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Supporting health and social care providers in Devon

COVID-19 testing and guidance overview

Situation Testing regime
Care home symptomatic Symptomatic care home residents and staff test with PCR. Full guidance.
Care home, no clinically suspected or confirmed cases in staff or residents i.e. routine testing Staff testing: LFT required prior to coming on shift.
Resident testing: Every 28 days with PCR
Full guidance.
Care home admission from community

Resident testing: PCR test before admission (within 72 hours), a PCR test on the day of admission (day zero).

A risk assessment should be completed if the resident is not fully vaccinated. If the risk assessment shows that an incoming resident should self-isolate, this should be for ten days. It may be possible to reduce the period of self-isolation if they receive three consecutive negative LFT’s taken on days six, seven and eight.
Full guidance.

Care home admission from hospital or high risk visit outside of the home

Vaccinated residents who have attended a high-risk setting should self-isolate and then take part in daily lateral flow testing from day four. After receiving three consecutive negative LFTs each 24 hours apart, or after ten days, they can end their isolation. High-risk exposures include having been discharged from an unplanned overnight stay in hospital or visiting a hospital experiencing nosocomial outbreaks.

Unvaccinated residents who have attended a high-risk setting should self-isolate and then take part in daily LFTs from day six. After receiving three consecutive negative lateral flow tests or after ten days, they can end their isolation.
Full guidance.

One case positive in staff or resident Continue daily LFTs for staff as per guidance.
Full guidance.
Care home Outbreak testing
(An outbreak is defined as more than one linked case of COVID-19 among residents/clients and/or staff within a specific setting within 14 days)

Outbreak restrictions should be implemented.

Resident testing: All able to be tested should be tested using PCR and LFT on day 0-1 and again between day 4-7 in a new outbreak. If it is too distressing for residents to have a PCR and LFT in close duration, then prioritise the PCR and attempt to carry out lateral flow test at a different time of day or the next day.

Staff testing: All should be tested using PCR and LFT on day 0-1 and again between day 4-7 in a new outbreak

The above testing regime only needs to be undertaken once during the provider’s outbreak.
Daily staff LFTs until five days of no positives
Whole home testing on day 15, if all negative outbreak closed.
Full guidance.

Cluster testing
(Initially between two to four cases of COVID-19 within a specific setting within 14 days AND the cases are considered highly likely to have acquired their infections outside of the setting of interest AND transmission within that setting is considered to be highly unlikely)

Outbreak restrictions should be implemented. If a home is able to accept admission pending a risk assessment, they can declare their admission status as “open” on the Capacity Tracker.

Resident testing: All able to be tested should be tested using PCR and LFT on day 0-1 and again between day 4-7 in a new outbreak.

Staff testing: All should be tested using PCR and LFT on day 0-1 and again between day 4-7 in a new outbreak

If the enhanced and/or routine testing regime identifies further cases by 14 days, then this is indicative of an Outbreak and the Provider case status will be upgraded to Outbreak.
Recovery testing undertaken no sooner than 14 days after the latest case, has returned wholly negative results.

Care home visitors

All family and friends visitors to care homes should be tested each time they visit with an LFT

All essential care givers should be tested each time they visit with an LFT as well as any rapid response or outbreak testing determined by the local HPT.
Full guidance.

Domiciliary care Asymptomatic Staff testing: All CQC registered domiciliary care workers should conduct LFT testing prior to coming on shift.
Full guidance.
Extra care and supporting living Asymptomatic Staff testing: LFT test required prior to coming on shift.
Service user testing: Monthly PCR testing
Full guidance.
Extra care and supporting living visitor testing All family and friends visitors to extra care and supported living should be tested each time they visit with an LFT.
Full guidance.
Extra care and supporting living
Outbreak testing
Report to UK Health Security Agency Southwest Health Protection Team (UKHSA SWHPT) Directors of Public Health. They will: undertake an initial risk assessment, provide advice on outbreak management and decide what testing is needed.
If service operates similar to a care home, care home outbreak testing regime is followed as on previous page.
Personal Assistants Personal Assistants: LFT test required prior to coming on shift.
Full guidance.
Day Centre services

Staff testing: LFT test required prior to coming on shift.

Service users: Service users can still visit the centres if they have not tested. Testing is not mandatory.

DHSC recommend for service users that are able to test, to test twice a week with 3-4 days in between using LFT only. If they are attending twice a week, test on the days of attendance.
If they are attending once a week, they only need to test once in the week. These should ideally be on the day, prior to attending the centre.
Testing can be completed either at-home or on-site at the discretion of the day care centre manager. Service users can also self-test.
Full guidance.

For further info please visit DHSC testing overview.

Situation Testing regime
Exemptions from self-isolation if a staff member is fully vaccinated and is identified as a contact of a case PCR test which should be negative prior to returning to work
LFT test every day for the ten days following their last contact with the case (even on days they are not at work).

If a staff member has had COVID-19 infection in the past 90 days, they should not have a PCR test and should only undertake daily LFT tests.
Full guidance.

If a staff member receives a positive LFT or PCR test result

Take an LFT test from the fifth day of their isolation period and another LFT test on the following day. The second LFT test should be taken at least 24 hours later. If both LFT tests results are negative, they may end their self-isolation immediately after the second negative LFT.

If either test is positive, staff member must continue to self-isolate until two negative lateral flow tests are taken on consecutive days.
The staff member should continue to undertake daily LFT tests for the remaining days of isolation period even if they have already returned to work.
If either test is positive, continue to self-isolate until two negative lateral flow tests taken on consecutive days.
Full guidance.

Professionals visiting care homes

National guidance is for social care professionals to be tested, using LFT testing, on the door of the first care home they visit on that day or ideally to test from home before the arrival of your first visit. It is also advisable for social care and NHS staff to contact the home before the visit to check the testing arrangements of the home and ascertain if the home requires any additional but reasonable requests.

National guidance is for NHS visiting professionals to produce evidence of a negative test result within the last 72 hours, demonstrating you are following the NHS staff regular testing programme.

In emergency visits such as a 999 response, it is not appropriate to ask for or provide proof before entry to a care home, given the potential delay this could cause and the implications for prompt management of the emergency situation.
Full guidance.

Glossary of guidance

General Adult Health and Social Care
COVID-19: management of staff and exposed patients and residents in health and social care settings
Coronavirus (COVID-19) testing for adult social care services
Coronavirus (COVID-19): reducing risk in adult social care
Coronavirus (COVID-19) testing for anyone working in adult social care who is not part of regular testing at work
Evidence on the accuracy of lateral flow device testing

Care home
Coronavirus (COVID-19): testing in adult care homes
Designated settings for people discharged to a care home
Coronavirus (COVID-19): admission and care of people in care homes
Visiting arrangements in care homes
Coronavirus (COVID-19): support for care homes
COVID-19: how to work safely in care homes
Testing for professionals visiting care homes

Home Care
Coronavirus (COVID-19): providing home care
Coronavirus (COVID-19) testing for homecare workers
COVID-19: how to work safely in domiciliary care in England
COVID-19: stepdown of infection control precautions and discharging patients to home settings

Supported Living/ Learning disability/ Extra Care
Supported living services during coronavirus (COVID-19)
COVID-19: supporting adults with learning disabilities and autistic adults
Coronavirus (COVID-19) testing in extra care and supported living settings


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