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Supporting health and social care providers in Devon

Testing (COVID-19)

Last Updated 11:45am, 13 May 2021


Introduction

If you have any specific issues or questions that you would like to raise please do so as follows:

Testing in care homes

All care homes can now apply for coronavirus testing kits to test residents and staff, regardless of whether or not anyone has coronavirus symptoms via the National Testing Portal. Read more about whole care home testing.
Care homes should receive regular COVID-19 testing updates directly from the Department of Health and Social Care (DHSC) via email.
If you aren’t successfully receiving it, please contact the DHSC (119) in the first instance to check the email address they have for your organisation.

From Wednesday 17 January, there are now several key changes to care home testing policy and process.

  • With immediate effect, if someone tests positive with a Polymerase Chain Reaction (PCR) test, they should not be tested using PCR or LFD for 90 days. If they develop new symptoms during this time, they should be retested immediately using PCR.
  • Rapid response Lateral Flow Device (LFD) testing for staff is being extended (from Monday 22 February). This should no longer automatically stop after seven days. Instead care homes should continue with rapid response testing until five days have elapsed since the last positive test. Staff should only be tested on the days they are due to attend work.
  • LFD testing for residents is being introduced (from Monday 22 February). This should be undertaken at the same time as the PCR testing in an outbreak – on day one and on an additional day between days 4 and 7. The usual principles of consent and best interest decisions apply to inform your decision whether this is appropriate for each resident.
  • PCR outbreak testing is moving from Pillar 1 to Pillar 2. The policy for when to carry out the outbreak PCR remains the same. All staff and residents should be tested on day one and on an additional day between days four and seven.

To support care homes with these changes, please see the following guidance:

What to do if a PCR COVID-19 test result could not be read or it is a void test result (inconclusive)

If you had a PCR test (test that was sent to a lab) and your sample could not be read, you will need to get another test as soon as possible. If the staff member does not have symptoms, and is not a contact, then they can continue working pending the result of the second PCR test.

Staff should self-isolate until they get the result of the second test if:

New guidance for testing professionals visiting care homes

The guidance strengthens the existing approach for testing professional visitors to care homes in order to reduce risks from visits from professionals.

The key changes are:

  • The default position is that without a negative test, the professional should not be allowed into the care home, unless in an emergency, unless overridden by the care home manager following a risk-based decision, or unless their entry is required by law such as CQC inspectors.
  • For NHS professionals, care homes should see evidence from the professional of a negative rapid lateral flow test within the last 72hrs, which shows they are following the NHS staff testing regime.
  • As per the previous guidance, professionals who are not part of regular testing for NHS staff or CQC inspectors (for example professionals such as podiatrists or engineers) will need to be tested at the care home in the same way as visitors.
  • If they are visiting multiple care homes in one day, they will now only need to be tested at the first care home they visit that day and can use evidence of this test at the next care home they visit that day.
  • CQC inspectors will now test at home using a lateral flow test on the day of a care home inspection, in addition to their weekly PCR.
  • Like care home staff, visiting professionals are exempt from testing for 90 days following a positive PCR test, unless they develop new symptoms.

Testing is, however, only one part of the approach to reduce risk and it is critical that visiting professionals don and doff PPE appropriately and follow the relevant infection control measures when visiting a care home including hand hygiene and distancing, in order to help keep care home residents and staff safe.

Testing guidance for professionals visiting care homes

There is now a Devon wide guidance for health and social care professionals visiting care homes, which builds on the national guidance for professionals visiting care homes.

The guidance provides clarity for professional visitors about what is required to promote safe access into a care home with an ethos of working with the home to meet their safe visiting policy.

Free home testing kits for social care workers

From Friday 9 April, everyone in England is being encouraged to take a free rapid coronavirus test twice a week using Lateral Flow Devices. Alongside vaccine roll-out, regular testing is at the heart of plans to reopen society and the economy, helping to suppress and control the spread of variants.

How to order home-testing kits

All front line staff, including personal assistants, can order and collect testing kits at the same time as their free PPE supplies using this simple online request form.

All collections are arranged in advance, please do not turn up without an agreed collection time. Staff can order as an individual or on behalf of their team and can collect two packs of home test kits per staff member. Each pack contains seven tests.

Emergency supply of test kits is also available via this route if any providers who already test weekly are having problems accessing tests through normal routes.

Mobile community testing

Devon County Council is also running a mobile community testing service throughout the county. This allows you to get tested and, from Friday 9 April 2021, to collect home-testing kits.

