HMG Guidance for those who provide unpaid care to friends or family
This guidance is for anyone who cares, unpaid, for a friend or family member who, due to a lifelong condition, illness, disability, serious injury, a mental health condition or an addiction, cannot cope without their support.
It builds on other guidance published on GOV.UK, including the Stay at home guidance and the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults.
What we mean by clinically ‘vulnerable groups’ and clinically ‘extremely vulnerable groups’ in relation to COVID-19 infection
Following the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults, clinically vulnerable people are those who are at increased risk of severe illness from coronavirus infection (COVID-19). This group includes:
- those who are aged 70 or older (regardless of medical conditions)
- those under 70 with a specified, underlying health condition (for adults, this usually means anyone instructed to get a flu jab as an adult each year on medical grounds)
- pregnant women
There are some clinical conditions that put people at even higher risk of severe illness from COVID-19. If you, or the person you care for, are in this category, from the week of 23 March the NHS in England will be in contact with advice on the more stringent measures you should take in order to keep you and those you care for safe. You should follow measures in the Guidance for clinically extremely vulnerable (shielded) groups.
It is important to consider your personal situation. The section below on ‘If you or the person you care for has symptoms’ gives advice for people with different types of clinical vulnerability to COVID-19.
General advice
What you should be doing to prepare
Where you or the person you care for have no symptoms then please refer to the guidance on hygiene on the NHS website.
We advise all carers to create an emergency plan with the person they care for, to use in circumstances where help from other people to deliver care may be needed. Depending on the circumstances, this could be help from family or friends, or a care provider.
In order to create an emergency plan that fits the needs of the person you care for, you will need to set out:
- the name and address and any other contact details of the person you look after
- who you and the person you look after would like to be contacted in an emergency
- details of any medication the person you look after is taking
- details of any ongoing treatment they need
- details of any medical appointments they need to keep
You should also ensure that it is in a format that can readily be shared with other people who will need to discuss the plan with the person you care for.
Further information can be found at Carers UK.
You may be able to arrange help and support from family and friends, but it can be reassuring to have the involvement of your local authority or healthcare provider in case informal arrangements fall through. It may also be helpful to contact your local carers support organisation who can help with contingency planning. You can find out about local carer organisations at Carers UK.
You can also find information out about local services on the Carers Trust website.
Protecting yourself and the person you care for
Keep up to date with announcements and advice on GOV.UK and follow the latest advice set out in the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults, which includes tips on how to help protect a vulnerable person you live with.
Cleaning your hands frequently throughout the day by washing with soap and water for at least 20 seconds or using hand sanitiser will help protect you and the people you live with. This step is one of the most effective ways of reducing the risk of infection for you and other people. This includes when you arrive at the home of the person you care for, if you do not live with them, or have been out.
See specific situations below for what to do if you or the person you care for display symptoms.
Caring for someone who is clinically ‘extremely vulnerable’
The guidance on shielding and protecting the clinically extremely vulnerable people from COVID-19 gives details. From the week of 23 March, those in the clinically ‘extremely vulnerable’ group should also have received a letter from the relevant GP or specialist with further information.
If you are caring for someone who falls into the clinically ‘extremely vulnerable’ category for risk of severe illness from COVID-19, there are some simple steps that you can take to protect them and to reduce their risk. Ensure you follow advice on good hygiene:
- only care that is essential should be provided
- wash your hands when you arrive at the home of the person you care for and often thereafter, using soap and water for at least 20 seconds or use hand sanitiser
- cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- put used tissues in the bin immediately and wash your hands afterwards
- do not visit if you are unwell and make alternative arrangements for their care
- provide information on who they should call if they feel unwell, how to use the NHS 111 online coronavirus service and leave the number for NHS 111 prominently displayed
- find out about different sources of support that could be used and access further advice on creating a contingency plan is available from Carers UK
If the person you care for is concerned about their usual paid carer coming in and out of their home and the risk of infection
The government has issued guidance to home care providers to ensure that appropriate levels of hygiene are achieved to reduce the risk of infection. Speak to the care provider about the processes they are following to maintain good hygiene.
