Coronavirus updates for Somerset Adult Care Providers

Daily testing in the event of a positive test in a care home

Please be aware that current guidance states that, in the event of a positive test in a care home, all staff must be tested daily for at least 7 days

Guidance

The government has published Care Home COVID-19 Testing Guidance For testing of staff and residents (UK Government and NHS Test and Trace, updated Aug 2021), which includes guidance coving all aspects of care home testing for both Polymerase Chain Reaction (PCR) (page 10) and Lateral Flow Tests (LFT) tests (page 24), including outbreak testing procedures (page 35).

Additional guidance that is also available includes:

• Detailed guidance using LFT self-test kits in your step-by-step guide for COVID-19 self-testing: Lateral Flow Device Test Kits (UK Government and NHS Test and Trace, updated 22/04/2021)
• Detailed guidance on administering on-site LFT tests in on-site testing for adult social care services: rapid lateral flow test guide (UK Government and NHS Test and Trace, updated 18/06/2021) for which a summary is also available in and rapid lateral flow testing in ASC settings: an overview (UK Government and NHS Test and Trace, updated June 2021).  

If your scheduled courier (booked at https://test-kit-collection.test-for-coronavirus.service.gov.uk/ – see below) does not arrive to collect your test kits please call the contact centre on 119. They will be able to book urgent replacement couriers for you, and will be able to escalate any other concerns that you may have.

Please note that all couriers should still be booked at https://test-kit-collection.test-for-coronavirus.service.gov.uk/, and 119 should only be called if one does not arrive as scheduled between 4pm and 10pm.

The whole home testing cycle is:

• Staff testing: Weekly Polymerase Chain Reaction (PCR) and twice weekly Lateral Flow Device Test (LFT) (one of the LFT on the same day as their PCR)
• Resident testing: Every 28 days with PCR When test kits are sent these are enough for four weeks and you can re-order more kits 21 days after your last order was dispatched.

Any care home workers with symptoms should be self-isolating and can access testing via the self-referral portal or be referred by their employer in the usual way.

Actions and testing frequency after a positive result

• If there is a positive case in the care home from either staff or residents with a PCR or LFT test, conduct rapid response LFT testing on staff daily and report to the Public Health England Health Protection Team 0300 303 8162 (including out of hours) they will provide public health advice, and arrange urgent testing of all symptomatic residents. 
• If no further positives are found within 7 days or the confirmatory PCR test (for the initial positive LFT test) is negative
  • Stop daily LFT and return to the regular staff testing regime of weekly PCR testing and twice weekly LFT testing
• If further positive cases are found, or the Public Health England Health Protection Team advises that it is required after the first positive tests (where it is unclear whether there is an outbreak, the Health Protection Team should err on the side of caution and recommend
  outbreak testing.):
  • PCR tests for all staff and residents on day 1 of the outbreak and once between
    days 4-7.
  • Start (or continue, depending on your circumstances) of daily LFT testing of all staff until there has not been a positive result in 5 days
  • When you carry out the outbreak PCR for residents (day 1 and once again between day 4-7), also test the resident with LFT on the same day
  • Any positive LFT tests from either staff or residents should be followed by a
    confirmatory PCR.
  • PCR test any newly symptomatic people.  Continue to isolate and ensure contract tracing has been completed.
• Once outbreak PCR and resident LFT testing is complete, continue with the regular testing cycle. Daily staff testing may continue in this scenario until no new cases have been identified for 5 days.

If staff are on annual leave, they are not required to join the daily testing until they return to work.

If staff develop symptoms, they should be tested at a test centre or by ordering a kit to be sent direct to their home. They can do this at:

https://www.gov.uk/apply-coronavirus-test-essential-workers 

Testing within 90 days of a positive PCR test

Following a substantial clinical review of the latest evidence and testing data, the Department of Health and Social Care (DHSC) has changed the advice for retesting within 90 days of a positive. From now on, if someone tests positive with a Polymerase Chain Reaction (PCR) test, they should not be tested using PCR or Lateral Flow Device Tests (LFTs) for 90 days, unless they develop new symptoms during this time, in which case they should be retested immediately using PCR. This 90 day period is from the initial onset of symptoms or, if asymptomatic when tested, their positive test result.

