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Supporting health and social care providers in Devon

Mandatory vaccination in care homes: FAQ

1. Who does the new law apply to?

The scope of the regulation is laid out in the operational guidance.
The new law applies to all Care Quality Commission (CQC) regulated care homes in England accommodating adults of any age. It does not apply to other health or care settings or services.

The government has initiated a consultation on extending mandatory vaccination to other frontline health and care roles undertaking regulated activities with a closing date of 22 October 2021.
They are also considering extending the mandate to include vaccination against influenza.

2. What are the key dates?

The key dates are:

  •  22 July 2021 – the law was approved by parliament
  • 16 September 2021 – the last date a care home worker can receive their first vaccination to be in time to receive their second before the 16 week grace period ends.
  • 11 November 2021 – this is when the 16-week grace period ends; all staff working in or deployed into a CQC regulated care home must have been fully vaccinated at this point.

Being fully vaccinated means having received both doses of a recognised vaccine and being able to evidence this in an approved manner.

3. Who needs to be vaccinated?

The roles covered by the regulation are laid out in the operational guidance.
They include everybody working in a CQC regulated care home in England regardless of role or contracted hours, and including bank staff, temporary workers, and volunteers.
Any newly employed staff will need to be fully vaccinated, as do any staff returning from long-term absence or maternity leave before they recommence work.
The law also applies to those coming into care homes to do other work e.g. healthcare workers, tradespeople, hairdressers, and beauticians.
CQC inspectors, Social Workers and other professional visitors will also have to follow the new regulations. There is specific guidance for visiting professionals.
Any prospective resident or family member wishing to visit a care home as a potential resident also needs to be vaccinated, but newly admitted residents who have an attendant contractual agreement with the provider and anyone accompanying them do not.

By fully vaccinated, the government means having received both doses of an authorised vaccine. (The regulation does not currently cover booster vaccinations.)
It is the responsible person / registered manager whose responsibility it is to check and maintain a record of evidence regardless of employer.

4. How can we encourage our staff and other workers deployed into the care home to become vaccinated?

Public Health England has produced a free resource to help adult social care employers promote the benefits of vaccination to their staff.
Further information on accessing a vaccine in Devon and materials to support those who may be hesitant can be found on the vaccination section of the PEN website.
If you have staff who are vaccine hesitant or there are specific concerns (e.g. staff with concerns about allergies) you can make a referral to the vaccination support team at NHS Devon CCG: d-ccg.devonvaccinationsupport@nhs.net. They will be able to offer a 1:1 discussion with a health care professional to talk through any concerns.
ACAS have also produced some helpful guidance to support employers and their staff in having conversations about vaccination where there is hesitancy.

5. Who does not need to be vaccinated?

The roles not covered by the regulation are laid out in the operational guidance.

The law does not apply to the residents of care homes, their personal visitors, or anyone visiting at end of life.
Neither does it apply to anyone under 18 years old although vaccination is available to 16 and 17 year olds and anyone employed by or volunteering in the care home of this age should be encouraged to be vaccinated.
People responding to an emergency, including undertaking emergency maintenance, are also exempt.
Providers will continue to define visiting policies that assess and mitigate risk with appropriate infection prevention and control measures.

6. What about medical exemptions?

The government has published details of a temporary process for self-certifying a medical exemption to vaccination outlined in this letter.
The letter outlines valid reasons for medical exemption.
This temporary guidance includes a form that staff who have a medical exemption can complete and give to their employer.
This temporary guidance also includes a form that staff who were vaccinated abroad can complete and give to their employer.

We are awaiting further guidance on the longer-term process for certifying medical exemption using the NHS Covid Pass Scheme. The DHSC Operational Guidance will be updated to include how staff can obtain an exemption and general guidance on medical exemptions.
From 12 weeks after guidance on this longer-term process for certifying medical exemption is published temporary certification will become invalid.

The government’s Impact Analysis estimates that only 1% of care home staff will be medically exempt from vaccination.
From the 11th November 2021, staff who have not been vaccinated will no longer be able to work at a CQC regulated care home in England.
They may be deployed to other roles by their employer where those are available.
Where dismissal is necessary, due notice should be given and process followed.

7. If staff have a medical exemption, are they able to perform their usual duties?

Providers should review their duties and risk assess appropriate mitigations including PPE and wider infection, prevention, and control measures.

8. What evidence of a person’s vaccination status or medical exemption is required?

The government guidance provides more detail on what employers need to look for but valid evidence includes:

  • NHS App
  • NHS website
  • NHS letter
  • Self-certification of medical exemption or vaccination received abroad.

Other forms of documentation such as the vaccination appointment card are not accepted.

9. What information on vaccination status should be retained and how should it be stored?

The government includes guidance on maintaining records that are compliant with the General Data Protection Regulation in its guidance to the responsible person who is the registered manager of the care home.

10. Why does the law not apply to other health and care settings and roles in England?

The government decided that care homes was a priority area for mandatory vaccination following its consultation with employers, staff, people who need care and support and their families. This government press release explains further.
The government has initiated a consultation on extending mandatory vaccination to other frontline health and care roles undertaking regulated activities with a closing date of 22 October 2021.
They are also considering extending the mandate to include vaccination against influenza.

11. How will regulated providers be checked to ensure that staff and others have been vaccinated?

The Care Quality Commission (CQC) will be responsible for checking that regulated care homes in England are complying with the new legal requirements.
These checks are expected to be undertaken as part of the CQC’s usual registration, monitoring and inspection of care home processes.
Further information on regulation has been published by the CQC.

12. Is the regulation and any consequent dismissal lawful?

Legislation underpinning the regulation has been passed into law by parliament.
It is important that employers comply with employment and equalities law and adhere to good employment practice including in situations where they decide to terminate a staff contract as a result of this regulation.
The government offers guidance on good employment practice in this circumstance.
Staff may threaten legal action or write stating that mandatory vaccination goes against their beliefs but personal beliefs about vaccinations are not considered a legitimate reason not to be vaccinated for care home staff.
Employers should ensure they follow due process: informing employees of the regulation and its implications, sharing with them government guidance for staff, offering redeployment where possible, and only terminating contracts through dismissal as a last resort honouring any due notice period.

13. What if a member of staff has been vaccinated abroad?

The government has published details of a temporary process for self-certifying vaccination received abroad in this letter which also includes details of the temporary process for self-certifying medical exemption.
This temporary guidance includes a form that staff who were vaccinated abroad can complete and give to their employer.

14. Where can I find further information?


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