If the person you care for receives regular health or social care from an organisation, either through your local authority or paid for by themselves, inform their care provider that they are reducing social contacts and agree on a plan for continuing their care.
As a carer, the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults provides advice on the extra precautions you can take to help keep the person you care for safe.
Facemasks
We do not recommend the use of facemasks as an effective means of preventing the spread of infection, unless advised by a healthcare professional. Facemasks play an important role in clinical settings, such as hospitals, where staff are trained in the use of personal protective equipment (PPE) but there is little evidence of benefit from their general use outside of these settings.
If the person you care for is in a care home
If you have no symptoms, you should keep in contact with the care home to understand any local arrangement to keep in touch with residents and follow the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults. This guidance includes tips on how to maintain contact with relatives or friends such as staying in touch via phone or post where you are unable, or it is not advisable, to visit.
Maintaining your own health while you are looking after others
It is important that you look after your own health and wellbeing as well as supporting others you care for, especially given the potential for additional stresses at the current time and the potential for reduced access to support such as respite care. There is information in the Stay at home guidance and the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults about looking after your wellbeing, as well as more detailed guidance on self-care and sources of support for mental health and wellbeing during the outbreak.
Tips include taking care of your mind as well as your body and getting support if you need it. Daily physical activity is important for health and wellbeing, including managing stress, and encouraging positive feelings and sleep. You can look for ideas of exercises you can do at home from Public Health England (PHE).
Draw on support you might have through your friends, family and other networks during this time. Try to stay in touch with those around you over the phone, by post, or online. Let people know how you would like to stay in touch and build that into your routine. This is also important in looking after your mental wellbeing and you may find it helpful to talk to them about how you are feeling.
There are sources of support and information that can help, such as the Every Mind Matters website.
Remember it is OK to share your concerns with others you trust and in doing so you may end up providing support to them, too. Or you can use a NHS recommended helpline.
It may also be helpful to contact your local carers support organisation who can help with contingency planning. You can find out about local carer organisations at Carers UK. There is also an online forum on Carers UK.
Accessing alternative care quickly if you are unable to provide care
Having to organise alternative care can be difficult and concerning. Where possible, you should contact friends and family who may be able to give immediate help in providing care. You should follow the guidelines set out in the Stay at home guidance and the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults to protect those coming into the home of the person who needs care.
If you cannot organise alternative care you can contact your local authority or health care provider.
If you do not know how to do this, you can contact NHS 111.
If you need time off work to care for a relative who has symptoms or is self-isolating
You should talk to your employer about your caring needs and what arrangements can be put in place. Information regarding statutory sick pay entitlements can be found in the Guidance for employees.
Some people may be entitled to benefits as a carer, such as Carer’s Allowance. You should check on GOV.UK for further details.
Collecting prescriptions if you are self-isolating
If you normally collect prescriptions for the person you care for, you will not be able to do this if you are self-isolating. Most pharmacies provide a home delivery service. Telephone them to see if this is available or if there is another scheme running locally to help you access prescriptions.
Pharmacy delivery services will be under pressure at the moment, so it is important that you order your repeat prescriptions in good time, to avoid delays in dispensing. Information on repeat prescriptions and delivery services may also be available via your GP practice website.
If you or the person you care for has symptoms
If the person you care for has symptoms
The person you care for has symptoms, and you are not in a clinically ‘vulnerable group’ or clinically ‘extremely vulnerable group’ with increased risk of severe illness
If someone in your household has symptoms you should follow the Stay at home guidance which states that if you live alone and you have symptoms of COVID-19, however mild, you should stay at home for 7 days from when your symptoms started or until you are better, whichever is the longer.