The previous policy to continue LFT testing following a positive PCR result was because although very unlikely, it is possible to be re-infected within 90 days. However based on the latest testing data and clinical advice, the policy has now changed.

The clinical view is that during this 90 day window from a positive test, given the low rate of reinfection during this window, it is significantly more likely that a positive LFT test would be a false result, rather than someone being re-infected, causing people to isolate unnecessarily. Therefore we are now stopping the regular testing using LFT during this 90 day period. The individual should return to the regular LFT and PCR regime once 90 days has passed.

This means that the policy for retesting within 90 days for Adult Social Care is now the same as the policy for NHS staff. The policy also applies to professionals visiting a care home who have received a positive PCR result in the last 90 days.

The 90 day period is from the initial onset of symptoms or, if asymptomatic when tested,  their positive test result. Individuals should use evidence of their positive PCR test to show  they are currently exempt from asymptomatic testing

A set of Frequently Asked questions (FAQs) has be produced about this change.

Testing in a confirmed or suspected outbreak.

In line with Scientific Advisory Group for Emergencies (SAGE) and Public Health England advice, the Department of Health and Social Care has introducing some changes to the testing procedures in the event of an outbreak.

In the event of a confirmed / suspected outbreak, you should immediately contact the local Health Protection Team (HPT) for advice using swhpt@phe.gov.uk.

An outbreak is defined as two or more confirmed or clinically suspected cases within 14 days – detected by either Lateral Flow Device Test (LFT) or Polymerase Chain Reaction (PCR) testing.  However, one positive test result may be the first sign of an outbreak, so you should also contact your health protection team for advice in this instance.

Please read the full Care Home COVID-19 Testing Guidance For testing of staff and residents (UK Government and NHS Test and Trace, updated August 2021) detailing the outbreak testing process and how you can best prepare your care home in the event of an outbreak. This guidance should be followed unless advised otherwise by the HPT. The outbreak testing section starts from page 35.

• Rapid response LFT testing for staff was been extended from 22 February. This should no longer automatically stop after 7 days. Instead care homes should continue with rapid response testing until 5 days have elapsed since the date of the last positive LFT
  (confirmed with PCR). Staff should only be tested on the days they are due to attend work.
• LFT testing for residents was introduced from 22 February. This should be undertaken at the same time as the PCR testing in an outbreak – on day 1 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 has moved 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 4 and 7.

Testing is only one part of the outbreak response. The local HPT will provide advice on how to manage the outbreak including the necessary Infection Prevention and Control measures such as cohorting, proper use of PPE, good hand hygiene and distancing.

Returning PCR tests in an outbreak

As you are already engaged in the National Coronavirus Testing Programme for staff / resident testing – you may already have couriers booked for the days that outbreak testing is taking place. If this is the case, you should return PCR tests through this regular channel – no additional return courier booking will be needed. Should this not be the case, you can arrange a courier for the next day on https://test-kit-collection.test-for-coronavirus.service.gov.uk/ and if required, you are able to call 119 to book a same day courier.

Please remember that no personally identifiable information should be included with the PCR test kit. All we need to process the test is the barcode on the test kit.

As a reminder, used LFT kits do not have to be sent to labs and should instead be disposed of in health care waste bins.

Determining end of outbreak testing

• All staff and residents should be tested with PCR 14 days after the last resident or staff had a positive test result or showed coronavirus-like symptoms.
• The local HPT will contact the care home if, following genomic sequencing of test results, they have identified a Variant of Concern at which point they will discuss whether additional measures need to be put in place to enable additional protection. This might include an extension to the period of an outbreak up to 28 days from the last positive test.
• If there are no positive PCR results from this “end of outbreak testing”, the Health Protection Team will declare the outbreak over.
• The regular resident testing cycle of 28 days can be delayed to coincide with this “end of outbreak testing” if the two test dates fall within a week of each other.

