Social Care Column: Preparing for Mandatory Vaccines

I’ve spoken to a lot of directors and managers who are preparing for the mandating of the COVID19 vaccine, over the last couple of weeks. With a lack of information from the government and the Care Quality Commission, many people have felt stuck and unsure of what decisions they need to make. With so many people looking for guidance, I thought I would write this column to share the support I’ve often given to others.

What’s happening?

From 11th November 2021 care homes must only allow individuals who are fully vaccinated against COVID-19 (or exempt) to enter a care home. This is a big change for care homes and a fundamental shift in the way we engage with staff from a legal point of view and, although we see mandatory vaccines already in the NHS, this is something new for the care sector and it doesn’t just affect staff employed within the care home but others visiting and working within them.

Those affected

• Staff employed directly by the care home, including those from agencies
• Volunteers working with homes
• People coming into the care home to do their work such as contractors and tradespeople such as maintenance teams, pest control teams, window cleaners, hairdressers, CQC (Care Quality Commission) inspectors, chiropodists, doctors, nurses, etc.

Those not affected

• Residents
• Individuals providing emergency assistance and members of the emergency services
• Individuals providing urgent maintenance assistance
• Friends or relatives of the resident
• Individuals visiting residents who are dying or offering bereavement support
• Under 18s

What do you need to know?

The deadline for staff to have had the first vaccine has been and gone, however, the government has announced that there are self-exemption forms care home staff can complete. Care home workers who are exempt will need to sign the form attached to this letter and give this to their employer as proof of their temporary exemption status. This temporary self-certification process has been introduced for a short period prior to the launch of the new NHS COVID Pass system which is due to go live soon. Once the NHS COVID Pass system is launched, care home workers will need to apply for a formal medical exemption through that process. This temporary self-certification will expire 12 weeks after the NHS COVID Pass system is launched.

I know there are still many members of staff who have not had one or both doses of the vaccine and I think it is important to think about these staff members before anything else. For me personally, I don’t think care providers should get into a conversation about whether someone has or hasn’t been fully vaccinated, and instead be empathetic as to why the individual has chosen not to do so. Honesty is important so now is the time for staff to know that this is deadline is looming, regardless of whether we agree with it or not.

There are a large number of factual resources now relating to the vaccine and it is important that providers are signposting the right information and ensuring that staff can access this. There will be some staff that do not want to speak to a doctor, some may not be computer literate and unable to find their way around the internet, others may just want support and it is important that we spend time talking to each member of staff somewhere confidential and listen to their concerns as to why they do not want the vaccine.

Whilst it is important that we do not pester and constantly harass staff, you also have to continue the conversation to get a clear view of how many people will and won’t be vaccinated by the November 11th deadline. My advice is keep the conversations very informal, take notes, and some kind of action from each meeting so that you can agree to meet in 2/3 weeks’ time once they have had a chance to look at any information or resources you have provided and continue the conversation about the vaccine.

At the end of the day, you must remember that we cannot force staff to have the vaccine. Your staff are people at the end of the day – they have concerns and anxieties and it is important as an employer that we respect these, as hard as it will be to lose these team members.  

You will also need to consider the staff that has been vaccinated outside of the UK. The Department of Health and Social Care has stated that they "Are aware some individuals will have been vaccinated outside of the UK. We are working on a solution to this and will provide further guidance on this as soon as possible."

Staff employed by the care home provider have up until the 11th November 2021 to have had both doses of the vaccine, so there is still time. There are numerous staff who haven’t had it yet due to being positive and having to wait 28 days. I would just recommend looking at the rota, offering staff annual leave or unpaid leave until they have had the second dose and are ready to work.

Of course, you will also have staff that do not want the vaccine and it is important that you follow the advice from your HR team if these members of staff can’t be deployed to another area of the business. There is a useful table here showing the timescale for meeting/consulting staff if they, unfortunately, need to be dismissed from the organisation. While these conversations may not be easy, they are likely to happen in the coming weeks so being prepared is vital.

Key dates

• 22 July 2021
  Regulations became law.
• 19 August 2021
  Deadline for dismissal for an employee with 12 weeks’ notice, to avoid payment in lieu of notice costs.
• 16 September 2021
  The last date for the first dose of the vaccine if the employee is to be fully vaccinated by 11th November 2021 (this assumes an 8 week period between jabs, but it may be possible to get the second jabs as early as 6 weeks after the first).
• 11 November 2021
  No staff can enter a care home unless fully vaccinated or exempt.

Updating and amending documentation and processes

Documentation is key and I cannot stress this enough! I have touched on the note-taking from conversations with care workers but there is more documentation that needs to be considered for this process.

There are several forms that will need to be updated or provided when you’re having discussions with staff members that have not been vaccinated and you’re thinking ahead to manage the shortfall in staff that could come in November. The list below isn’t exhaustive and I would recommend seeking advice from your HR provider for further information and clarity.

CQC inspections

Make sure you have all of this documentation ready for your next inspection so you can clearly demonstrate how you’re meeting the new regulations. The Care Quality Commission have stated that they will ‘look for evidence to confirm systems and processes are in place to comply with the requirement’ but have stated that:

“Registered persons will not be required to show a record of the evidence itself, but will need to provide assurance that systems and processes are in place to ensure that individuals who enter the premises are fully vaccinated or exempt. Registered persons may choose to make a record of the evidence they have seen for their own internal staff employment record keeping. If the evidence is collected and recorded, all personal data must be handled in accordance with UK GDPR. This includes providing individuals with privacy information at the stage their data is being collected.”

With this in mind, I would recommend having:

• Evidence from a recruitment point of view for new starters.
• Evidence of existing staff members being encouraged to have the vaccine and actions taken for those who didn’t have the vaccine.
• Booster vaccines – something simple like a traffic light system, red when due for a booster, amber for approaching, and green have had it.
• Evidence of how you check the COVID vaccine status of contractors, agency staff, etc.
• Evidence of resources and signposting materials used to help inform and reduce anxieties of staff during the consultation period.

Having the right evidence

When checking that staff have been vaccinated, these are the forms of evidence that you can request:

• NHS App
• NHS Covid Pass App
• NHS COVID Pass Letter

Remember that an individual’s NHS appointment card cannot be used as proof of vaccination status.

Booster vaccines

At this moment in time, the booster vaccine is not mandatory, however, the government and Department of Health and Social Care have said that they are awaiting feedback from the JCVI (Joint Committee on Vaccination and Immunisation). So lookout for any updates on this in the coming weeks.

To sum things up…

The one thing we all know about rolling out a change in an organisation is that people don’t always like it. Therefore we must manage the process thoughtfully. Your approach, the information that you’re sharing with staff, being open and transparent; and all these will make the process easier. You may be met with obstacles but it is so important to give everyone the information they need and not be cagey or hide things. Finally, remember that (at present) it’s only England that is introducing the mandatory vaccine, not Scotland, Ireland, or Wales.

Useful links

• UK GOV: Vaccination of people working or deployed in care homes: operational guidance‍
• CQC Statement on COVID-19 vaccines of people working in care homes‍
• Skills for Care – requirements to be vaccinated FAQ‍
• Royds Withy King Solicitors – ask to speak to James Sage‍
• Nectar HR – ask to speak to Sonia‍
• The Caring View Chat Show‍
• UK GOV: COVID-19 the greenbook chapter 14a‍
• Staff Self-Exemption Forms‍
• Staff risk assessment