COVID-19: Testing

Testing guidance

Please find below tables outlining what testing providers need to do, this is based on the guidance, which can be found here:


Care home autonomy to initiate COVID-19 Outbreak management risk-asessments 

In the event of a COVID-19 outbreak, care homes can now begin to  initiate their  own risk-assessments should they   feel able to do so. This means care homes can determine and implement proportionate and risk-based outbreak measures relevant for the individual setting. As part of the updated guidance, care homes should:

  • Continue to inform the local health protection team (HPT) of a suspected outbreak as per previous guidance, but updated guidance means  you are no longer required to wait for advice from the HPT (or other relevant partner ) should you  feel able to initiate a risk assessment independently
  • Follow updated guidance set-out in the  COVID-19 supplement to the infection prevention and control resource for adult social care – GOV.UK (www.gov.uk) to establish if cases are linked and determine outbreak measures, if opting to initiate the risk assessment
  • Ensure any measures implemented are proportionate, risk-based and temporary
  • Continue to facilitate  visiting during an outbreak. In all circumstances, each resident should as a minimum be able to have one visitor at a time inside the care home, and end-of life visiting should always be supported
  • Initiate rapid response testing and outbreak testing in line with updated guidance as soon as possible. This is set-out in the  Coronavirus (COVID-19) testing for adult social care services – GOV.UK (www.gov.uk) Providers do not need to wait for HPT advice to do so
  • Ask for further support where necessary from the local HPT (or other local partner) if you  need further advice or if there are specific issues of concern.

Outbreak Testing changes for small care homes

Coronavirus (COVID-19) testing for adult social care services – GOV.UK (www.gov.uk) has been updated on 15/12/22 to streamline outbreak testing specific to  small care homes in line with the latest evidence and to advise when rapid response testing is relevant for small care homes . A small care home is defined as 1 to 10 beds .

Providers should move to this guidance by 22 December , but can begin to implement the new guidance before this as soon as feel able to do so

  • Small care homes should continue to undertake rapid response testing in the event of one positive case to help determine if an outbreak may be occurring.
  • Small care homes should initiate outbreak testing as soon as possible if two or more cases are identified as there is a higher likelihood that the cases are linked due to the close networks in small settings.
  • Small care homes may opt to undertake both rapid response and outbreak testing or just outbreak testing. Please refer  COVID-19 testing in adult social care – GOV.UK (www.gov.uk) to determine if rapid response testing has value.
  • Small care homes no longer need to undertake PCR  outbreak recovery testing of all staff and residents 10 days after the last individual developed symptoms or tested positive. This is because transmission is likely to occur early in the outbreak with less potential for hidden chains of transmission in small populations. Instead, the outbreak can be declared over once all resident self-isolation periods are over.

It is up to a service to determine and be prepared to evidence that small care home guidance applies to them if the size of the care home is above 10 beds. For example, if there are individual units or floors with completely separate staff and residents who do not mix with other staff and residents outside of this unit or floor.


Public Health Testing update:

As of 31st August 2022

The vaccination programme means COVID-19 cases have now fallen to 40,027 and the risk of transmission has reduced. Deaths have fallen to 744 and hospitalisations to 6,005 in the last 7 days. Therefore whilst prevalence of COVID-19 is relatively low, adult social care staff should no longer conduct regular asymptomatic staff testing. This is in line with updated national guidance and will take effect from the 31/8/22

  • Adult social care staff working in settings where asymptomatic testing of staff and patients or residents is undertaken will be paused until further notice.
  • Visitors providing personal care to residents are no longer required to test before visiting a care home.
  • Symptomatic testing in high-risk settings will continue.
  • Testing will continue for outbreaks in certain high-risk settings such as care homes.
  • Testing will remain in place for admissions into care homes and hospices from both hospitals and the community, and for transfers for immunocompromised patients into and within hospital to protect those who are most vulnerable.
  • Care homes enrolled in the Vivaldi study may be asked to undertake additional asymptomatic testing to support ongoing research and surveillance in the sector. Care homes that participate in this study should follow any separate guidance they receive.

All other existing guidance remains valid and in place and the infection prevention control measures advised by public health are even more important at this time in order to keep us moving in the right direction and keep case rates and outbreaks to a minimum.


Asymptomatic testing for social care

As of the 4th of April 2022, the following groups continue to qualify for free testing via the national portal

  • Care Homes
  • Extra care and supported living settings are eligible if they meet one of the following criteria:
    • the setting is a closed community with substantial facilities shared between multiple people
    • it is a setting where the majority of residents (more than 50%) receive the kind of personal care that is CQC-regulated (rather than help with cooking, cleaning and shopping)
  • Day care centres – run by paid care staff, for adults over 18 and provided within non-residential care settings that support the health and wellbeing of adults.
  • Personal assistants if directly employed by an individual (or self-employed) to provide care and support to an adult to enable them to live as independently as possible.
  • Shared Lives carers are eligible if they are working with a regulated Shared Lives scheme to provide care and support to an adult to enable them to live as independently as possible. This includes both carers who live with the person they support and those who live separately.

Some key points:

  • Recording of all test results, including negative and void is encouraged
  • Staff who have tested positive within 90 days should only be tested using LFT’s
  • Tests can be accessed via this link : Apply for getting onboarded – GOV.UK (test-for-coronavirus.service.gov.uk) If you do not know your organisation’s UON, this can be found here or by calling 119
  • Please remember day 1 is the day after the positive result or when symptoms start, the day of the positive result or the day symptoms start is defined day 0.

 

Staff Residents
Asymptomatic testing for the eligible groups Asymptomatic testing of staff paused until further notice (as of 31st Aug 2022) in line with government guidance. No asmptomatic testing of residents
Contacts of COVID cases

Are able to continue to work but should comply with IPC and PPE guidance. They no longer need to undertake any additional testing.

