioritised for the vaccine according to the Joint Committee on Vaccination and Immunisation (JCVI) recommendation. For more information see Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI.

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

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

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

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

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

The spring booster programme began on Monday 21 March 2022. Invitations are being sent to eligible people and visits offered to older adult care homes by local NHS teams.

Since 4 April 2022, providers are asked to record spring booster vaccinations in the Capacity Tracker. Data on spring boosters will be published in future reports. This report only presents data on first booster doses, which were introduced in autumn 2021.

COVID-19 vaccinations in older adult care homes

99.4% of older adult care homes have provided data on the number of staff and residents who received a first COVID-19 booster dose, as of week ending 26 April 2022. This means the first and second dose rates, and the number of staff and residents receiving a first booster dose may be underestimated compared with the true value.

For full response rates, see the accompanying ‘COVID-19 vaccination response rates, May 2022: data tables’ on the ASC monthly statistics page.

Residents of older adult care homes

As of week ending 26 April 2022, in older adult care homes:

• 95.3% of residents have been reported to have received 2 doses
• 90.2% of residents have been reported to have received their first booster dose

First booster vaccination rates increased steeply between mid-October 2021 and January 2022 and have stabilised since the end of January 2022.

There is some variation in reported first booster doses administered regionally, with the East of England region having the largest uptake with 91.9% of residents vaccinated, compared with the lowest uptake in London with 87.5%.

Staff of older adult care homes

As of week ending 26 April 2022, in older adult care homes:

• 94.6% of staff have been reported to have received 2 doses
• 53.9% of staff have been reported to have received their first booster dose

Reported booster vaccination rates have stabilised in April following a continued period of increase between January and March. There is large regional variation in rates, with the North East having the highest uptake with 60.2%, and London having the lowest at 43.0%.

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

Figure 1: percentage of staff and residents of older adult care homes who have received the first, second and booster doses of the COVID-19 vaccination, cumulative rate, 15 December 2020 to 26 April 2022, England

Reported booster vaccination rates have stabilised for residents and are starting to stabilse for staff in older adult care homes.

Source: Capacity Tracker

Figure 2: percentage of older adult care home staff who have received their booster dose of the COVID-19 vaccination by local authority, as of 26 April 2022, England

The majority of local authorities have a reported booster vaccination rate of between 50% and 70% for staff in older adult care homes.

Source: Capacity Tracker

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

Notes:

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

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

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

The following proportions of social care staff have been reported to have received their COVID-19 vaccination doses:

In younger adult care homes as of week ending 26 April 2022:

• 94.2% of staff have been reported to have received 2 doses
• 50.3% of staff have been reported to have received their first booster dose

For domiciliary care staff as of week ending 26 April 2022:

• 85.1% of staff have been reported to have received 2 doses
• 46.2% of staff have been reported to have received their first booster dose

Among staff working in other settings as of week ending 27 April 2022:

• 34.7% of staff have been reported to have received 2 doses
• 4.9% of staff have been reported to have received their first booster dose

As data is self-reported by care providers, COVID-19 vaccination rates are affected by response rates. An overview of response rates is in the table below.

Table 1: percentage of providers that have provided data on the number of staff vaccinated at least once as of 26 April 2022

Dose	Younger adult care home providers on behalf of their staff	Domiciliary care providers on behalf of their staff	Local authorities on behalf of staff working in other settings (as of 27 April)
Provided data on second dose	99.1	94.6	63.8
Provided data on first booster dose	98.9	93.5	26.3

Notes:

• due to these response rates, the number of staff and residents, particularly for boosters, will be underestimated compared with the true value. For full response rates see the accompanying ‘COVID-19 vaccination response rates, May 2022: data tables’ on the ASC monthly statistics page
• there is regional variation for all staff groups – see table 2 for further details

Figure 3: percentage of staff in younger adult care homes, domiciliary care settings and other care settings who have received the first, second and booster dose of the COVID-19 vaccination, cumulative rate, 15 December 2020 to 26 April 2022, (27 April 2022 for other care settings), England

Reported booster vaccination rates for staff are starting to stabilise across all settings.