Ordering Test Kits

The Department of Health and Social Care has said that it will continue to send care homes more Polymerase Chain Reaction (PCR) and Lateral Flow Device Test (LFT) test kits than necessary to carry out the recommended weekly testing for both staff and residents. This means you should have spare LFT and PCR kits that you can use in case of an outbreak.  It will also will continue to monitor kit levels as the current lockdown restrictions evolve to ensure you continue to have enough test kits to meet your testing needs.

If you are in an outbreak and do not have enough stock to last until your next routine order, you can place an additional order via 119. You should receive these kits within 48 hours.

If you are not in outbreak you can place an order via the ordering portal, gov.uk/coronavirus, in line with your normal 21-day reordering cycle. After 21 days, automatic emails will remind you that your home is eligible to place an order.  You should make sure to re-order before running low – you can reorder every 3 weeks.  Please note that you will need your organisations Unique Organisation Number (UON) in order to place an order.

Labelling of tests for staff

We have received feedback that sometimes it can be unclear which setting a test relates to where the information completed only shows the care provider name rather than care setting.  Please could you there ensure that you complete as much detail as possible (setting name(s) and postcodes) as well as the name of care provider associated with it.  This will enable the location that the staff member is working at to be more quickly identified.

Simplification of the registration journey

From Thursday 11th March the single registration journey has been be simplified. The DHSC has combined some screens to remove unnecessary steps, which will save you time and make the registration process easier. The updated screens are as follows:

1. Personal details
2. Where to send the results
3. Address
4. Work details
5. Check answers submitted

Further to this, the DHSC have updated the mobile number entry option in the second screen; ‘Where to send the results’. You will now have the option to confirm your mobile number, ensuring that it is entered correctly and results are received safely.

Priority Post Boxes

If an individual tests positive with an LFT, they will need to take a confirmatory PCR test. Your home has been provided with additional PCR tests for this purpose, which come with Royal Mail return labels. You can affix these to the confirmatory PCR test kit and post them via your nearest priority post box. You can find your nearest priority post box at:

https://www.royalmail.com/priority-postboxes

Please make sure the label is affixed to the test kit box before posting.

If you cannot post the confirmatory PCR test kit for whatever reason, the care home manager can ring 119 to book a same day courier to collect the test kit from the care home – however, we would encourage you to post the test kit if at all possible to avoid needing a courier for only one test kit. The turnaround time for results for test kits returned via Royal Mail are in line with those returned via courier.

Your regular PCR staff and resident test kits still need to be returned via courier. We do not provide Royal Mail return labels for regular PCR tests and a test kit cannot be posted without a Royal Mail return label.

If you already have a courier booked for your regular PCR testing, and you complete a confirmatory PCR kit at the home on the same day, you can include the confirmatory PCR kit along with the regular PCR kits.

Additional option to order Universal PCR test kits that can be returned via Royal Mail priority post boxes

From 24/06/2021 onwards the DHSC  will be offering adult care homes the option to order PCR test kits that include a Royal Mail return label.

If you only have a small number of PCR tests to conduct (8 or less in any testing day), you can use these test kits and return them using the Royal Mail labels provided.

These tests will not replace the standard PCR test kits returned by courier. Courier collection will remain the primary route for returning most of your PCR test kits to the lab.

This is a completely optional addition, introduced to offer Care Homes flexibility and supplement your regular testing routine.

How to use this service

• Visit the online order portal as usual and enter your Unique Organisation Number (UON) at: https://www.gov.uk/apply-coronavirus-test-care-home.
• You will see an option to order – Swab tests (PCR tests) to return by priority post box
• Each individual test kit comes with its own individual box and return label
• Return test kits to the lab by posting in your closest Royal Mail priority post box

Wording of results

The testing programme no longer uses wording for ‘void’ or ‘inconclusive’ results. This has been replaced with the wording below:

We could not read your coronavirus test sample. This means it’s not possible to say if you had the virus when the test was done.
We’re sorry, but you’ll need to get another test as soon as possible.
Keep self-isolating (and stay off work if relevant) if:

• You have or develop symptoms of coronavirus
• Someone you live with has symptoms or tests positive
  You’ve been traced as a contact of someone who tested positive

Registering LFT test results

All lateral flow device tests must be registered (whether positive, indeterminate/void, or negative) as a legal requirement at:  https://www.gov.uk/report-covid19-result

Understanding results, and the prevalence rate is crucial for public health teams to understand the prevalence of coronavirus in care homes across the country and be able to support the care sector appropriately. It is therefore very important that care homes have made the necessary arrangements with staff self-testing at home to ensure that all results from lateral flow device tests are registered online, and the DHSC has informed us that it will be monitoring compliance.