Anyone 18 or over can collect from a Community Collect Van. There is no need to book, you can just turn up and collect your tests. Please see the timetable for the mobile testing van’s visits.

Other ways of ordering test kits

Businesses with more than ten employees can offer on-site testing to their staff and it is not too late to register.

Anyone 18 or over can also:

  • order home-testing kits from the NHS by post. You can order one pack of home test kits containing seven tests for home delivery. Your tests should arrive within two days
  • collect home-testing kits from NHS testing locations and pharmacies that are part of the Pharmacy Collect scheme.

For further information please visit: Community lateral flow testing – Coronavirus (COVID-19).

New analysis of lateral flow tests shows specificity of at least 99.9%

New analysis published on 10 March shows lateral flow tests (LFD) to have a specificity of at least 99.9% when used to test in the community and could be as high as 99.97%.
Following the roll-out of millions of LFD tests in the community, which has provided real world data, NHS Test and Trace has been able to conduct further analysis of rapid testing using LFDs. New findings on their specificity, which is a measure of how good the test is at detecting true negative cases, show that for every 1,000 lateral flow tests carried out, there is less than one false positive result.
Further information is on GOV.UK.

Vaccines scams warning

Criminals are sending out texts and emails trying to make money from the pandemic, often with links to convincing fake NHS websites. Please remember that the NHS will NEVER ask for payment details so any requests for them will be fraudulent ones.
Information and advice on scams and how to report them

90 Days Testing Policy

The Government has published a note explaining the policy relating to the 14-90 day time period since positive COVID-19 test result. The note provides clarity on section 4.3 of the existing guidance, and does not include any new policy. The note aims to communicate the policy more clearly to acute staff and care homes and provides a step-by-step process to determine whether it is appropriate for the person to be discharged into a normal care home setting without having to enter and isolate in a designated care setting. A PDF version of the note is also attached.

Discharge into care homes: Designated Settings

The Department of Health and Social Care have recently published updated guidance ‘Discharge into Care Homes: Designated Settings’.

This guidance builds on the previous letters that were sent to Directors of Adult Social Care over recent months and clarifies the times where a designated setting must be used. It also sets out the actions discharge teams must undertake before a discharge can be made for any individual who has tested positive for Covid-19.

The priority remains that everyone receives the right care, in the right place, at the right time, whilst ensuring the prevention of virus transmission in care homes.

Hospital Discharges into care homes

The guidance makes it clear that every patient must receive a COVID-19 PCR test result within 48 hours prior to discharge. No one will be discharged into, or back into, a registered care home setting without being tested and having received their test result. Crucially, individuals will be clinically assessed prior to discharge no-one will be discharged if the receiving care home is not able to meet the individuals needs. A detailed ‘hand-over’ is expected in all cases.

Any individual who tests positive must be discharged into a ‘designated setting’ for a 14-day isolation period. Within Devon the only designated settings are currently NHS facilities.

The guidance does however, allow for immunocompetent individuals (those who have a normal immune response) who have previously tested positive for COVID-19 by PCR, and who have already completed their 14-day isolation period, to be exempt from testing prior to hospital discharge within a period of 90 days from their initial illness onset or test (if asymptomatic), unless they develop new COVID-19 symptoms.

Where a person is retested within 90 days from their initial illness and they are found to still be positive for COVID-19, a clinically led approach should be used to interpret the result prior to their discharge back to (or into a new) Care Home i.e. if they are asymptomatic and testing positive they can still be discharged following clinical review, and in agreement with the Care Home.

Requirements on Hospital Discharge Teams when arranging a discharge into a care home:

  • Ensure everyone being discharged into a care home has a time-stamped reported COVID-19 test result, and this must be communicated to the person themselves and the care home prior to the person being discharged from hospital
  • A COVID-19 test does not need to be completed for immunocompetent individuals who had previously tested positive within a period of 90 days from their initial illness onset or test (if asymptomatic), unless they develop new COVID-19 symptoms
  • No care home should be forced to admit an existing or new resident to the care home if they are unable to cope with the impact of the person’s COVID-19 illness
  • If the individual is not able to be discharged into their existing Care Home (due to the point above) alternative short-term placement could be considered
  • Where a placement cannot be agreed, Hospital Discharge Teams should escalate this to the local QAIT team to support a direct communication with the Care Home to understand the specific challenges and how a home may be supported.