Source: Capacity Tracker

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

Table 2: percentage of younger adult care home and domiciliary care staff reported to have received a first booster dose of the COVID-19 vaccine, up to 26 April 2022 by region, England

Region	Younger adult care home staff	Domiciliary care staff	Staff working in other settings
East Midlands	50.7	47.9	12.1
East of England	51.0	50.3	0.8
London	47.5	29.2	0.7
North East	63.9	54.1	9.0
North West	48.3	44.3	5.5
South East	48.8	50.6	3.5
South West	50.6	54.7	1.8
West Midlands	50.8	45.4	3.9
Yorkshire and the Humber	48.8	49.3	13.4

COVID-19 vaccinations for residents of younger adult care homes

Residents of younger adult care homes were not part of a single priority group for the COVID-19 vaccine. However, the conditions for which they reside in care homes are likely to make them more vulnerable to COVID-19 and they were therefore likely to be part of priority groups 3 to 9. First booster dose roll out, however, is dependent on the recommended time gap between second dose and booster dose rather than specific priority groups.

As of week ending 26 April 2022, in younger adult care homes:

• 92.3% of residents have been reported to have received 2 doses
• 81.5% of residents have been reported to have received their first booster dose

Infection prevention control measures

Until 31 March 2022, the Adult Social Care Infection Control and Testing Fund provided funding from local authorities to ensure that infection prevention control (IPC) measures were in place to curb the spread of COVID-19, including limitation of staff movement across different social care settings, payment of full wages when care home staff were isolating due to COVID-19 and accommodating COVID-19 safe visitation in care homes in line with government guidance.

On 31 March 2022, the Adult Social Care Infection Control Fund reached the end of its extension period. The end of the fund means that since 4 April 2022, among other implications, the government no longer provides funding for COVID-positive social care staff to stay away from work and staff movement restrictions have been lifted, allowing pressure on workforce to be alleviated. Restrictions on care home visiting have also been lifted.

As a result, among other data collected about infection prevention control measures, the data on staff pay and staff movement ceased to be collected since 4 April 2022 and therefore the last data point in the timeseries for these 2 metrics is 29 March 2022. This bulletin no longer covers these 2 metrics, however, the end of the timeseries is presented in table 2 and 3 of the accompanying ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page. These tables will be removed from June 2022 onwards, but historical data will still be available to users.

The question on COVID-safe visitation in care homes is still included in the data collection and in this publication, but might be modified in upcoming weeks, as part of the data collection tool review.

More details on the data collection, coverage and quality of this data can be found in the ‘About this data’ section below.

Accommodating COVID-safe visitation in care homes

Background information

How the data can be used

This data can be used for:

• estimating the number and proportion of care homes that indicate they are accommodating COVID-safe visits within the care homes in line with government guidance
• monitoring trends over time
• comparisons across local authorities and regions in England

This data cannot be used for:

• estimating the number of visitors in care homes and their infection or vaccination status
• comparing with other countries of the UK
• linking staff movement across settings to positivity rates

Visiting guidance and data trends

There are currently no restrictions on visiting in care homes under normal circumstances. However, during periods of outbreak or when a resident is COVID-positive, visits inside a care home should be limited to one named visitor only. From 4 April 2022, visitors are no longer required to test before the visit, unless they are providing personal care.

The guidance on allowing care home residents to have visitors has changed since December 2020 and is summarised in the table below.

Table 3: changes in visiting guidance since December 2020

Date	Guidance
From 4 April 2022	No restrictions on visitation in care homes. Every care home resident should have one visitor who can visit in all circumstances (including during periods of isolation and outbreak) Visitors are no longer required to test before a visit, unless providing personal care. Visitors providing personal care will not need to test more than twice a week.
From 31 January 2022 to 3 April 2022	No limits on the number of named visitors, with testing and guidance to support safe visiting in place
From 15 December 2021 to 30 January 2022	Residents are permitted to have 3 named visitors for regular visits with testing in place
19 July 2021 to 14 December 2021	No limits on the number of named visitors, with testing and guidance to support safe visiting in place
17 May 2021 to 18 July 2021	Residents are permitted to have 5 named visitors for regular visits with testing in place
12 April 2021 to 16 May 2021	Residents are permitted to have 2 named visitors for regular visits with testing in place
8 March 2021 to 11 April 2021	Residents are permitted to have 1 named visitor for indoor visits with testing in place
6 January 2021 to 7 March 2021	No indoor visits permitted due to the national lockdown
1 December 2020 to 5 January 2021	Indoor visits permitted with testing in place (from 19 December 2020 – no indoor visits permitted in tier 4 areas)

Note: timelines for guidance are accurate as of 12 May 2022.