Registration should be done within 24hrs to ensure that results can assist NHS Test and Trace in understanding transmission and prevalence.

Please note that LFT tests should not be returned with a courier under any circumstances – returning LFT tests can affect the safety of laboratory staff and result in a temporary closure of the lab. Used LFT tests must be disposed of in your healthcare waste.

User account function for LFT registration

Please follow the guidance on page 16 of the your step-by-step guide for COVID-19 self-testing: Lateral Flow Device Test Kits self-test guidance (UK Government and NHS Test and Trace, updated 22/04/2021) to set your account up.

Please note you will need to enter all your personal details when creating the account. You will be required to input an email address and phone number, as part of the account creation and verification process, so please make sure you have access to an email address and phone.

Once you have created your account, the amount of time taken to register your LFT result will decrease significantly, as your personal details will be saved.   If you do not want to create an account, the single registration process will still available.

Changes to the online registration portal which took effect from 25th February

Test kits with barcodes prefixed with SAT can only be registered up until 24th February 2021. After this date these test kits cannot be used and registered.

Organisations are asked to check their stock of test kits as barcodes with the prefix SAT will not be accepted after 24th February 2021

Organisations that only have test kits with the prefix SAT should please order more test kits via the link below:

https://request-testing.test-for-coronavirus.service.gov.uk/

Testing training

Whole home testing webinar

The Department of Health and Social Care has set up regular care home testing webinars. The webinars will last 90mins and give detailed information about all aspects of care home testing, including: registering to receive tests, preparing for testing, test kit delivery, the testing process itself, testing certain care groups, registering test kits, booking your collection, and results and what they mean for you home

The session will include a Q&A with representatives from the national care home testing team, who will be able to answer your questions and address any concerns in the session.

Use this link to sign up to attend the webinars.  If you are not able to attend the webinars please sign up and a recording of the session will be made available to you after the session

The government has published a set of Frequently Asked Questions (FAQs) that have been asked at webinars.

LFT Testing Training

All care home staff members that are using LFT tests must have completed the training on the NHS Test and Trace online training portal. The training videos last about 15 minutes followed by a competency assessment.

Link: https://go.tessello.co.uk/TestDeviceTraining/

Token: 3wkcVi4UTX

Any care home staff member who has not yet completed the training can use the above link to create an account, access the training videos, and complete the competency assessment. Once the training is complete, screengrabs of the competency assessment can be sent to the care home manager to be stored for internal records.

Please note, the registration process on the training portal is different to the one described above. You must follow the registration process highlighted in the section above (please see pages 16 to 19 in the self-test guidance for further detail on the registration process).

It is critical that your care home staff member does not begin LFT testing until they have completed the assessment.

Can I share test kits with another provider, friends or family

• Test kits for a setting must not be shared with anyone outside of the setting
• Sharing test kits may lead to issues with test kit registration, courier collection and also contact tracing
• If you have any spare test kits, they should be stored between 5 and 22 degrees Celsius until their expiry date, which is displayed on the swabs
• Anyone that is symptomatic can get a test here: https://www.gov.uk/get-coronavirus-test

Safety notice: Checking the barcodes on your test kits

The Department of Health and social Care have informed us that  they have received a small number of reports that the four barcodes in some test kits have not matched.

It is critical that all barcodes in each test kit match, so that registration data and results are correctly associated with the right person.

When using your test kits, please check that all four barcodes (found on the vial, the bag, the box and the loose barcode for your records) are identical.

If they do not match, please do not use the test kit and contact the Test and Trace contact centre on 119 to inform them of the issue and request replacement kits.