Requirements for care homes when agreeing an admission:

  • Care Home Registered Manager must assure themselves that they have received a time-stamped reported COVID-19 test result before accepting the admission
  • A COVID-19 test does not need to be completed for immunocompetent individuals who had previously tested positive within a period of 90 days from their initial illness onset or test (if asymptomatic), unless they develop new COVID-19 symptoms
  • Any individual admitted into a home should be self isolated for a further 14 day period (regardless of any initial isolation within a designated care setting)
  • If a Care Home Manager is asked to accept an admission, and would like further guidance or support prior to accepting the admission, please contact your local QAIT team for support

Testing in Adult Social Care graphics and guidance

Graphic summarising tests available for Adults Social Care in England

Care home testing guidance for residents and staff: PCR and LFD (England)

Statement of support for care home visiting. Questions and answers.

Devon County Council is working with care home providers and through the Devon Care Home Collaborative to support arrangements for family and friends to visit people who live in care homes. Please read the joint statement of support and questions and answers which have been compiled in line with the new lateral flow testing of visitors in care homes guidance .

Testing for domiciliary care staff / homecare workers

The Department of Health and Social Care (DHSC) has made regular weekly asymptomatic Coronavirus testing available to all registered home care workers (domiciliary care workers) from 23 November. The scheme uses PCR test kits with combined throat and nasal swabs.

The guidance on Coronavirus (COVID-19) testing for homecare workers sets out how regulated providers can order their regular tests.

Once the test kits have arrived, the agency manager should make arrangements to distribute a 4-week supply to every home care worker or arrange for staff to collect them.

Due to availability of lab capacity and to ensure faster turnaround of results, testing must only be carried out on Thursday – Sunday inclusive (for Sunday testing staff must be able to access a priority post box with a Sunday collection.

To ensure that all of your homecare workers are accurately registering tests every week, an interactive one page document has been created for agency managers to distribute to homecare workers. The one-page document allows managers to fill in their organisations UON, employer name and can be distributed digitally or physically.

Please continue to encourage and re-emphasise the importance of conducting weekly testing and of registering each test correctly to your homecare workers.

Many managers have set up a system for tracking test kit results in their agency. A system like this will help you to have evidence of each staff member’s PCR registration every week.

Testing for extra care and supported living settings

Extra care and supported living services now have the ability to register for regular COVID-19 testing. Regular retesting involves weekly staff testing and monthly resident testing. The guidance provides information on regular retesting for extra care and supported living services that meet the eligibility criteria.

To request the Onboarding process and register your organisation please email adults.covid19workforcetesting-mailbox@devon.gov.uk

Staff are also able to access tests through the Community Testing Sites.

The Department of Health and Social Care has announced that extra care and supported living services are now able to access the Rapid Lateral Flow Device (LFD) Testing, in addition to the existing Polymerase Chain Reaction (PCR) testing regime.

For high risk supported living and extra care setting, who qualify for LFD, please make your order for LFD tests for your organisation via GOV.UK.

Further information can be found via their extra care and supported living testing webinars and in the attached update.

If you are a supporting living provider or extra care provider not receiving weekly PCR testing please contact: workforce.testing@devon.gov.uk.

Testing for day centre workers

Rapid Lateral Flow Testing is now available for all staff and service users in adult day care centres in England

After the completion of a successful pilot study, DHSC are pleased to inform you that NHS Test and Trace is making regular lateral flow testing available to all staff and service users in adult day care centres in England, to be conducted alongside the existing weekly staff PCR testing.

In addition to the current regular PCR testing regime, the new guidance advises all staff to:

Undertake an additional two rapid lateral flow tests per week, ideally before they begin their shift:

  • One rapid LFT should be completed on the same day as the PCR test;
  • One rapid LFT test should be taken 3-4 days later.

If any member of staff tests positive with a rapid LFT, they must take a confirmatory PCR test and self-isolate at home immediately until they receive their result.

Staff members may self-test or test with the assistance of another adult.

The guidance is clear that service users attending a centre does not depend on them taking a test, however, we advise service users who are able to test to:

• Test twice a week, with 3-4 days in between using rapid LFT. If a service user is only visiting once or twice per week, they only need to test on the day of their visits.
• Service users should ideally test before attending the centre if travelling by shared or public transport.

Testing can be completed either at the day care centre, or at home by themselves or with the support of a parent or carer. This is at the discretion of the day care centre.

DHSC understand that not all service users will be able to test, and testing should not be considered mandatory for entry into the day care centre. Service users can still visit the centre if they have not tested. However, if a service user tests positive, they should self-isolate immediately, take a confirmatory PCR test and not attend the day care centre.

Please use this link to order rapid LFT kits using the same Unique Organisation Number (UON) that you use to order PCR tests.