If the staff member develops symptoms, they should follow the guidance for staff with symptoms

Users who are contacts of confirmed COVID-19 cases are. advised that they minimise contact with the person who has COVID-19, avoid contact with anyone who is at higher risk of becoming severely unwell if they are infected with COVID-19, especially those whose immune system means that they are at a higher risk of serious illness, despite vaccination and follow the advice regarding testing and isolation if they develop symptoms of COVID-19

 

Care Homes and Supported Living sites

Staff Residents

Outbreak testing in care homes

UKHSA Health Protection Team will only follow up  outbreaks where there are 3 residents or more, especially if  any of the factors mentioned above  are also present

Staff should complete a PCR (who are not previously positive in the last 90 days) and LFT:

  • On day 1
  • On one day between day 4 -7

Outbreak recovery testing (all staff who are not previously positive in the last 90 days tested via PCR) should be completed on Day 10 after last positive case

Residents should complete a PCR (who are not previously positive in the last 90 days) and LFT:

  • On day 1
  • On one day between day 4 -7

Outbreak recovery testing (all residents who are not previously positive in the last 90 days tested via PCR) should be completed on Day 10 after last positive case.

This should be a PCR test only.

Rapid response testing in care homes and high risk extra care and Supported Living sites (If one or more positive cases in staff or residents are found)

Staff should complete LFD testing daily for 5 days.

This is not extended if further positive cases are found within 5 days.

Symptoms developed If a staff member develops symptoms (Symptoms of coronavirus (COVID-19) – NHS (www.nhs.uk), then they should stay at home and take an LFD immediately. If the result is negative they should take another LFD 48 hours after the last test. If both are negative, then they can return to work if well enough to do so.

Residents who have symptoms of COVID-19 should isolate and take 2 lateral flow tests: as soon as they develop symptoms (day 0); and another lateral flow test 48 hours after the first test (day 2) to confirm their COVID-19 status.

If negative, then they can return to their usual activities if well enough to do so. 

Positive result

The staff member should not attend work until they have had 2 consecutive negative lateral flow test results (taken at least 24 hours apart), they feel well, and they do not have a high temperature.

The first lateral flow test should only be taken from 5 days after day 0. If both lateral flow tests results are negative, they may return to work immediately after the second negative lateral flow test result on day 6, if their symptoms have resolved, or their only symptoms are cough or anosmia which can last for several weeks.

If the staff member cares for people who are at higher risk of becoming seriously unwell with COVID-19, a risk assessment should be in place and consideration given to redeployment until 10 days after their symptoms started (or the day their test was taken if they did not have symptoms).

If the LFT is still testing positive after day 10, the staff member can return to work with a single negative lateral flow test

If the staff member is still testing positive on day 14, they can return to work on day 15 but risk assessment should be undertaken

Residents who test positive for COVID-19 should isolate for 10 days and take part in daily lateral flow testing from day 5. They can end self-isolation after receiving 2 consecutive negative tests 24 hours apart, or after 10 days’ isolation.

If the resident, is unable to test they should be isolated for the full 10 days following a positive test. Isolation should only be stopped when there is an absence of fever (less than 37.8°C) for 48 hours without the use of medication.

 

Day opportunities / Home Care

Staff Residents
Symptoms developed

If a staff member develops symptoms (Symptoms of coronavirus (COVID-19) – NHS (www.nhs.uk), then they should stay take an LFT immediately and stay away from work. This should be followed by another LFT 48 hours after the last test. If both are negative, then they can come out of isolation. Staff are able to work if medically fit to do so.

If an individual who uses the service develops symptoms, they should not attend the day opportunities until their symptoms have ended or their only symptoms are cough or anosmia which can last for several weeks.

If this decision puts the individual at risk, then contact the placing social care team (if care act eligible) 

Positive result

The staff member should not attend work until they have had 2 consecutive negative lateral flow test results (taken at least 24 hours apart), they feel well, and they do not have a high temperature.

The first lateral flow test should only be taken from 5 days after day 0. If both lateral flow tests results are negative, they may return to work immediately after the second negative lateral flow test result on day 6, if their symptoms have resolved, or their only symptoms are cough or anosmia which can last for several weeks.

If the staff member cares for people who are at higher risk of becoming seriously unwell with COVID-19, a risk assessment should be in place and consideration given to redeployment until 10 days after their symptoms started (or the day their test was taken if they did not have symptoms).

If the LFT is still testing positive after day 10, the staff member can return to work with a single negative lateral flow test.

If the staff member is still testing positive on day 14, they can return to work on day 15 but risk assessment should be undertaken.

If an individual has positive test result due to being tested by family or another service, they should stay away from the service for 10 days or they have had 2 consecutive negative lateral flow results (taken at least 24 hours apart), they feel well and they do not have a high temperature.

The first lateral flow test should only be taken from 5 days after day 0 (the day their symptoms started, or the day their test was taken if they did not have symptoms).

Any individual who is unable to test should be isolated for the full 10 days following a positive test. Isolation should only be stopped when there is an absence of fever (less than 37.8°C) for 48 hours without the use of medication.

If this decision puts the individual at risk, then contact the placing social care team (if care act eligible).

 

Test kit expiry dates

 It has been brought to our attention that several test kits gave unreadable results.

To make sure you are using valid tests and minimise the chance of further void results, it is important to always note the expiry date and use tests in the order they were received. Dispose of any expired tests and those within one week of expiry. Any expired tests will be classed as void.

If you have any questions or doubts, please call the hub 01707 708108 / assistance@hcpa.co.uk

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