More information on the current visiting guidance can be found in the COVID-19 supplement, which accompanies the Infection prevention and control in adult social care settings. DHSC have also published a summary of changes to COVID-19 guidance for adult social care providers which provides details on the recent changes to the visiting guidance.

In the week ending 27 April 2022:

• 91.6% of care homes in England were able to accommodate residents receiving visitors within care homes in all circumstances. This proportion has broadly increased since the end of January 2022. It decreased slightly, temporarily, in March 2022, before increasing again throughout April 2022

• a further 4.3% were able to accommodate visits in exceptional circumstances, which is a decrease compared to the week ending 6 April 2022. This figure has broadly declined since mid-January 2022, with the exception of a slight increase at the end of March 2022. Exceptional circumstances are individually defined by each care home but are generally thought to be considered when residents are palliative

• there is some variation across regions, with 93.9% of care homes accommodated visiting in the South East compared to 87.2% in the East Midlands in the week ending 27 April 2022

Figure 4: percentage of care homes accommodating or limiting visits for residents, 15 December 2020 to 27April 2022, England

The proportion of care homes accommodating visiting for residents has broadly increased since mid-January.

Source: Capacity Tracker

This data can be found in table 1 of the accompanying ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page, in addition to data by region and local authority.

PPE availability in care settings

How the data can be used

This data can be used for:

• estimating the number and proportion of care homes and domiciliary care providers who are experiencing PPE shortages in the next 48 hours, and comparing across local authorities and regions in England
• monitoring trends over time

This data cannot be used for:

• predicting PPE shortages in the coming weeks
• comparing with other countries of the UK
• linking PPE shortage to positivity rates

All care homes and domiciliary care providers are responsible for ensuring safe systems of work and have duties concerning the provision and use of PPE in the workplace.

The COVID-19 supplement, which accompanies the Infection prevention and control in adult social care settings, sets out the PPE recommendations for adult social care services in England. The government will continue to provide free PPE to the adult social care sector until the end of March 2023, or until guidance is withdrawn or substantially amended.

This publication covers the availability of the following 5 items of PPE:

• aprons

• eye protection

• gloves

• hand sanitiser

• face masks

In care homes

In the week ending 26 April 2022, 0.2% of care homes in England had either no supply or were expecting to experience a shortage in the next 48 hours of at least one item of PPE. This gradually decreased from late September 2020 when 1.1% of care homes were experiencing a shortage and has remained relatively unchanged since March 2021.

In domiciliary care

In the week ending 26 April 2022, 1.0% of domiciliary care providers in England, excluding London, reported having no supply or were expecting to experience a shortage in the next 48 hours of at least one item of PPE. This proportion has gradually decreased since July 2021.

This figure does not include figures from local authorities in the London region and therefore is not a complete picture of the national situation. This is due to incomparable data across London and other regions. 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. Work is currently being done to harmonise the data across regions.

Local figures for the London region and London local authorities have therefore been suppressed from the data tables. Data for other regions and local authorities outside of London can be found in table 8 of the accompanying ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page.

This publication only presents figures from the week ending 6 July 2021, when the wording of the question in the collection tool was changed, which resulted in the incomparability of the data between London and other regions. Data prior to July 2021 can be found in previous editions of the publication. The last edition to present data prior to July 2021 is the Adult social care in England, monthly statistics: March 2022.

Adult social care workforce

Care home staffing levels

How the data can be used

This data can be used for:

• estimating the number and proportion of care homes that indicate they are operating within their agreed staffing ratios
• monitoring trends over time
• comparisons across local authorities and regions in England

This data cannot be used for:

• identifying the reasons for care home staff shortages and absences
• linking staff shortages and the number of positive cases among care home staff
• comparing with other countries of the UK

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. More details on how staffing ratios are agreed can be found within the CQC guidance on staffing.

An additional adult social care workforce report providing more information on the pressures faced by the adult social care workforce, received through an ad hoc survey, was published as part of this collection on 17 December 2021. 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.

This 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.

