COVID-19 action plan for adult social care

On 31 January 2020, the Chief Medical Officer, Chris Whitty, confirmed the first two cases of COVID-19, an infectious disease caused by a novel coronavirus, in England. In February 2020, Public Health England, responsible for health protection and improving population health, issued guidance on COVID-19 for adult social care settings. It stated that it was ‘very unlikely that anyone receiving care in a care home or the community will be infected’. 

Early evidence suggested that certain population groups were at higher risk from the virus, including older people and people with underlying health conditions, who were over-represented among social care users. The first recorded deaths from COVID-19 among care home residents in England occurred on 6 March 2020. 

On 11 March 2020, the World Health Organization (WHO) declared the outbreak of COVID-19 a pandemic. The government in England introduced a combination of policies in response to the pandemic, including a national ‘lockdown’ on 23 March 2020. The NHS set out actions for providers to reorganise services and increase the availability of staff, beds and equipment. Hospitals were asked to 'urgently discharge' medically fit patients without testing them for COVID-19, including into social care settings. Government also implemented some initial measures in social care settings in March 2020, introducing ‘easements’ to the Care Act 2014 enabling local authorities to suspend their adult social care duties and funding for local authorities to help with pressures on care services.

Action plan

On 15 April 2020, the Department of Health and Social Care published its plan for the COVID-19 response in adult social care in England. This plan set out four objectives: ‘controlling the spread of infection’, ‘supporting the workforce’, ‘supporting independence and people at the end of their lives and responding to individual needs’ and ‘supporting local authorities and the providers of care’. 
It outlined measures including:

• testing residents prior to admission into care homes and testing symptomatic residents and care workers
• undertaking a recruitment drive for care workers and extending the NHS support package to social care workers
• formally establishing a ‘CARE’ brand and app.

Impact and later developments

In June 2020, government announced a COVID-19 support taskforce for the social care sector to oversee the implementation of the plan. It reported in September 2020 that most of the plan had been delivered. There were no data available on the impact of the recruitment campaign in increasing the number of care workers.

In June and July 2020, the National Audit Office (NAO) and the House of Commons Public Accounts Committee (PAC) published reports which assessed the COVID-19 response in adult social care. The PAC found that government had been ‘slow, inconsistent and, at times, negligent’ in its support for social care. The NAO highlighted challenges in gathering data in a fragmented sector and problems with PPE supplies for the workforce. Neil Ferguson, a member of the scientific advisory group for emergencies (SAGE) to the government, also stated in June 2020 that policies to protect care homes and the elderly had ‘failed to be enacted until recently’.

The government approach to the pandemic response in adult social care changed over time, with changes to guidance on visiting in care homes, testing policies, additional funding to support recruitment and more support for community settings and unpaid carers. By 2 April 2021, there were 27,279 excess deaths among care home residents in England and 9,571 excess deaths reported among people receiving domiciliary care. Social care staff were also more likely to die from COVID-19 than others of the same age and sex.