Movement between care settings guidance released

Staff movement between care settings should be avoided unless absolutely necessary and this includes:

• staff who work for one care business across several care settings
• staff who work on a part-time basis for multiple employers in multiple care homes or other care settings
• agency or other temporary staff

• Staffing requirements should be planned so routine movement is not necessary to maintain safe staffing levels.
• If they do need to use an individual who usually attends two settings, they should ensure there is a 10-day interval between attending the two settings and require a negative test result from the individual prior to entering the home. "This should be followed in all but exceptional circumstances."
• When using an agency or temporary worker, the care business should take steps to ensure that they have not attended another health or social care setting in the previous 10 days. The guidance suggests that providers could consider using block bookings and exclusivity contracts with agencies to limit agency staff movement.

The guidance refers to the fact that the Infection Control Fund can be used to fund the additional costs of these measures or the recently launched Workforce Capacity Fund (although the guidance to the latter states that expenditure covered needs to be incurred between 16 January and 31 March).

It’s not clear how these measures will be funded after March. It’s also worth noting that although the government gave care businesses wide discretion as to how to use the Infection Control Fund grant, there now seems to be a clear expectation that it will be used to cover these costs (only recently it was also made clear that care providers were expected to use this grant to meet the costs of paying self-isolating staff full pay during the isolation period).

The guidance states that the: "CQC continues to monitor staff movement and uses that information to help plan its inspection activity. Where information is received that unnecessary staff movement is taking place, the CQC will inspect."

The guidance states that this may be permitted where a provider has planned its staffing requirements in line with CQC's fundamental standards and is actively taking steps to address any ongoing resourcing needs but has insufficient staff to deliver care safely. Even then, they "should ensure this is for as limited a period of time as possible and should only be for as long as is needed for the provider to resolve any staffing issues."

The individual should have:

• a negative PCR test in the seven days before starting a placement and
• a negative lateral flow test on their first day before they start their shift
• If using an individual who is working at another setting, that individual should also have a lateral flow test before their shift every time they have been working elsewhere
• they should take part in the businesses regular testing programme
• if someone has previously tested positive for COVID on a PCR test, they should not be tested using PCR or rapid lateral flow within 90 days UNLESS they develop new possible COVID symptoms. Individuals who fall within this should use evidence of their positive PCR test result to show that they are exempt from testing until this 90-day period has elapsed

In addition to limiting movement between settings, the guidance states that providers should take steps to limit staff's use of public transport and staff should avoid lift-sharing arrangements and travel solo in their own vehicle where possible.

Where this is not possible, the Infection Control Fund grant can be used "to provide private transport or encourage walking or cycling to and from work and support this with changing facilities or rooms." Many care businesses may feel that the extent of measures they are expected to fund from the grant is very wide compared to the remaining grant monies available to them.