In the week ending 26 April 2022:

• 0.5% of providers flagged that their agreed staffing ratios had been breached. This has decreased slightly since the week ending 29 March 2022, when it reached 0.7%. Since January 2022, when it reached a peak of 0.8%, this proportion has fluctuated between 0.7% and 0.5%. The proportion of providers flagging a breach of their staffing ratios has consistently remained lower than 1% since the start of the timeseries in December 2020
• 5.3% flagged that they were operating within the agreed staffing ratios but there is a significant risk of escalation in the coming days. This proportion has been decreasing throughout April 2022, following a period of increase in March 2022. This figure reached a peak of 6.7% in the week ending 11 January 2022 but has remained below this level since.
• 94.2% were operating within their agreed staffing ratios, which is an increase compared the start of April 2022. This proportion had reached its lowest point of 92.5% in the week ending 11 January 2022

If a care home’s staffing ratio has been breached, then business continuity measures may be put in place.

Figure 5: percentage of care homes operating within agreed staffing ratios, week ending 26 April 2022, England

More than 9 in 10 care homes report operating within their agreed staffing ratios.

Source: Capacity Tracker

This data can be found in table 4 of the accompanying ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page, in addition to data by region and local authority.

Staff absence rates

How the data can be used

This data can be used for:

• estimating the number and percentage of staff absent because of COVID-19 related reasons
• monitoring trends over time
• comparisons across local authorities and regions in England

This data cannot be used:

• as a sole indicator of all workforce pressures faced by the social care sector, since they only cover COVID-19 related absence
• to directly compare absence rates related to COVID-19 between domiciliary care and care home staff
• for comparing with other countries of the UK
• for linking COVID-19 related absence rates with test positivity rates

Absence rates related to COVID-19 are calculated using the reported number of staff employed and the reported number of staff out of work that day because of COVID-19 related reasons. Both the number of total staff employed, and the number of staff absent might be affected by provider response rates as only numbers reported by providers in the last 7 days are included in the total counts.

Absence data started to be reported by care providers in Capacity Tracker from December 2020. However, low response rates in the first few months of collection mean that the workforce data is incomplete, which affects the accuracy of the absence data during that period.

Providers who are the least likely to respond are likely to be those experiencing the most pressures on delivery due to high levels of staff absence. For this reason, data from December 2020 to the start of February 2021 for care homes, and from December 2020 to the start of March 2021 for domiciliary care providers, are not presented in this publication.

COVID-19 related absences cannot be directly linked to staff test positivity rates. This is because absences related to COVID-19 can cover a wide range of reasons, including but not restricted to staff:

• testing positive to COVID-19
• self-isolating
• caring for someone who has tested positive to COVID-19
• suffering from illness related to COVID-19

For more information, see the background quality and methodology note.

Absence rate statistics presented in this section were added for the first time in February 2022, following growing general interest in workforce pressures from various sources. They complement the statistics on staffing ratios presented in the previous section.

The staffing ratios statistics have not presented substantial variation over the past year, with the exception of the last few months. In the adult social care workforce survey published in December 2021, however, care providers have reported facing pressures on staffing levels. This suggests that the staffing ratio statistics may not accurately illustrate these workforce pressures.

COVID-19 related absence rate statistics alone are still not sufficient to give a full picture of workforce pressures faced by the sector, however they may provide more insight on some of the challenges. Additional statistics, such as general absences, retention or recruitment could provide a more complete picture.

In care homes

Data on care home staff absences related to COVID-19 is available from 9 February 2021.

In the week ending 26 April 2022, 1.1% of care home staff were absent because of COVID-19 related reasons. Absence rates decreased throughout April 2022, following a period of increase in March 2022. Care home staff absences related to COVID-19 reached a peak of 2.9% in the week ending 11 January 2022, and has remained below this level since.

Variation across regions increased throughout March 2022 but decreased again in April 2022. In the week ending 26 April, 1.3% of staff were absent because of COVID-19 related reasons in the South West, compared with 1.0% in the South East, East of England and East Midlands. Since January 2022, care home staff COVID-19 related absence rates in London have remained consistently and substantially lower than in other regions. In the week ending 26 April 2022, 0.4% of care home staff were absent because of COVID-19 related reasons in London.

The data suggests that the size of the care home workforce has been gradually declining since April 2021. This may however be partly driven by a change in response rates over the period. A reduction in the care home workforce size is another indication of pressures faced by the sector to deliver care.

Data on workforce counts and response rates can be found in tables 5 and 10, respectively, of the accompanying ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page,

More information about other sources of adult social care workforce data can be found in ‘Other sources of adult social care COVID-19 data’ (in the ‘About this data’ section below).

