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Covid-19 testing and infection control

 


  

Latest update 14 August 2020

Randox recall - more information from DHSC

Following theirits, DHSC have now provided care homes with detailed instructions on how to return the kits.  A copy of the instructions can be downloaded here: 

Randox recall instruction DHSC130820  (180 KB)

Care Home Regular Testing Programme

As a result of a numbers of factors including rising demand across testing and unexpected delays, DHSC has not been able to deliver test kits to all care homes for older people and people with dementia as quickly as they had hoped.  The timelines for distribution of kits for re-testing has been revised as follows:

  • Those care homes for older people and people with dementia who have already successfully registered for test kits should now receive their kits by 7 September 2020
  • If care homes have already started regular testing, there may be a wait for their second month’s order to be fulfilled until all care homes for older people and people with dementia have received their first delivery
  • All other adult care homes will be able to start to place orders for test kits from 31 August 2020. 

However, DHSC have also advised that in the period up to 7 September they will prioritise providing test kits to care homes in areas on the Contain Framework Local Authority Watchlist.  If this list continues to grow, it may have an impact on how soon kits will be delivered to Staffordshire homes. It should be noted that neither Staffordshire nor Stoke-on-Trent are currently on the Watchlist.

Further information on Care Home Regular Testing Programme and testing in the event of an outbreak can be found in this DHSC information sheet for care providers.

Changes to guidance on re-testing individuals who previously tested positive

Please note the guidance in relation to re-testing any individual who has previously tested positive has changed, any individual that tests positive should not be tested for six weeks, (previously 28 days). This is because any repeat test would likely give a positive result due to the residual virus within the individual’s system. The DHSC have confirmed that following the relevant isolation period (14 days for care home residents, 10 days for everybody else) the individual would no longer be contagious if they are not displaying symptoms and there is no residual clinical risk of transmission.

Bulk Registration of Tests

DHSC have recognised that that registering tests individually is unnecessarily burdensome. From the 7 August 2020, care homes will be able to bulk register tests, which will speed up the process and alleviate the administrative burden. Guidance will be issued about how the bulk registration process will work and it will be covered in the regular DHSC webinar - DHSC testing webinar Please note: this relates to registering completed swab kits prior to courier collection for processing at the lab, not placing an order for repeat test kits.

Recent Press Announcements LampORE rapid testing

On 3 August DHSC shared an update about “encouraging progress with the LampORE rapid tests ... which has been found to detect the presence of COVID-19 in under 90 minutes”.  There will be a validation programme over the next few weeks at regional laboratories. Should the results be as expected, DHSC will look to roll out this technology more widely.

Department of Health and Social Care (DHSC) update - 4 August 2020

The latest update from DHSC has information on:

  • Whole home testing programme update
  • LampORE rapid testing
  • Bulk registration of test kits
  • Unique Organisation Numbers to access services across all DHSC testing portals
  • Practical tips to prepare test kits 
  • Reminder of the outbreak management and rapid testing for care home outbreaks
  • a link to DHSC's regular care home testing webinars which we recommend your staff join.  

DHSC update 4 August 2020 (211 KB)


 

Symptoms

The main symptoms of coronavirus are:

  • high temperature - this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • new, continuous cough - this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  • loss or change to your sense of smell or taste - this means you've noticed you cannot smell or taste anything, or things smell or taste different to normal.

Most people with coronavirus have at least one of these symptoms.


  

Testing arrangements for care staff who are symptomatic

Care workers (or members of their family) who are symptomatic can access testing through the national testing programme.  ‘Care workers’ includes those working in nursing, residential and home care, as well as supported living, extra care and day services.

Please make your teams aware of the testing offer and ensure you have the necessary processes in place to access it. 

Staff with symptoms can access a test through the national testing system either by self-referral or employer referral if the locations are more convenient. The Bet365 Stadium in Stoke-on-Trent and Stafford Education and Enterprise Park, Beaconside have been accepted as regional testing sites.  Temporary Mobile Testing Units are also being deployed, although the location of these may change from time to time.

To book a test at either of these sites, you should book online through the National Testing Programme’s self-referral or employer referral portals. Please note that these regional centres will provide testing to all people showing coronavirus symptoms, not just critical workers, and whilst they may be very busy the Government has advised that essential workers will be given priority.  Tests can be arranged by appointment at either one of the regional testing sites or a mobile testing unit dependent upon the closest available site.  It is important to note that bookings at these sites are managed via a national portal and as such the local system has no control or influence over location or availability.  Alternatively, there are a limited number of self-administered home testing kits available for delivery.