Tests can be ordered immediately. Please be aware, similar to when you place an order for a PCR test, you will not be able to place another rapid LFT order until 21 days have passed from when your order was processed. The online replenishment portal will highlight the date that you can place your next rapid LFT order

Further day care resources:

Testing for personal assistants

Following The Department of Health and Social Care (DHSC) review of testing for personal assistants and consultation with the sector, DHSC are pleased to announce that testing for personal assistants has moved to twice weekly rapid Lateral Flow Testing (LFT), with confirmatory PCR tests for a positive test. Further information can be found on the Government’s website.

Staff are also able to access tests via the Devon County Community Testing page.

Swabbing guidance

Public Health have produced guidance on the use of swabs.

How to report symptoms and confirmed COVID-19 test results in your social care provision

For symptomatic clients the following protocol needs to be followed:

  1. Alert DCC by emailing the COVID mailbox. All symptomatic cases need to be flagged irrespective of whether they are DCC, CCG, DPT or self-funded.
  2. For regulated: providers must update CQC Home Care Tracker (Personal Care) or Care Homes Tracker (Care Homes).

For symptomatic staff or those who are required to self-isolate the following protocol needs to be followed:

  1. Alert DCC by emailing the COVID mailbox.
  2. For regulated: providers must update CQC Home Care Tracker (Personal Care) or Care Homes Tracker (Care Homes).

For confirmed cases following a positive test result immediately take these actions in addition to the above:

  1. Notify Public Health England by calling 0300 303 8162, Option 1 then Option 1 again.
  2. Alert DCC by emailing the COVID mailbox.
  3. For regulated: providers must update CQC Home Care Tracker (Personal Care) or Care Homes Tracker (Care Homes).
  4. For staff members only: A RIDDOR report is required where the member of staff is known to have contracted coronavirus through contact with a confirmed positive case through the course of their work.
    Reporting should be made in accordance with advice offered by the Health & Safety Executive.

Are you eligible for the Test and Trace Support Payment?

The government has updated its guidance about claiming financial support if you’re told to self-isolate.

If you have been told by NHS Test and Trace to self-isolate, and you’re eligible for the Test and Trace Support Payment or a discretionary payment, you will receive £500 in addition to any benefits and Statutory Sick Pay that you currently receive.

You are eligible for the £500 Test and Trace Support Payment if you live in England and meet the government’s criteria.

If you are a parent or a guardian of a child who has been told to self-isolate by their education setting or by NHS Test and Trace, and you are therefore unable to attend work due to childcare responsibilities, you might also be eligible for a £500 Test and Trace Support Payment or discretionary payment, if you meet the government’s criteria.
The government’s website tells you how to apply.

Staff do not always need to self-isolate if a service user tests positive

Please note that section 6 of the national guidance for health and social care settings covers ‘Contact risk assessment and exemption criteria’.

That guidance states that if health and social care staff are providing direct care to a patient or a resident with COVID-19 and are wearing the correct PPE in accordance with the current IPC guidance, they will NOT be considered as a contact for the purposes of contact tracing and isolation, and will NOT be required to self-isolate for 14 days.

If, however, a staff member has been in close contact with a confirmed COVID-19 patient or service user while not wearing PPE, or had a breach in their PPE while providing personal care, they should inform their line manager, who must then complete a risk assessment and follow guidance accordingly.

If the risk assessment concludes there has been a significant breach or close contact without PPE, the worker should remain off work for 14 days.

Test and Trace: response to provider queries

Guidance on the national Test and Trace service was published on 27 May 2020.

Since then, we have received a number of enquiries from providers raising concerns at the potential impact on the availability of staff in their settings given the potential for self-isolation.

Please note this published guidance signposts to separate guidance for health and care workers on testing which was updated on 31 May 2020. This followed publication of a letter from Ros Roughton, Director General of Social Care at DHSC, which outlined how the test and trace guidance about isolating after ‘close contact’ with someone with symptoms or COVID-19, would apply to care settings.

This specifies that the process for such staff is different depending on whether the contact was made in the community or in a health and care work setting.

In the former case, the guidance applies as it does to any other person – refer to the Test and Trace guidance.

In the latter case, if the contact occurred when the staff member was wearing appropriate PPE for the setting and activity, no further action is usually required.

If appropriate PPE was not being used, or there was a breach in the PPE, then this should be reported to the person’s line manager who is asked to carry out a risk assessment as detailed in section 4 of the guidance.