In domiciliary care

Data on domiciliary care staff COVID-19 related absences is available from 2 March 2021. Absence rates in domiciliary care settings are not directly comparable with those in residential care homes.

Domiciliary staff COVID-19 absence rates have decreased since late March 2022, reaching 1.5% in the week ending 26 April 2022. This follows a short period of increase throughout March 2022. This figure reached a peak of 4.8% in week ending 4 January 2022, which was the highest level seen since the start of the timeseries in March 2021 but has remained below that level since. Domiciliary care staff COVID-19 related rates are now reaching towards levels seen before the January 2022 peak.

There has been some variation across regions, throughout the timeseries, especially during periods of high absences. Variation across regions increased in March 2022, before decreasing again throughout April 2022. In the week ending 26 April 2022, 1.5% of domiciliary care staff were absent due to COVID-19 related reasons in the North East, compared with 1.1% in the North West and in the East Midlands.

London has consistently been an outlier and shown substantially higher COVID-19 related absence rates compared with other regions. This could however partly be explained by consistently and substantially lower response rates in the London region, compared to other regions.

Similarly to care homes, the data suggests that the domiciliary care workforce size has been gradually declining during the last year. This may however be partly driven by a change in response rates over the period.

Data on workforce counts and response rates can be found in tables 6 and 12 of the accompanying ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page.

More information about other sources of adult social care workforce data can be found in ‘Other sources of adult social care COVID-19 data’ (in the ‘About this data’ section below).

Figure 6: percentage of staff absent due to COVID-19 related reasons, up to week ending 26 April 2022, England

Absence rates due to COVID-19 related reasons have decreased throughout April 2022, following a period of increase in March 2022, in both care homes and domiciliary care settings.

Source: Capacity Tracker

Note: the proportion of staff absent due to COVID-19 reasons is not comparable across care settings.

This data can be found in tables 5 and 6 of the accompanying ‘Infection control, PPE and workforce statistics, May 2022: data tables’ on the ASC monthly statistics page, in addition to data by region and local authority.

COVID-19 testing in adult care homes

How the data can be used

This data can be used for:

• estimating the number of PCR and rapid lateral flow tests taken and positive results returned in care homes, and comparing across local authorities and regions in England
• estimating trends in prevalence and positivity rates for COVID-19 in care homes based on trends in positive tests

This data cannot be used for:

• calculating positivity rates for COVID-19 in care homes due to routine and repeat testing of individuals
• linking positivity rates in care homes to lower vaccination rates in care homes
• estimating the number of people tested and positive cases in care homes as people can take more than one test

For more information on:

• the rollout of the testing programme in care homes, see the ‘About this data’ section below
• testing kits used, see the ‘Terminology’ section below

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

The number of positive rapid lateral flow tests returned for both care home residents and staff decreased throughout April 2022. This decrease follows a previous period of increase seen throughout March 2022. The number of positive PCR tests also decreased this month, for both residents and staff.

The overall number of tests conducted in care homes decreased throughout April. Recent changes to testing guidance in care homes have affected the number of PCR and rapid lateral flow tests conducted among staff and residents. An overview of the changes to the testing guidance in care homes since June 2022 is presented in table 4 below.

From 4 April 2022 the requirement of care home staff to complete pre-shift rapid lateral flow tests is replaced by twice weekly rapid lateral flow tests, and asymptomatic testing for residents is removed. Additionally, symptomatic testing is now done with rapid lateral flow tests instead of PCR tests. DHSC published a summary of changes to testing and other IPC measures. These recent changes have influenced the trends seen throughout April 2022.

Table 4: changes in testing guidance in care homes since June 2020

Date	Changes in guidance
From 4 April 2022	Staff – 2 rapid lateral flow tests per week If symptomatic 2 rapid lateral flow tests taken 48 hours apart Residents – no testing If symptomatic 2 rapid lateral flow tests taken 48 hours apart Visitors – no testing unless providing personal care
From 16 February 2022 to 3 April 2022	Staff – pre shift rapid lateral flow tests
From 11 January 2022	Staff and residents – removal of confirmatory PCR test following a positive rapid lateral flow test
15 December 2021 to 15 February 2022	Staff – weekly PCR and 3 rapid lateral flow tests per week
7 June 2020 to 14 December 2021	Staff – weekly PCR and 2 rapid lateral flow tests per week Residents – monthly PCR PCR tests for staff and residents if symptomatic Visitors – required to take a rapid lateral flow test before each visit (tests are free)

To see the latest testing regime guidance for care homes, see the COVID-19 testing in adult social care guidance and the Infection prevention and control in adult social care settings. DHSC have also published a summary of changes to COVID-19 guidance for adult social care providers which provides details on the recent changes to the testing guidance.