If you live with others and you are the first in the household to have symptoms of coronavirus, then you must stay at home for 7 days, or until your symptoms have gone, but all other household members who remain well must stay at home and not leave the house for 14 days.
The 14-day period starts from the day when the first person in the house became ill. For anyone else in the household who starts displaying symptoms, they need to stay at home for 7 days from when their symptoms appeared – or until their symptoms have gone, whichever is the longer – regardless of what day they are on in the original 14-day isolation period.
However, we appreciate following the Stay at Home guidance may not be easy to achieve where you provide close contact care, such as washing and bathing, for a spouse or relative.
If you do not fall into the clinically ‘vulnerable group’ or the clinically ‘extremely vulnerable group’ you can continue to provide care. You should review the above guidelines to take measures to protect yourself and others in the household as best you can by following advice on hygiene and distancing where possible.
Information on cleaning and hygiene when caring for someone with symptoms
The Stay at home guidance provides information on washing your hands, cleaning and disposing of waste, and cleaning laundry, as well as other information for those living with a vulnerable person.
The person you care for has symptoms and you are in a clinically ‘vulnerable group’ (see above)
If someone in your household has symptoms you should follow the Stay at home guidance which states that if you live alone and you have symptoms of COVID-19, however mild, stay at home for 7 days from when your symptoms started.
If you live with others and you are the first in the household to have symptoms of coronavirus, then you must stay at home for 7 days, but all other household members who remain well must stay at home and not leave the house for 14 days.
The 14-day period starts from the day when the first person in the house became ill. For anyone else in the household who starts displaying symptoms, they need to stay at home for 7 days from when the symptoms appeared, regardless of what day they are on in the original 14-day isolation period.
You should also review the Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults for information about those people who are considered at increased risk of severe illness from coronavirus (COVID-19). If you are within this group, you should be particularly stringent in following social distancing measures set out in the guidance.
However, we appreciate this may not be easy to achieve where you provide close contact care for a spouse or relative such as washing and bathing.
Where possible ask friends and family who can support you in providing care. You should distance yourself from the person you care for as much as possible and follow the above guidance.
You can find out about local carer organisations at Carers UK or through your local authority.
The person you care for has symptoms and you are in a clinically ‘extremely vulnerable group’ (see above)
As per the guidance for clinically extremely vulnerable groups, you should strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19).
Where possible, ask friends and family who can support you in providing care for their help. You should distance yourself from the person you care for as much as possible and follow the above guidance.
If you cannot organise alternative care you can contact your local authority or health care provider. If you do not know how to do this you can contact NHS 111. It may also be helpful to contact your local carers support organisation. You can find out about local carer organisations at Carers UK.
If you are a carer and you have symptoms
If someone in your household has symptoms you should follow the Stay at home guidance which states that if you live alone and you have symptoms of COVID-19, however mild, stay at home for 7 days from when your symptoms started.
If you live with others and you are the first in the household to have symptoms of coronavirus, then you must stay at home for 7 days, but all other household members who remain well must stay at home and not leave the house for 14 days.
The 14-day period starts from the day when the first person in the house became ill. For anyone else in the household who starts displaying symptoms, they need to stay at home for 7 days from when the symptoms appeared, regardless of what day they are on in the original 14-day isolation period.
However, we appreciate this may not be easy to achieve where you provide close contact care for a spouse or relative such as washing and bathing.
If you care for a person in a clinically ‘vulnerable group’ do not visit if you are unwell and make alternative arrangements for their care with family members and friends. If you cannot organise alternative care you can contact your local authority or NHS trust.
If you care for a person in a clinically ‘extremely vulnerable group’, you should strictly avoid contact with the person you care for and, where possible, ask friends and family who can support you for help in providing care. You should distance yourself from the person you care for as much as possible and follow the above guidance.
If you cannot organise alternative care you can contact your local authority or health care provider. If you do not know how to do this, you can contact NHS 111. It may also be helpful to contact your local carers support organisation. You can find out about local carer organisations at Carers UK.