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COVID-19 testing for care homes

 

Who is eligible?

The department of Health and Social Care (DHSC) has made regular repeat testing available to all care homes (staff, residents and visitors) registered with the Care Quality Commission (CQC).

 


 

What type of test is recommended?

The DHSC recommends the use of PCR and LFD tests in care home settings for both staff and residents.

In addition, the DHSC recommends the use of LFD test kits for visitors.

 


 

What is the recommended testing regime?

Routine testing

The DHSC recommends staff in care homes should routinely:

  • PCR test once per week
  • LFD test twice per week – one LFD test should be completed on the same day as their PCR and the other LFD test three to four days later. LFD testing should be completed before their shift begins.

DHSC recommends residents in these settings should routinely:

  • PCR test once per month
  • Consider the use of LFD testing to facilitate safe visiting out of care homes

In addition, from Monday 21 June 2021, new residents admitted from the community to care homes, in specific circumstances to prevent the requirement to isolate for fourteen days, should:

  • PCR test prior to their admission
  • PCR test on the day of their admission
  • PCR test seven days after their admission

Single positive case in a care home

In the event of a single suspected or confirmed COVID-19 case (staff or resident), staff should start rapid response daily testing for seven days (noting this does not apply to staff who are exempt from testing due to the 90 day rule, unless symptomatic). This means staff should LFD test for seven consecutive days.

Outbreak in a care home

In the event of two or more positive cases (staff or resident / suspected or confirmed), detected in a care home in the same fourteen day period, the following enhanced testing regime should be implemented (noting this does not apply to staff and residents who are exempt from testing due to the 90 day rule, unless symptomatic):

  • Day one: conduct a PCR test and an LFD test for staff and residents
  • Staff should LFD test daily, until there have been no new positive COVID-19 cases for five consecutive days (staff or residents)
  • Between days four to seven: conduct a PCR test and an LFD test for staff and residents
  • Continue with the routine testing for staff
  • Fourteen days after the last positive COVID-19 case, conduct a PCR test and an LFD test for staff and residents

If there are no further positive COVID-19 cases, the outbreak may be declared over after day fourteen, unless a variant of concern (other than Alpha) is identified.

If there are further cases after day fourteen and/or a variant of concern (other than Alpha) is identified, additional measures will be discussed by Public Health England and/or the council, which may include delaying end of outbreak testing until twenty-eight days after the last positive COVID-19 case.

Family / relatives visiting a care home should test using a LFD test on the day of their planned visit.

For visiting professionals, care homes should refer to the visiting professionals guidance to determine whether to accept evidence from an existing testing regime or if the professional is required to take an LFD test on-site.

 


 

How are test kits ordered?

Care homes have an individual Unique Organisation Number (UON).

To order LFD and PCR test kits, care homes are required to log on to the portal and input their UON.

The care home will need to select if the type of test kit they require; noting you can order PCR and LFD test kits separately, as required.

The care home will need to review their details, including delivery address, number of staff and number of residents for each order placed.

The portal will calculate the number of PCR and LFD test kits required, including LFD test kits for visitors, based on the current occupancy of the care home.

If a care home orders LFD test kits, they will receive a small number of additional confirmatory PCR test kits with this order.

Once an order has been placed, the care home representative will receive confirmatory email. The care home will receive a second email to advise of the delivery arrangements.

The portal will tell the care home when they are next able to order test kits.

 


 

How do you test?

PCR and LFD tests require a combined throat and nasal swab. Where it is not possible to take a combined swab, a nasal swab (both nostrils) is sufficient. Further information can be found the care home testing guidance.

PCR tests should be completed in the care home. 

It is recommended care home staff complete the COVID-19 care home swabbing online individual competency assessment to improve the success of the swab test.

Staff members can self-swab. Residents can also self-swab if they wish to, and should watch the self-swabbing instruction video.

Each PCR test kit contains instructions on how to complete a PCR test, how to store them and pack them safely for their return to the laboratory.

Registering PCR test kits is essential, as without registration the laboratory will not be able to process your PCR test kits and return the result.

A care home can register single or multiple test kits, using a barcode scanner (advice on how to use this device can be found on the registration portal), as appropriate, following the specified steps.

Prior to commencing PCR testing, a care home should book a courier using their UON. 

A care home must book a courier before they start testing and have completed testing, and packaged the PCR test kits appropriately, before the courier arrives. If the courier does not arrive, a care home should contact 119 in the first instance.

LFD tests are recommended to be completed on site for staff, residents and visitors, where possible. Noting, care homes should refer to the visiting professionals guidance to determine the requirement to test on-site.

Staff and visitors can also LFD test at home, using the blue boxes containing seven test kits only.

Staff completing LFD tests should complete a short mandatory training module; settings should use the token code: 3wkcVi4UTX to access this training and create an account.

Care home COVID-19 testing guidance contains information on the steps a care home needs to take to safely test on-site, including creating a designed area and the associated processes.

As per PCR testing, a care home can register single or multiple test kits, using a barcode scanner (advice on how to use this device can be found on the registration portal), as appropriate, following the specified steps.

If a staff member or visitor is testing at home, it is important to remind them every LFD result should be reported online, using the UON of the care home.

The DHSC have produced a range of supporting guidance notes detailing testing on and off site, which should be shared with staff and visitors.

 


 

How are results reported?

The details used to register the PCR and LFD (if uploaded by the care home) test kit will receive an email and text message, containing the results.

A staff member, resident or visitor should immediately isolate and inform the setting if they test positive for COVID-19.

If a person receives a positive LFD result, they should take a confirmatory PCR test within two days of the initial LFD test.

 


 

What are the reporting requirements?

Care homes are required to report COVID-19 cases to Public Health England.

Care homes should regularly update the Capacity Tracker, including if there are positive COVID-19 cases in their service (staff or residents).

Care homes do not need to notify CQC of individual positive COVID-19 cases in their service, but should notify CQC if COVID-19 affects the day to day running of their services.

 


 

Help and information 

If a care home is unable to locate their UON, they can use the online organisation look up function or contact the council.

COVID-19 testing in care homes and COVID-19 testing for adult social care settings contains a range of useful documents and summaries, detailing the step by step process and different recommended testing regimes.

The admissions to care homes is a useful guide about requirements on admission and isolations requirements for residents.

COVID-19 working safely in care homes is useful, including detailing PPE requirements.

Visiting care homes and facilitating visiting out of care homes guidance notes also details information in respect of testing recommendations / requirements.

Care homes should contact 119 in the first instance for testing issues, including:

  • Test kit order and supply issues
  • Courier issues
  • Missing test results

Alternatively they can contact the council for further support if 119 have been unable to help.

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