Care home staff

Rapid lateral flow tests

In the week ending 26 April 2022, there were 7,136 positive tests returned from rapid lateral flow test kits in care home staff. This number decreased throughout April 2022 following a period of rapid increase seen throughout March 2022.

The number of rapid lateral flow tests conducted in care home staff, which includes positive, negative and void tests, decreased throughout April 2022 with 465,938 in the week ending 26 April 2022, compared to 692,388 at the start of the month. This decrease follows a period of slight increase between early and mid-March 2022.

The decrease in the overall number of tests completed throughout April 2022 was influenced by the change in testing guidance which came into place on 4 April 2022 and reduced the number of occurrences when staff are required to take an asymptomatic test. From 4 April 2022, care home staff are required to complete rapid lateral flow tests twice a week, instead of one before each shift.

PCR tests

The overall number of PCR tests conducted – including positive, negative and void tests – in care home staff decreased throughout April 2022. This decrease is in line with the implementation of new testing guidance on 4 April 2022 which requires symptomatic staff to take rapid lateral flow tests instead of PCR tests. Since this guidance change, the number of tests conducted almost halved, with 42,095 tests conducted in the week ending 26 April 2022. The lowest number of PCR test conducted since the timeseries began was recorded in the week ending 19 April 2022, with 41,415 PCR tests conducted during that week.

Despite this general decrease, there was a slight increase in the number of PCR tests conducted among care home staff in the last week.

Due to the recent changes in testing guidance for care home staff, PCR test results are now less relevant than rapid lateral flow test results in measuring COVID-19 prevalence in care homes.

Care home residents

The testing regime for staff is more frequent than for residents. As a result, the total number of staff tests is higher than the total number of resident tests. For more information, see the ‘About this data’ section.

Rapid lateral flow tests

In the week ending 26 April 2022, there were 1,610 positive tests returned from rapid lateral flow test kits in care home residents. The number of positive rapid lateral flow tests returned during April 2022 decreased substantially, with figures less than half those recorded at the start of the month. This recent decrease follows a previous period of increase seen throughout March 2022.

The overall number of rapid lateral flow tests conducted in care home residents, which includes positive, negative and void tests, also decreased throughout April 2022 following a period of increase in March. In the week ending 26 April 2022 there were 18,212 tests conducted, which is almost half those recorded at the start of the month.

PCR tests

The number of PCR tests conducted – including positive, negative and void tests – in care home residents also decreased throughout April 2022, following a period of increase in March 2022.

On 4 April 2022, asymptomatic testing for care home residents was removed. This means residents are only required to take PCR tests in the event of an outbreak, prior to discharge from hospital or on new admissions to a care home. This change in guidance has impacted the figures in this publication, contributing to the decrease in the number of PCR tests conducted throughout April 2022.

Figure 7: number of tests conducted in care home staff and residents, 2 September 2020 to 26 April 2022, England

The number of tests conducted among staff and residents has decreased throughout April 2022 for both rapid lateral flows and PCR tests, following a change in guidance at the start of April 2022.

Source: NHS Test and Trace

Note: the dotted lines in this chart represent the implementation of the 4 most recent changes in care home testing guidance:

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

See table 6 for a breakdown of the specific changes.

This data can be found in tables 1 and 2 of the accompanying ‘COVID-19 testing statistics, May 2022: data tables’ on the ASC monthly statistics page, in addition to data by region and local authority.

Figure 8: number of positive test results in care home staff and residents, 2 September 2020 to 26 April 2022, England

The number of positive test results returned in care home staff and residents rapidly decreased throughout April 2022, following a period of rapid increase in March 2022.

Source: NHS Test and Trace

Note: the dotted lines in this chart represent the implementation of the 4 most recent changes in care home testing guidance:

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

See table 6 for a breakdown of the specific changes.

This data can be found in tables 1 and 2 of the accompanying ‘COVID-19 testing statistics, May 2022: data tables’ on the ASC monthly statistics page, in addition to data by region and local authority.