 


 

Blanket testing in care home settings 

We understand that testing of staff and residents is a major concern for care homes, and we are doing everything we can to ensure care homes have the information and support they need. The Coronavirus Testing Guidance for Care Homes below should help you to understand the testing routes and options available to you, it is updated regularly and has information on:

  • Outbreak management and rapid testing for care homes
  • Whole home testing
  • Consent to test a resident
  • How to book a courier
  • Testing on hospital discharge
  • Testing admissions to a care home
  • Care home testing process map
  • FAQs

Coronavirus testing guide for care homes (507 KB) 10 August 2020

The DHSC hold regular webinars which provide an opportunity to ask questions. We highly recommend you sign up to the webinar if you have not already. This can be booked on DHSC's Event Registration page. 

More information about Getting Tested  can be found on the Government's website, including links to guidance on testing.  

Blanket testing in other care settings

The Government issued the following key messages in its update on 6 July 2020:

Extra care and supported living:  some supported living and extra care facilities share similarities with care homes in terms of care and risks, consequently the Government plan to roll out an initial round of testing for staff and residents in the settings which meet certain risk-based criteria. The operational details of rolling out this testing to this sector are being worked through and more details will be provided shortly.

Domiciliary care:  asymptomatic testing for domiciliary care workers will be guided by the results from the Public Health England prevalence study into domiciliary care which is due shortly.

 


 

Antibody testing

At the moment antibody testing is only available for the NHS however when this changes we will update our webpages and communicate to all affected services accordingly.

Please note: the antibody test kits can only indicate if a person has been exposed to the virus, it is not yet clear whether a positive antibody is a marker of immunity. This means that a positive antibody test is not a guarantee of safety from further infection and cannot be used to assess clinical risk or management of residents and staff, as such social distancing, isolation, cohorting and infection control practices are still required.

 


 

Impact of test and trace system on health and care settings

The government has just introduced the new test and trace system to minimise community transmission of Covid-19.  

Following a positive test, contact tracers will work with the individual to determine close contact in the 48 hours before onset of symptoms. Close contact is defined as:

  • having face-to-face contact with someone (less than 1 metre away)
  • spending more than 15 minutes within 2 metres of someone
  • travelling in a car or other small vehicle with someone (even on a short journey) or close to them on a plane

The following guidance was updated on 14 June 2020 regarding how test and trace is likely to impact on health and care settings Covid-19: management of staff and exposed patients or residents in health and social care settings

Most relevantly it states:

  • if you have had close recent contact with someone who has Covid-19, you must self-isolate if the NHS test and trace service advises you to do so, however
  • close contact excludes circumstances where PPE is being worn in accordance with current guidance on infection, prevention and control.

Please note: that our provider incident management service is operational 7 days per week, currently 9am to 5pm to support homes experiencing any difficulties such as insufficient care or clinical staff or access to PPE. Please contact us at ascincidentmanagement@staffordshire.gov.uk

 

What to do if you or your staff are contacted by the Test and Trace Programme

As you will be aware, the government’s Test and Trace programme is at the heart of the country’s drive to prevent a second peak of Covid-19 infections in the country.

With lockdown easing further from July 4 2020, it is hugely important that everyone is not only aware of Test and Trace, but if they are contacted by a NHS tracer they should self-isolate for 14 days.

It is also important that care workers across all settings let the tracers know that they work in a care setting, this will help prioritise tracing and continue to help the most vulnerable.

With this in mind we would be very grateful if you could share the message below with all your employees:

 

Test and trace scam warning (issued 20 June 2020)

Adult social care providers are advised to read and inform their staff of the Local Government Association test and trace scam alert article warning that criminals are trying to trick people out of money by pretending to be from the NHS Test and Trace Service through bogus phone calls, emails and text messages asking for bank card details to cover the cost of the testing kit.

Please note: the genuine NHS service is free.

 


 

Government guidance on the management of exposed staff and patients in health and social care settings

The Government has updated its guidance on the management of workers and patients exposed to Covid-19, and has produced two flowcharts which describe the return to work process for symptomatic and asymptomatic workers following a SARS-CoV-2 test. 

 


 

Staffordshire's infection control resource pack

Health partners in Staffordshire have compiled useful links and resources on infection control and PPE specifically for care homes, some of which are relevant for other care settings, as set out below:

Bespoke infection control advice for all care providers

The Red Day telephone line is available for care providers who are having infection control issues and need guidance. You can contact the on-call Infection Control team on 07977 208 783 between the following times:

  • Monday - Friday 9am - 5pm
  • Saturday - Sunday 8am - 4pm

Infection control resources for care homes and other care settings:

Infection control resources for care homes only:

The recommended PPE resources can be found on the PPE page.


 

Helpful links to national guidance on infection control

Guidance on cleaning in community and public settings after the case has left the setting or area, including advice on laundry and waste disposal.

This is specific guidance for people who are clinically extremely vulnerable, including people living at home with or without additional support and people in long-term care facilities. It's also for their family, friends and carers. Care home and home care providers should ensure they are familiar with the contents of this guidance. 

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