This puts further emphasis on the correct usage of PPE appropriate to the activity and setting. It also puts emphasis on the importance of social distancing when not wearing PPE in the work setting including in staff rooms when taking breaks. And also in doing all we can to limit the number of staff working in a setting and contact between them as outlined in the recently updated guidance on infection prevention and control.

Pausing contact tracing

Healthcare workers are encouraged to download and use the NHS COVID-19 app. However, they are advised to pause contact tracing while they are working in healthcare buildings, including hospitals and GP surgeries. This advice is being given as healthcare workers are working in highly specialised secure environments, trained in infection prevention and control processes, and wearing medical grade PPE as required. Specialist contact tracing controls are in place to understand how staff are moving around the building and when they are at risk of contracting coronavirus.

How and when should I pause contact tracing?

How home care providers can support Test and Trace

Staff from NHS Test and Trace or other public health professionals may contact home care providers if one of their staff or service users has tested positive for coronavirus in order to alert those who have been in close contact with them.

Home care providers can assist NHS Test and Trace by keeping a temporary record of their care staff and recipients of care. Many providers will already have the necessary record systems to store and provide this information on request. In these cases, providers do not need to duplicate records.

If you do not currently have a system to record this information, this should be done in a way that is manageable for your business, but sufficiently detailed to effectively support NHS Test and Trace.

It is recommended that providers ensure that their systems are set up in such a way that this information can be reported rapidly on request and identify the person(s) who can produce this information at short notice.
If a provider is contacted, the following information may be requested at short notice:

  • the name and telephone number for a home care worker
  • the dates and times that a home care worker is at work
  • a log of the care worker’s visits to individuals receiving care for the previous 21 days. This should include, where possible, arrival and departure times of their visit, as well as a record of the name and residence of any individual(s) they provided care to (‘the client’)
  • the name and telephone number of the client and/or the client’s representative
  • the names and telephone numbers of other home care workers, when working in close proximity (for example, during a ‘double up’ visit)

National guidance for home care contains further information and there is guidance on How NHS Test and Trace works and on maintaining records of staff, customers and visitors.

Antibody testing for all adult social care staff

The Government have launched a new at-home antibody testing service which is now available to all staff in the adult social care sector in England.

The Department of Health and Social Care are inviting all staff in the adult social care sector to register. Please encourage your staff sign up on the portal

People who are eligible for the antibody test are personal assistants who provide care and support, staff working in residential care, domiciliary care, extra care, supported living, and local authority adult social care departments.

An antibody test result can only tell an individual whether or not they have had the virus in the past and developed antibodies. Therefore, regardless of the result of an antibody test, individuals must continue to comply with government guidelines, including wearing PPE and social distancing.

This testing is separate from weekly swab retesting and outbreak testing by PHE and local HPTs, and that swab retesting of all staff and residents in care homes continues as a priority, even if individuals receive a positive antibody test result.

Find out more about what an antibody test is.

All questions about booking antibody tests should be sent to antibodytesting@dhsc.gov.uk and 119 are able to answer questions and provide support with regards to antibody test results.

Antibody testing: questions answered

We have produced two sets of questions and answers about antibody tests: one for care home staff and one for all other adult social care staff.

National Self-Referral Portal

A test can be applied for via this portal if you are an essential worker with coronavirus symptoms.

If you meet the eligibility criteria listed in the portal you can attend a drive-through testing sites in Devon, run by the Department of Health and Social Care.

A number of pop up mobile testing sites are available.

Community testing

A community testing programme has been launched to provide free lateral flow tests that deliver rapid results, typically within 30 minutes.

Why are we doing community testing?

Community testing will help to find individuals who have COVID-19 but do not have symptoms and need to isolate and who may inadvertently be spreading the virus. A Local Programme Team led by Devon County Council (DCC) Public Health, has been coordinating the local Devon offer to provide free lateral flow tests that deliver rapid results.

Community testing will complement but not substitute national coronavirus testing. People with symptoms should still book a test through the NHS website.

Who is eligible?

Everyone in England is now eligible for free rapid COVID-19 tests, twice a week. This campaign launched on 9 April.

Where can I get tested?

Please visit the DCC main testing webpage for further details on community LFD testing including how to book a test.

If you have any questions please contact Gabrielle Lester-Smith on: adultsc.covid19workforcetesting-mailbox@devon.gov.uk.

Home testing and visual impairment

NHS Test and Trace has been working in partnership with the Royal National Institute of Blind People to improve the home testing service for people with visual impairments, including an information line you can call to hear a recorded version of the instructions and a live video assistance service.

You can read the full story on the government’s website.


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