Staff and residents have different testing regimes as outlined in the ‘About this data’ section below. As a result, the number of positive test results returned are expected to be of a different scale between staff and residents.

Visitors

The number of positive tests returned in both care home visitors and visiting professionals has decreased in April 2022.

In the week ending 26 April 2022 there were:

• 220 positive rapid lateral flow tests returned in care home visitors
• 50 positive rapid lateral flow tests returned among visiting professionals to care homes

The number of rapid lateral flow tests conducted – including positive, negative and void tests – among visitors continued to decrease in April 2022. In the week ending 26 April 2022, there were 46,822 rapid lateral flow tests conducted among visitors compared to 90,825 at the end of March 2022. This follows a period of increase from mid-January to mid-February, which coincided with the relaxation of visiting restrictions allowing more visitors per resident in care homes.

Additionally, there were 6,305 rapid lateral flow tests conducted among visiting professionals to care homes in the week ending 26 April 2022. The number of tests conducted started to decrease in April after remaining broadly consistent since early January 2022.

Terminology

Care home: facilities providing residential care. The data in this bulletin refers to Care Quality Commission (CQC) registered care homes.

Older adult care homes: care homes serving any older people (aged 65 and over) as identified from the latest CQC data on care homes in the ‘older people service’ user band. A small number of residents within care homes serving older people may be aged under 65.

Younger adult care homes: care homes not serving any older people (aged 65 and over) as identified from the latest CQC data on care homes in the ‘older people service’ user band.

Domiciliary care: services providing personal care for people living in their own homes. The data in this bulletin refers to domiciliary staff employed by independent CQC registered providers.

Staff: unless specified, staff can refer to staff directly employed by a provider and/or through an agency.

Staff employed by other settings: this includes non-registered providers and local authority employed: all other eligible frontline social care staff working in close and personal contact with people clinically vulnerable to COVID-19 (as defined by the Joint Committee on Vaccination and Immunisation (JCVI) priority groups) who need care and support irrespective of where they work or who they are employed by, for example, local government, NHS, private sector or third sector.

Agreed staffing ratios: the agreed number of residents for any given member of staff. This is determined by individual providers to ensure there is safe levels of staffing for care to be delivered. This can be subject to inspection by the CQC. See Regulation of staffing for more information.

PCR (polymerase chain reaction) tests: PCR tests check for the genetic material of the coronavirus in the sample, which is taken using a swab and is processed in a lab via a polymerase chain reaction (PCR). These are predominantly used in care homes for people who experience symptoms, and for routine asymptomatic testing for staff and residents.

Rapid lateral flow tests: often referred to as ‘rapid tests’, or lateral flow device, these test for the presence of proteins called ‘antigens’ which are produced by the virus. They are swab tests that give results in 30 minutes or less, without the need for processing in a laboratory. These tests are primarily used in care homes for routine asymptomatic testing for staff, residents and visitors.

PPE (personal protective equipment): equipment worn by staff or visitors in care homes to reduce transmission of COVID-19. This publication refers to supplies of aprons, eye protection, gloves, hand sanitiser and face masks in care homes.

About this data

These statistics are being published as a part of a wider landscape of statistics on adult social care. The Government Statistical Service (GSS) compiles a UK adult social care database of official statistics on adult social care across the 4 nations of the UK. This is updated on a monthly basis.

The UK Statistics Authority (UKSA) conducted a review of adult social care statistics in England which called for:

• better leadership and collaboration across different organisations publishing official statistics. This publication has been produced in collaboration with other statistics providers of COVID-19 adult social care data and DHSC will endeavour to work with various stakeholders as more data is published through this publication

• addressing of gaps in available data, particularly in privately funded care. This bulletin aims to plug some of that gap by including data on residents privately funding their care in addition to those funded by local authorities

• improving existing official statistics. These statistics are being badged as experimental statistics and more data will be added iteratively based on user needs

Other sources of adult social care COVID-19 data

COVID-19 vaccinations

NHS England and Improvement (NHSEI) also publish data on vaccinations in adult social care settings as part of their broader statistical release on COVID-19 vaccination, using the same methodology and the same data source as this publication but there are differences in the:

• reporting period; data in this publication reports data collected up to 11:59pm on a Tuesday whereas NHSEI use data collected up to 11:59pm on a Sunday

• 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 in the weekly NHS Test and Trace statistics (England) at national level. This publication uses the same data source but has a different methodology for presenting testing in care homes and differences in the figures will occur 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). This also means that changes in the guidance for the wider population might affect the trends differently across both publications

• 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 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 with 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 (ASC-WDS) 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 use a wider definition of ‘domiciliary care’ than is used in Capacity Tracker and include 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 with 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.

