This is the latest information from Department of Health & Social Care.
Who this guidance is for
This guidance aims to help care staff keep people with learning disabilities and autistic people safe, to support them to understand the changes they need to make during the COVID-19 outbreak, and to protect their own wellbeing.
It builds on the COVID-19 adult social care action plan and more detailed guidance published by the Social Care Institute for Excellence which will continue to be updated with resources to support those who care for people with learning disabilities and autistic people. The advice and resources may also be helpful for those supporting people with other needs relating to a cognitive impairment, such as dementia or mental health conditions.
When following this guidance, it is important to note that people with learning disabilities and autistic people will have unique needs and preferences. They are more likely to need support to understand the current measures, such as the stay at home guidance, and any changes to their care and support provision. All care and support should continue to be given in the least restrictive way possible and continue to maximise independence wherever possible. More guidance is in the supporting the person through change section.
Protecting yourself and the person you care for
Keep up to date with announcements and advice on GOV.UK and follow the latest advice as set out in:
- guidance on infection prevention and control, which includes advice on appropriate use of personal protective equipment (PPE) in specific settings and general best practice to prevent infection, including effective hand hygiene
- guidance for supported living and home care provision which includes advice on delivery of care, cleaning and laundry
- guidance on admission and care of people in care homes
- guidance on social distancing and protecting vulnerable adults
- guidance on shielding and protecting people defined as extremely vulnerable on clinical grounds
- NICE and SCIE guide for managers and staff in care homes
You must also keep up to date with guidance that supports care and support planning during the outbreak, being mindful of any updates to statutory duties. The latest advice is set out in:
- easements to the Care Act
- The ethical framework for adult social care
- guidance on looking after people who lack mental capacity
Maintaining good hygiene practices
Detailed advice about maintaining good hygiene practices is set out in the guidance on infection prevention and control, and the guidance for supported living and home care provision.
Important points to consider when supporting people with learning disabilities and autistic people:
- Cleaning your hands frequently throughout the day by washing with soap and water for at least 20 seconds or using hand sanitiser is one of the most effective ways of reducing the risk of infection. Both you and the person you support should do this. The need for this should be explained to the person you support in the way they are most likely to understand, and any potential skin care issues addressed.
- The person you care for is likely to have a care plan which maximises self-care – this must be closely followed to reduce the need for hands on personal care where possible.
- Where guidance recommends use of PPE, you should ensure that the person you care for understands why it is being used.
Many people caring for someone will already have contingency plans in place in case someone is unable to continue in their caring role. If you are worried that you or your organisation do not have a plan in place, then you can make a start by:
- talking to the person you support and involving them as much as possible in producing a plan and what to expect
- writing down any key contacts (family, neighbours, friends or professionals) who can be called upon for assistance
- making sure that information about the support the person needs is available, particularly if they would not be able to communicate this for themselves – for example, information about specific needs, medication, routines and supplies
- working with local social care and health staff such as social workers and learning disability nurses who can support you in developing and sharing these plans
If you have symptoms of COVID-19
If you have symptoms of COVID-19, you should closely follow the stay at home guidance which provides full details of when and how to self-isolate.
If you require alternative arrangements to be put into place at work, you should talk to your employer who will be responsible to make arrangements. The guidance for employers sets out the processes that are in place and support that is available.
If the person being cared for has symptoms of COVID-19
If the person being cared for has symptoms or is part of a household that is isolating, you must follow the advice set out in the guidance for supported living and home care provision and on the use of PPE for health and social care workers.
There are some simple steps that can be taken to protect the person you care for and reduce their risk:
- closely follow the guidance on infection prevention and control to maintain good hygiene and infection control practice
- provide information on who the person should call if they feel unwell, how to use the NHS 111 online coronavirus service and leave the number for NHS 111 prominently displayed
- consider whether there are tasks that you have usually done hands-on with a person, where prompting or alternative arrangements may now be possible instead
Caring for someone who is clinically ‘extremely vulnerable’ (shielding)
People with learning disabilities and autistic people are often at a generally higher risk of respiratory illnesses. However, a few with very specific health conditions may be clinically defined as ‘extremely vulnerable’. The guidance on shielding and protecting the clinically extremely vulnerable provides full details on how to care for someone who falls into this category.