The Department of Health and Social Care (DHSC) has updated its guidance a testing service for homecare workers in England (Department of Health and Social Care, updated 14/05/2021)

About the service

The service involves:

• weekly testing of all homecare workers in adult social care using polymerase chain reaction (PCR) test kits. This includes all carers in domiciliary care organisations
• agency managers should order tests every 28 days for their homecare workers
• 4 tests are delivered for each homecare worker to the agency, for a 28-day testing cycle
• each homecare worker should be given 4 test kits every 28 days
• every 7 days a care worker should take a test, register it online, and return it by post between Thursday and Sunday
• homecare workers will receive their results in 2 to 4 days by email and text message (SMS)

Why testing is important

Testing:

• identifies homecare workers who currently have COVID-19 so they are able to self-isolate if positive
• protects those receiving care from infection passed to them by homecare workers who are confirmed positive
• prevents and controls the spread of the virus by identifying asymptomatic cases

Eligible organisations

Your organisation is eligible if you are a Care Quality Commission (CQC)-regulated homecare organisation in England providing personal care.

This is defined in the CQC data as locations with the primary inspection category ‘Community based adult social care services’ and providing the service type ‘Domiciliary care service’.

If you believe you match this criterion and have not been contacted by NHS Test and Trace with information on ordering test kits, please call 119.

Ordering Test Kits

The agency manager is responsible for ordering test kits for the homecare workers in the team.

Each agency manager must register for test kits.

In order to apply, you will need:

• your Unique Organisation Number (UON)
• total number of homecare workers for testing

When ordering you will be asked to enter the number of residents or non-staff. You should enter zero for this.

Once you have placed an order, you will receive a confirmatory email from organisation.coronavirus.testing@notifications.service.gov.uk.

The agency manager will receive an email from organisation.coronavirus.testing@notifications.service.gov.uk when their test kits have been dispatched, informing them of their delivery date.

Test kits will be delivered in boxes of 40 to the address of your homecare agency, as registered with CQC.

The agency manager is responsible for taking delivery of the test kits.

The agency manager must then order kits every 28 days for their homecare workers.

If you have any issues ordering test kits, please call 119.

Webinars 

For more information you can join live webinars, which will be hosted every week by the DHSC.

These live webinars will talk you through the end-to-end process for homecare worker testing and include a live Q&A with the homecare testing team, who will be happy to answer your questions.

Sign up for the webinars

Lateral Flow Device Testing for domiciliary care staff

We acknowledge that currently the national focus on testing with domiciliary care is weekly testing with PCR, in line with the guidance above.  Providers have though raised concerns with regards the lack of parity with care homes, where additional testing is available with Lateral Flow Device Testing (LFTs). 

LFT testing kits can be ordered and utilised by individual staff, although we appreciate this requires staff compliance and agreement to manage this independently. 

How to get a lateral flow test:  Coronavirus – Get a test if you do not have symptoms (somerset.gov.uk)

Everyone in England who is not currently displaying symptoms of COVID-19 infection, can access free lateral flow tests to enable them to test twice weekly.

There are several routes available to receive twice weekly testing:

• Book a test at a local Community Test Site – Check this map of test site locations, dates and times for the nearest service to you. You can also find the addresses of the sites using this link.
• Collect a home test kit from a local Community Test Site – You do not need to book to collect a test, but the tests will only be available for collection at specific times. Check this map of test site locations, dates and times for the nearest service to you.
• Get a test kit sent to your home – If you are unable to get to a test centre to collect a test kit you can order a home testing kit to be sent to your home. You can order a test online here.
• Collect a test from a pharmacy – A new pharmacy collect service is now available in Somerset with 99 pharmacies signed up and more to come online soon. You will be able to use this if you are over the age of 18 without symptoms. Participating pharmacies will provide a box of 7 rapid tests to use twice a week at home. Find a pharmacy where you can collect tests.

The government has published guidance on regular retesting for extra care and supported living settings that meet the eligibility criteria (Department of Health and Social Care, 01/07/2021).

From the 09/12/2020 eligible Extra Care and Supported Living settings will be able to place orders to regularly test their residents and staff.

