Publication - Advice and guidance

Coronavirus (COVID-19): clinical guidance for the management of clients accessing care at home, housing support and supported housing

Published: 6 Aug 2020
Last updated: 8 Sep 2021 - see all updates

Guidance for local authorities, Health and Social Care Partnerships (HSCPs) and registered providers, who deliver care and support to people in their own homes or provide supported accommodation including sheltered housing, extra care housing and supported living during the pandemic.

Coronavirus (COVID-19): clinical guidance for the management of clients accessing care at home, housing support and supported housing
Protective measures and precautions

Protective measures and precautions

Infection prevention and control

Effective infection prevention and control (IPC) remains an important line of defence against infectious diseases.

Providers and visiting health and social care professionals should continue to follow COVID-19 IPC guidance and the additional guidance on face mask use, when providing care and support to an individual living in their own home or in a supported housing setting.

Physical distancing

A letter was sent to all service providers on 1 September to inform them of the updates to physical distancing in social care settings.

As you know, two-metre physical distancing was introduced at the start of the COVID-19 pandemic as a mitigation measure to prevent transmission of the virus between individuals. Following the roll out of the successful vaccination programme, expansion of testing and the use of face coverings by the general public, physical distancing is no longer obligatory in the general community.

Within health and social care settings, physical distancing has continued to be recommended. Full guidance on physical distancing for social care services has been updated in the COVID-19 IPC Addendum for community health and care settings.

In summary the advice is as follows

  • physical distancing amongst social care staff is now recommended to be reduced to one metre or more when fluid resistant surgical masks (FRSMs) are in use
  • if social care staff remove their FRSMs for any reason e.g. eating, drinking, changing (e.g. in staff rooms, changing rooms). To support residents/supported individuals who are in distress, it is advised that two metres or more be obtained to avoid high numbers of staff being identified as contacts should a positive case arise
  • for non-direct care staff whom wear face coverings instead of FRSM, one metre or more applies when wearing a face covering and two metres or more should be observed when the face covering is removed
  • staff must aim to maintain one metre or more physical distancing from residents/individuals when not delivering care which requires physical contact
  • residents, and individuals who share living accommodation including supported housing, do not need to physically distance from each other
  • supported people living in their own home, sheltered housing, supported housing or supported shared housing no longer need to physically distance from each other or their visitors, though they should continue to follow national guidance and legal requirements for face coverings as applicable
  • physical distancing may be reduced to one metre  between patients/service users and staff on service user transport
  • staff should follow national guidance and legal requirements for face coverings as applicable when supporting residents or supported individuals in outside environments and public spaces. Staff are advised to maintain physical distance and wear FRSMs where possible in indoor public spaces as an additional measure to protect against transmission

The updated guidance sets out the minimum level of physical distancing in each particular setting. Where services decide that they wish to maintain two-metres physical distancing, they are able to do so within their own governance arrangements.


Social care providers, unpaid carers should continue to follow the existing guidance on use of PPE.

Personal assistants should continue to follow existing guidance on how to access and use PPE.

Staff movement and use of agency staff

Service providers should continue to reduce the movement of staff including through staff cohorting and should continue to follow guidance on the use of agency staff.


It is important for staff to be aware of any changes in symptoms for those who they provide care and/ or support to. Social care staff and those providing care and support to individuals should be vigilant for COVID-19 symptoms and report to their manager at the earliest stage. Older adults may experience a wider range of symptoms, and providers of care should also look out for:

  • lethargy/fatigue
  • reduced appetite/fluid intake
  • loose stools, nausea, abdominal pain
  • headache, new aches and pains
  • change in behaviour, particularly for those living with dementia

Those providing care and support to individuals in these settings should also be vigilant of any symptoms of COVID-19 and if they display any symptoms they should report these to their manager at the earliest stage possible.


Advice on testing remains unchanged and staff should continue to follow the advice set out on testing as at 18 January 2021.

However, for staff who log their LFD test results through the NSS portal, updated advice was issued on 13 July 2021 which relates to some staff undertaking LFD testing within their home.

Friends and family whom will be meeting with individuals in receipt of care or support, including unpaid carers, are encouraged to take regular tests, even if you don’t have symptoms to reduce the risk of spreading the virus. If you have symptoms you should book a PCR Test and stay at home. 


It remains important that all those who experience symptoms of COVID-19, test positive for COVID-19 or are deemed close contacts of someone with COVID-19 continue to meet the requirements of self-isolation

Social care workers who are experiencing symptoms or are a close contact of a COVID-19 diagnosis should follow the updated self-isolation advice which details when exemptions to self-isolation for work apply.

First published: 6 Aug 2020 Last updated: 8 Sep 2021 -