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. See the adult social care workforce survey: December 2021 report.

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.

Data sources

COVID-19 vaccination, infection prevention control (IPC), PPE availability, absence rates and staffing levels

Data in this publication is taken from self-reported data submitted by care providers in England through a data collection and insight tool called Capacity Tracker.

Up until 4 April 2022, care providers were expected to submit data on IPC compliance on a weekly basis while data on vaccinations, PPE availability, staff absences and staffing levels was expected to be updated on a daily basis. From 4 April 2022, all data fields are expected to be updated weekly, to reduce the burden on providers.

Care home visiting 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, absence rates and staffing-levels, data relates up to 11:59pm on the date stated as the ‘week ending’. 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, for care home visiting data and vaccination data for ‘other care settings’, the reporting week ends on a Wednesday instead of Tuesdays. This is due to a change in the timings at which these data are downloaded from the data portal.

This bulletin presents the proportion of staff and residents vaccinated out of the total number of staff and residents as self-reported by care providers. Only individuals who have not tested positive for COVID-19 in the last 28 days are eligible to receive the vaccine. Data on the number of staff and residents of older adult care homes eligible for the vaccination over time can be found in the accompanying COVID-19 vaccination tables on the ASC monthly statistics page.

For more information, see the ‘Data Sources’ section of the accompanying background quality and methodology note.

COVID-19 testing data

Testing data is collected from management information generated during the operation of the NHS Test and Trace service.

For more information, see the ‘Data Sources’ section of the accompanying background quality and methodology note.

Data coverage and quality

All data in this publication refers to adult 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.

Visiting, PPE availability, absence rates and staffing levels

Providers are expected to submit data on care home visiting, staffing levels and PPE availability on a weekly basis. Any providers who have not submitted data within the last 7 days are excluded from the relevant analysis for the associated time period where no response was received. The full response rates for all data points are available in tables 9 to 12 of the accompanying ‘Infection control, PPE and workforce statistics data tables’ on the ASC monthly statistics page. Before 4 April 2022, the expectation for reporting data on staffing levels and PPE availability data was daily.

COVID-19 vaccinations

Data on total number of staff and residents as well as those vaccinated is self-reported by care providers and local authorities. From 4 April 2022, providers are expected to update their vaccination data on a weekly basis. Before 4 April 2022, the expectation was daily.

There may be a time lag between individuals receiving the vaccine and the week they are reported in the statistics depending on when providers have updated their vaccination data.

COVID-19 testing

This report includes the number of tests conducted on care homes residents, staff and visitors who were tested by:

• PCR and rapid lateral flow test 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 test 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. Because people can have more than one test, the data should not be compared with prevalence rates or case positivity rates.

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

Data for each reporting period relates to the day an individual took their test.

To see the latest testing regime guidance for care homes see the COVID-19 testing in adult social care guidance and the Infection prevention and control in adult social care settings guidance.

From 4 April 2022, staff are expected to take rapid lateral flow tests twice a week, and asymptomatic testing for residents is removed. Additionally, symptomatic testing is now done with rapid lateral flow tests instead of PCR tests. On 31 March 2022, DHSC published a summary of changes to testing and other IPC measures.

As of the week ending 26 April 2022, which is the latest data point included in this publication, the regular testing regime in place was as follows:

care home staff testing:

• 2 rapid lateral flow tests a week
• if symptomatic, 2 rapid lateral flow tests taken 48 hours apart

care home residents testing:

• no asymptomatic testing
• if symptomatic, 2 rapid lateral flow tests taken 48 hours apart
• as soon as they join a care home, if they are new, with a PCR test

care home visitors testing:

• no testing is recommended, unless visitor providing personal care

visiting professionals to care homes:

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

Different testing regimes apply when there is an outbreak of COVID-19 in a care home. See the COVID-19 testing in adult social care guidance for more details.

Revisions

Any revisions to past publications will be in line with DHSC’s revision policy and highlighted in future publications accordingly.

Feedback

For feedback and any further questions, contact asc.statistics@dhsc.gov.uk.