The Department of Health and Care (DHSC) has rolled out regular testing for staff and residents to extra care and supported living settings that meet the following criteria:​

• a closed community with substantial facilities shared between multiple people, and ​
• where most residents receive the kind of personal care that is CQC regulated (rather than help with cooking, cleaning and shopping)

Eligible Extra Care and Supported Living settings in England should conduct regular testing over a period of 4 weeks.

Staff should be tested on a weekly basis and residents should be tested every 28 days. Orders should be placed every 28 days.

Ordering Test Kits

Test kits should be ordered via the online portal: gov.uk/coronavirus.  Lines are open from 7am – 11pm daily.  Please note that you will need your organisations Unique Organisation Number (UON) in order to place an order.

Please be aware that you will not be able to place another 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 order.

Webinars

The DHSC would like to invite providers to regular Extra Care and Supported Living testing webinars and are strongly encouraging providers and those involved in the testing process join the webinar.

The webinars will last 1 hour and give detailed information about all aspects of testing, including:

• Ordering tests
• Preparing for testing
• Test kit delivery
• The testing process itself
• Registering completed test kits
• How to send test kits back to our labs
• Results and what they mean for your organisation.

The content of the webinars will largely be the same for each session, however will include key updates on testing so is subject to change.

The session will include a Q&A with representatives from the testing team, who will be able to answer your questions and address any concerns in the session.

Use this link to sign up to attend an Extra Care and Supported Living testing webinars.  If you are not able to attend the webinars, a recording of the session will be made available to you after the webinar has been completed using the same link.

Can settings share test kits with another provider, friends or family

• Test kits for a setting must not be shared with anyone outside of the setting
• Sharing test kits may lead to issues with test kit registration, courier collection and also contact tracing
• If you have any spare test kits, they should be stored between 5 and 22 degrees Celsius until their expiry date, which is displayed on the swabs
• Anyone that is symptomatic can get a test here: https://www.gov.uk/get-coronavirus-test

How can settings store spare tests?

• The DHSC will send test kits in batches of 40 to Extra Care and Supported Living settings, so we appreciate that you may have a few spare
• Test kits must be stored at an ambient temperature of between 5 and 22 degrees Celsius
• You can store spare kits for future use if you have received a result that states ‘we could not read your sample’, or if you are directed to use your kits in the case of an outbreak

Can settings test throughout the whole week?

• Yes, eligible settings can conduct testing throughout the whole week
• Testing can be spread out throughout the week, settings do not have to test everyone on one day
• If you are using the courier return method for 9 or more test kits, you can test throughout the whole week, including on weekends. You can book a courier at https://test-kit-collection.test-for-coronavirus.service.gov.uk/   
• If you are using the post-box return method for 8 test kits or less, you should not test on Sunday unless the post box has a Sunday collection time. Please join our webinars for more information

Rapid Lateral Flow Testing available to support visits in and out of settings

The Department of Health and social Care (DHSC) has announce that visits in and out of extra care and supported living settings can now be supported by rapid lateral flow testing.

Testing is one tool that can be used to help mitigate the risks to identify asymptomatic visitors who are likely to be infectious before they visit so they are able to self-isolate immediately.

For full guidance on visits in and out, please use the following link:  https://www.gov.uk/government/publications/supported-living-services-during-coronavirus-covid-19/covid-19-guidance-for-supported-living (Department of Health and Social Care and Public Health England, updated 17/08/2021)

For the on-site testing rapid lateral flow test guidance, please use the following link:  https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-testing-in-adult-social-care-settings (Department of Health and Social Care, updated 09/07/2021)

