COVID-19 vaccination

The government have announced new regulations making vaccination a condition of deployment for any individual working in a Care Quality Commission (CQC) regulated care home in England providing nursing or personal care, subject to certain exemptions.

We know that there are regional variations in vaccine take-up across the sector and that this policy presents a variety of challenges. Skills for Care is committed to offering resources to help employers fully engage with their teams, including guidance on wellbeing and information on vaccines.

On this page, we have collated a range of resources to help care providers and local authorities in implementing these regulations and supporting their people through the change. This includes some practical case studies from organisations that have started to implement these changes already.

DHSC operational guidance

The Department for Health and Social Care (DHSC) has produced this national operational guidance for the implementation of this new mandatory requirement for CQC regulated care homes.

The guidance is aimed at care home managers, care workers and local authorities. It includes key information about the incoming legal requirements, including the initial 16-week grace period. The guidance explains who will need to be vaccinated, who might be exempt, what is legally expected of the care home and implications for staff who choose not to be vaccinated. 

Download the guidance

Information on clinically reviewed medical exemptions for COVID-19 vaccination of people deployed in care homes

Watch the DHSC webinar: Guidance for COVID-19 vaccination of people working deployed in care homes below.


The Care Quality Commission's role

Read the CQC's statement on COVID-19 vaccination of people working/deployed in care homes.

See the statement.

Free e-learning  

The University of Nottingham has developed an online learning resource designed to raise awareness about the COVID-19 vaccine and support healthcare professionals and healthcare students with promoting the vaccine to others. This is an open access, free, online resource that can help employers discuss issues and concerns with their staff.

Access the e-learning.

Frequently asked questions

To complement the DHSC guidance, Skills for Care will regularly update our own 'Frequently asked questions' document looking at some of the workforce issues resulting from vaccination as a condition of deployment. Download the document (last updated 11 November 2021)

How the care home mandatory vaccinations are being supported at a local level may vary in different parts of the country. Connect with your Skills for Care locality manager to find out the latest local advice.

If you require further guidance, Skills for Care’s Information Team are available 9:00 to 17:00, Monday to Friday. You can contact them via or calling 0113 241 1275.

Case examples

We will be sharing examples of where employers have encouraged their staff to take up the vaccine prior to it becoming mandatory in care homes. These will give an indication of the issues of resistance faced and what steps they took to reassure staff, address their concerns and increase the take up of the vaccine.

Read the blog from Barchester Healthcare

Read Community Integrated Care's approach

Read HC-One's approach

Read Care Through The Millennium's approach

Read Jane Caress's approach

Resources for employers and local authorities

DHSC have shared some resources you may find useful, including a timeline graphic for use on social media and a stakeholder question and answer document. Access the Google Drive.

Notifying people about the change

Below you'll find some example letters that have been used to communicate the change. 

The following resources are recommended for both care providers and local authorities. They can help address some of the issues that may result from this change being introduced, from relationships with staff to impact on recruitment and longer-term workforce planning.

The resources pre-date mandatory vaccinations but can help care providers and commissioners manage some of the impact this may have on the workforce.

The following resources may be useful for informing conversations with your staff:

Medical exemptions

Some staff may be currently exempt from vaccination, including individuals:

  • Receiving end of life care where vaccination is not in the individual’s interests.
  • With learning disabilities or autistic individuals, or with a combination of impairments which result in the same distress, who find vaccination and testing distressing because of their condition and cannot be achieved through reasonable adjustments such as provision of an accessible environment.
  • With medical contraindications to the vaccines such as severe allergy to all COVID-19 vaccines or their constituents.
  • Who have had adverse reactions to the first dose (e.g. myocarditis).

Time-limited exemptions will also be available for those with short-term medical conditions or who are pregnant, should they choose to take it.

A temporary self-certification process was introduced in September 2021 (see letter and forms below) and this was promptly followed by the announcement of the new COVID Pass process for Medical Exemptions on 01 October 2021.

Letter on exemptions Claire Armstrong, DHSC Director of Adult Social Care Delivery

Medical exemption self-certification form

Self-certification form for people vaccinated abroad

The new COVID Pass process for Medical Exemptions is explained in updated government guidance here.  People applying for medical exemptions must do it at the earliest opportunity as they will not be able to work in care homes beyond 24 December 2021 if they cannot demonstrate a formal exemption, even if they have previously submitted a self-certificate.  The government anticipates that it will take most applicants 2 to 3 weeks from submitting information for the new COVID Pass to show their exemption.

 Planning for the future

  • Workforce planning - these resources can help you to develop your own workforce plan to help you ensure you have the right workforce to meet your business objectives and meet the needs of the people you provide care and support for.

 Recruitment and retention

  • Attract and recruit the right people - recruiting the right people, with the behaviours and values you're looking for, can result in better performance and lower staff turnover. 
  • Retaining your staff - guidance and tools to support you in retaining your workforce, resulting in less time and money spent on recruiting new staff and a happier, more productive workforce.

Managing people

  • People performance management - this guide helps managers prepare for difficult conversations with staff and explains some of the practical steps to consider. 
  • Supervision guide - regular supervisions provide the opportunity to discuss staff concerns and this guide helps managers to support staff.


The following resources are recommended for local authorities:

Shaping the adult social care market

  • Workforce productivity and quality model - commissioners and local authority quality assurance leads can use the model to work together with providers to increase productivity and quality with commissioned services and influence workforce planning and market shaping.
  • Commissioning and planning the workforce - guidance on planning the workforce so that the needs and aspirations of local individuals and communities are at its heart. 


Acas is an independent public body that receives funding from the government.

 They provide free impartial advice to employers, employees and their representatives on:

  • employment rights
  • best practice and policies
  • resolving workplace conflict

When things go wrong, they help to resolve workplace disputes between employers and employees.

They can work with you to provide tailored support and practical solutions to address challenges in your organisation.
Tailored support for your organisation
Coronavirus (COVID-19): advice for employers and employees
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