The NHS in England is directly contacting people with these conditions to provide further advice. If you think the person you care for falls into one of the categories of extremely clinically vulnerable people and they have not received a letter or been contacted by their GP, you should discuss your concerns with their GP.
Supporting the person through change
Changes in routines and care can be particularly stressful for people with learning disabilities and autistic people, and the measures that have been put in place during the outbreak will be bring additional challenges in how best to support and how best to communicate change to them.
It is important that accessible information is provided to support the person you care for to understand the outbreak and the measures introduced. There may be a need for more considered solutions, especially as the person you care for may be anxious about the current situation. You may also need to consider how to manage behaviour that challenges, particularly if usual techniques are not appropriate or possible during the outbreak.
There are some steps you can take and guidance you can follow to support the person you care for through change:
- The principles of ‘Respect’ and ‘Inclusivity’ as outlined in the ethical framework for adult social care provide useful considerations which will support your decision making and planning.
- Think about the things that can remain consistent, for example, whether it is possible to keep contact with the usual staff who provide support with certain tasks.
- Try to explain in simple and familiar terms why things are changing, emphasising what will remain normal and how long change will likely last for.
- Consider where you can support the person you care for to continue doing what they enjoy and what calms them. The guidance on mental health and wellbeing offers examples of activities that can be done at home.
- The Challenging Behaviour Foundation has helpful resources, including a visual summary of what to do if the behaviour of the person you support changes and begins to challenge.
It is important to point the person to resources which are accessible and can explain the outbreak and latest guidance, such as:
- easy read overview of COVID-19
- easy read explanation of social distancing
- easy read overview of shielding the clinically 'extremely vulnerable'
- MENCAP resources
- World Health Organization guide to effective hand-washing
The guidance on social distancing sets out the restrictions in place during the COVID-19 outbreak and the circumstances in which you are allowed to leave your home.
It is important that the person you care for understands why it is important to maintain a social distance, and what may happen if they do not. An easy read explanation of the current guidance is available.
However, if the person in your care has a specific health condition which requires them to leave their home to maintain good health – including if that involves reasonable specific travel beyond your local area – then they can do so. This could, for example, include where people with learning disabilities or autistic people require specific exercise in an open space 2 or 3 times each day – ideally in line with a care plan agreed with a medical professional.
Wherever possible, you should support the person to continue their usual activities outside, in line with the guidance on social distancing. If it is not possible to continue their usual activities outside, alternative arrangements should be considered. These may include accessing online services such as food delivery or online prescription orders.
You may be able to access help from COVID-19 Mutual Aid UK which provides voluntary support to those who are in need. You may want to approach your local authority, who are strategically supporting these groups, so you can access safe, appropriate support.
Coping with bereavement
It is possible that the person you care for may experience the death of someone they know during this period or may experience anxiety at deaths reported in the media. In this instance, it is important to have open and honest discussions about death and coping with the person you care for.
The links below provide accessible resources to support communicating death to people with learning disabilities and autistic people:
- NHS advice on coping with bereavement
- Beyond Words guide for when someone dies from coronavirus
- CWP NHS Trust bereavement guide for carers
- MENCAP guide to dealing with bereavement
Maintaining your own health and wellbeing
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. The government is committed to supporting the social care workforce throughout the outbreak and sets out its plans in the COVID-19 adult social care action plan.
There is information in the stay at home guidance and the guidance on social distancing 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. You can find tips and advice for frontline health and care workers in the MindEd COVID-19 Resilience Hub.
Remember it is ok to share your concerns with others you trust and in doing so you may be able to provide support to them too. There are sources of support and information that can help, such as NHS recommended helplines and the Every Mind Matters website.