Key messages from the DHSC for Extra Care and supported Living services

• Extra care and supported living settings will be able to access rapid Lateral Flow Tests (LFTs) to support safer visits
• Managers can place an order for tests using their Unique Organisation Number (UON) from the standard test kit ordering portal
• Each setting will receive four test kits per person living in the setting per week which can be used to support both visits in and visits out
• Setting managers may decide to use some of their additional rapid lateral flow testing allocation for testing of the person being supported to support safer visits at their discretion and with the consent of the person being supported
• All testing for visitors and people receiving visits should be conducted on site assisted by trained staff. Test kits must not be given out for self-testing.
• Testing and PPE should be viewed as a tool to mitigate risk, rather than a requirement for people to visit settings or receive visitors. Managers may wish to provide visitors with appropriate PPE where visiting is judged to be high-risk and the PPE can be tolerated by both the visitor and the person being visited
• In the event of an outbreak, managers should take advice from the local health protection team who will undertake a risk assessment and determine subsequent next steps. Your HPT might recommend some visiting restrictions, these should continue until such time as it is understood that the outbreak has been brought under control

DHSC tips to prepare for visitation:

• Communicate testing offering and expectations to the people living in these settings, families and visitors
• Prepare staff for visitation, including appropriate training and reading the guidance for rapid lateral flow testing in adult social care settings
• Have devices available if visitors require assistance registering their result

Registering LFT results

All LFT results (negative, positive, or void) must be registered online and this can either be done by the visitor themselves or a staff member.
You should register all LFT results at:  https://www.gov.uk/report-covid19-result

Registration should be done within 24hrs to help NHS Test and Trace understand results. This is crucial for the DHSC to understand the prevalence of coronavirus in care homes across the country and be able to support the care sector appropriately. It is therefore especially important that you have made the necessary arrangements to make sure that all LFT results are registered online.

Summary

• Staff should test using weekly Polymerase Chain Reaction (PCR) testing and twice weekly Lateral Flow Tests (LFTs).
• Service users that can test, should test twice weekly with LFT 3-4 days apart. If a service user is only visiting once a week, they only need to test on that day.
• Centres must be signed up via the self-referral portal to gain access to testing, then once approved, managers can order test kits every month for staff and service users

COVID-19 testing for adult day care centres guidance for day services on how to access testing has been published by the Social Care Institute for Excellence (SCIE).  This guidance also includes information about an Adult Day Care Centres Testing Webinar – Please use this link to sign up to attend.

The link for day care centres to sign-up on the self-referral portal is https://request-onboarding.test-for-coronavirus.service.gov.uk/. Day Centres should sign-up using the referral UON 99915258 and select that they are an “adult day care centre”. Once reviewed and accepted they will then receive an email containing their own specific UON to order test kits.

Further Information

Reporting LFT Results to Managers

The Department of Health and Social care (DHSC) has told us that they are aware that reporting of Lateral Flow Test results to managers can be time consuming, and that they are working on a digital solution to this. Whilst this is in progress they are happy to be able to support an alternative way to have results sent to a management email address as follows:

1. Enter your details as normal.
2. At the final step, when you are asked to verify the information you have input, you are able to edit the email address section to include a management email address.
3. Enter alternative email address. This should contain some detail which identifies the address as an administrative account (e.g. admin@daycentre.com or manager@charityname.com)
4. Submit your registration. Results will be registered, and a record of the registration will be sent to the contact details entered.

PCR staff testing

Weekly routine staff PCR testing is currently available for all adult day care centres that are run by paid day care staff and deemed critical to be open during lockdown by Local Authorities. Services must be for adults over 18 and provided within non-residential care settings that support the health and wellbeing of adults. This includes settings such as:

• purpose-built day centres
• day centres attached to or part of a care home or supported living
• other buildings in communities specifically used for regular adult day care

Full information can be found here: https://www.gov.uk/government/publications/coronavirus-covid-19-testing-for-adult-day-care-centre-workers (Department of Health and Social Care, updated 27/08/2021)

Why Dual Testing is used in Adult Day Care Centres

Rapid Lateral Flow Tests (LFTs) and Polymerase Chain Reaction (PCR) tests deliver different benefits. Conducting both tests on the same day combines the speed of LFTs with the higher sensitivity of PCR tests.

Using LFTs helps to quickly identify some individuals who have a high volume of the virus in their body and are more likely to be infectious. LFTs will not identify everyone who is infected, but speed is important for stopping the spread of the virus. LFTs can help to give an earlier warning of infection in the setting, rather than waiting for the PCR result to return from the lab. This helps to contain the infection as quickly as possible.

