Coronavirus (COVID-19) adult social care building-based day services: guidance

Introduction and context

This guidance is for regulated building-based day services for adults. Other guidance is available on re-opening registered school age childcare services.

Adult day services provide supported people with opportunities to participate in a wide range of stimulating and enjoyable activities in a safe, social setting. Importantly, this may also support unpaid carers to have a break from their caring responsibilities, and support the health and wellbeing of both the unpaid carer and person using the service.  The approach and form of support will vary according to the needs of the supported person and the carer. 

The majority of building-based day services for adults were closed following Scottish Government advice in March that day services posed significant risks to client groups from COVID-19. The closure of these settings has undoubtedly had an impact on the lives of supported people and unpaid carers throughout Scotland. There was little time to prepare for the changes and relationships and support were interrupted. 

People continued to need support during lockdown and people’s needs may have changed. Many local authorities and services providing day services worked collaboratively through Health and Social Care Partnerships (HSCPs) to adopt new models of delivery to support those who needed it. Some used online and activity-based support or a blended approach to address the reduced capacity in physical spaces. There was however, additional pressure placed on many unpaid carers to pick up where support was reduced or not available. 

That is why Scotland’s route map through and out of the crisis includes “access to respite/day care to support unpaid carers and for families with a disabled family member” as part of Phase 1. There has been a phased remobilisation of various forms of modified support since Phase 1, and this must continue in order to relieve some of the pressure on families and unpaid carers. This reflects a focus on ensuring that social care support is maintained with minimal interruption to ensure the safety, dignity and human rights of those who need support and their unpaid carers.

We know there will be many considerations for adapting and re-opening services after a significant interruption. Scottish Government’s focus is on supporting local authorities and other service providers to ensure people receive the support they need in an enjoyable and dignified way, while meeting the requirements of all core public health measures in relation to hygiene and the prevention and control of the spread of infection.

However, given the extent of the impact of COVID-19 across society, it may take some time to ensure the appropriate modifications are in place. Local authorities and other service providers will need to be mindful of the impact of other ongoing recovery efforts, such as the return of schools. Services will also need to be aware of and respond to changing levels of infection risk in their local community and comply with any local lockdown measures, if introduced. 

The wide range of user groups and settings for building-based adult day services means that there is no ‘one size fits all approach’. Some supports will take longer than others to re-open in a way that is safe for both the people using them and staff working in them. Each service needs to follow existing infection prevention and control measures and tailor procedures to their own particular setting and circumstances, and to the individual circumstances of each person and family they support. 

Ongoing physical distancing requirements for the general population must be followed between supported people, which means that support will look different. Many services will need to operate at reduced capacity compared to before COVID-19. It will therefore remain vital to maximise the availability of other forms of support alongside re-opening building-based adult day service settings. 

If supported people are unable to, or choose not to, attend the service once re-opened for any reason, consideration should be given to what other support may be available to them in order to meet their needs. People should be fully involved in all decisions about the support that would suit them best, and those eligible for social care support may wish to explore whether moving to a different self-directed support option would support their goals. 

Coordination and communication with all partners will be key to a successful remobilisation. Service providers, whether they are local authority, private or independent services, should ensure that they are properly engaging with their local Health Protection team and the Care Inspectorate to ensure the safety of all those attending. They should also engage with their staff, supported people and unpaid carers regarding the re-opening of the service, and the modifications that will be required. This is key to ensuring decisions made are suitable, and staff, supported people and unpaid carers feel comfortable and confident in returning to the setting.