The PCR tests find people who are infected but were not identified by the LFT, for example people who have lower amounts of the virus in their body because they may be at the start of the infection. Testing with LFTs midweek and on the same day as the PCR is the best way to identify people who are infectious

How can adult day care centres get access to testing via the self-referral portal?

• Day care centre managers that meet the eligibility criteria set out above can navigate to https://request-onboarding.test-for-coronavirus.service.gov.uk/
• Managers will need to enter the referral UON of ‘99915258’ and provide details of their adult day care centre. Please note, this is only a referral code and cannot be used to order test kits. Centres will receive a separate UON via email once they have been accepted for them to be able to order test kits.
• Organisations which run multiple day care centres at various locations will need to register each centre separately to receive multiple UONs, even if the contact details for each of these are the same.
• Once they have received an acceptance from the Local Authority, NHS Test & Trace will email day care centre managers with their UON and instructions to place orders from the test kit ordering portal

Testing for all staff and service users in adult day care centres in England

After the completion of a successful pilot study, NHS Test and Trace is making regular lateral flow (LFT) testing available to all staff and service users in adult day care centres in England, to be conducted alongside the existing weekly staff Polymerase Chain Reaction (PCR) testing.

• Staff testing schedule:  2 rapid lateral flow tests and 1 PCR test per week, ideally before starting their work shift:
  • One rapid LFT on the same day as the PCR test (Thurs-Sun).
  • One rapid LFT on days 3-4 between PCR tests.
• Service users testing schedule:
  • Service users can still visit day centres if they have not tested.
  • Testing is not mandatory.
    • For service users that are able to test – test twice a week with 3-4 days in between using rapid 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, the day prior to attending the centre.

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.

The Department of Health and Social Care (DHSC) understands 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 the following link to order rapid LFT kits using the same Unique Organisation Number (UON) that you use to order PCR tests:  https://request-testing.test-for-coronavirus.service.gov.uk/

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.

For further support and information, please attend one of the DHSC’s rapid lateral flow testing webinars at 11:00am on Tuesday 4th May and then recurring weekly on Mondays (see below).  We strongly encourage providers and those involved in the testing process to join the webinar, which can also be attended by service users and carers/parents.

Sign-up to regular adult day care centre testing webinars

The Department of Health and Social Care hosts regular interactive testing webinars every Monday, including a live Q&A, to go through test kit ordering, conducting testing, registering, returning test kits and results.  If centres are not able to attend the webinar, they are able to sign up and a recording of the session will be made available after the session.

Sign up for the webinars

Personal Assistants (PAs) in England are entitled to regular weekly PCR testing, from 17/02/2021.  This applies to all PAs in England who provide care and support to individuals in their own homes, where they come within 2m of the person they care for.

This is in addition to the existing support available to PAs to keep themselves and those they provide care and support to as safe as possible.

This includes guidance on Infection Prevention and Control (IPC) measures and the availability of free PPE in government guidance on using direct payments during the coronavirus outbreak: full guidance for people receiving direct payments and personal assistants (Department of Heath and Social Care, updated 24/08/2021)

PA’s will be able to order a month’s supply of test PCR kits every 28 days, delivered to their home address, enabling them to conduct weekly coronavirus testing at home.

This is part of the Department of Health and Social Care (DHSC) commitment to protect frontline workers, their loved ones and the people they care for and reduce the spread of coronavirus.

Further guidance about how PAs can order tests, how to conduct testing and what the results mean is available in government guidance on Coronavirus (COVID-19) testing for anyone working in adult social care who are not part of regular testing at work and unpaid carers (Department of Health and social Care, updated 18/06/2021).  A Guidance document and  summary has also been produced, along with a User Guide and FAQs.  The DHSC are also running a Personal Assistant testing webinars.  Please use this link to sign up to attend the webinar.

Please note that this testing programme is only for directly employed or self-employed carers who support people in their own homes.

If you are already part of a regular national testing programme through your employer or another organisation (e.g. through the homecare, or extra care and supported living testing programme), please continue.