Norfolk & Suffolk Care Support Ltd
Regular coronavirus testing update for care home managers in England
< December 2020

Regular coronavirus testing update for care home managers in England

The Department of Health & Social Care has issued an update regarding lateral flow device testing.

The DHSC statement reads:

In this week’s update are important changes for you to be aware of:

  • Announcement: Grace period for registering your lateral flow tests
  • Reminder: Increase staff testing using lateral flow devices (LFD) alongside existing PCR testing
  • Reminder: Additional funding to support testing in care homes
  • Answers to frequently asked questions from our recent webinars on the changes to staff testing
  • Important links and where to go for further information

Announcement: Lateral flow device registration grace period

The results of all lateral flow device tests must be registered (whether positive, indeterminate, negative or void) at: https://www.gov.uk/report-covid19-result

However, we understand the pressures that care homes are under and, to allow care homes time to set up the additional testing, we are implementing a two-week grace period, where you only need to register positive, indeterminate and void results for staff LFD tests.

From today until Friday 15 January care homes will only be required to register online the positive, indeterminate or void results from staff lateral flow device tests.

For this two-week period there is no mandatory requirement to also register negative tests online. Registration should still be done within 24hrs to ensure the results can assist NHS Test and Trace in understanding transmission and prevalence.

Care homes should keep an internal record of the number of tests completed each day and their results. In January, care homes will be asked to input the total number of tests completed each day and the number of negatives into a single survey administered by the capacity tracker.

Results from all visitor and visiting professionals LFD tests must still be registered, even if negative.

Please note that from Saturday 16 January, care homes will need to register all lateral flow device test results, including those that are negative.

This is important to help public health teams understand the prevalence of coronavirus in care homes, and across the country and it is a legal requirement. It is therefore very important that care homes use this two-week period to make whatever arrangements are necessary to ensure that all results from lateral flow device tests can be registered online.

We hope this grace period will support your teams while you implement processes to support additional staff testing.


Reminder: Increase staff testing using lateral flow devices (LFD) alongside existing PCR testing

On Wednesday 23 December we wrote to inform you of the updated national guidance for coronavirus testing in care homes.

In addition to the existing weekly staff testing using PCR tests, care homes will now need to test their staff twice a week with lateral flow device (LFD) tests. The new guidance advises all care home staff in all tiers to undertake:

  • One LFD test on the same day as the PCR test.
  • One LFD test midweek between PCR tests. If any staff test positive, they will need to undertake a confirmatory PCR and self-isolate at home immediately until they receive their result.

Staff should also undertake an LFD test before beginning their shift if they’ve worked elsewhere since their last shift or have had a period of leave resulting in them missing their weekly PCR test.

This additional LFD testing should not in any way prevent the regular weekly PCR testing of staff and monthly PCR testing of residents which you must continue to do.

Staff who are not working on the day of the mid-week LFD test do not need to come into work specifically for a test, but they should do the mid-week LFD whenever they are next in work.

If you are in tier 4 and a single positive test result is found in the care home (either from a PCR or LFD), all staff on duty should test with LFD tests every day for a 7-day period from this first single positive test.

Staff who are not working on any given day do not need to come in specifically to be tested. You will only need to do this once, and will not need to repeat it if you find positive results within those 7 days. This is in addition to any other outbreak testing that may be required by your local Health Protection Team.

There are no changes to the testing of residents, who will continue to have a PCR test every 28 days.

These steps have been put into place following a significant rise in infections, attributed to the rapid spread of a new variant of coronavirus and based on the advice from SAGE.

We understand that this will be difficult for care homes to implement straight away and that every care home is different. We ask that you implement the policy as closely as you are able to do so taking into account the operational constraints you may face.

For further information, please see the full updated care home testing guidance here and the frequently asked questions below.


Additional £149m funding for testing

We have also announced an additional £149m of funding to support care homes with the increased testing of staff and visitors: https://www.gov.uk/government/news/149-million-to-support-increased-care-home-testing

The money can be used for care home providers to set up safe testing areas, provide staff training and contribute towards staff time spent on administering and receiving the tests. The money will be made available early next year and will be distributed via local authorities. We will provide further information about the grant in the new year.


Answers to frequently asked questions from our recent webinars on the changes to staff testing

We hosted two webinars about the changes to staff testing, the rationale for those changes and the additional support available to care homes. To access a recording of these special webinars please visit:

https://event.webcasts.com/starthere.jsp?ei=1369434&tp_key=296e54cdc9

Some of the frequently asked questions on those webinars are listed below:

What is the new policy for staff testing in care homes in all tiers?

Staff need to undertake an additional two LFD tests per week, ideally at the beginning of the shift:

  • One LFD test on the same day as the PCR test
  • One LFD test midweek three to four days later

If any staff test positive, they will need to immediately undertake a confirmatory PCR test and self-isolate at home until they receive their result.

Staff will need to undertake an LFD test at the start of their shift if they’ve worked elsewhere since their last shift or are returning from leave.

What is the new policy for staff testing in care homes in tier 4 when a positive test has been detected?

If you are in tier 4 and a single positive test result is found in the care home (either from a PCR or LFD), all staff on duty should test with LFD tests every day for a 7-day period.

Staff who are not working on any given day do not need to come in specifically to be tested.

This is to help identify all asymptomatic cases, and you will not need to start the 7 days testing again for any subsequent positives identified within those 7 days. After 7 days you should stop daily rapid testing.

This is in addition to any other outbreak testing that may be required by your local Health Protection Team.

If any staff test positive, they will need to immediately undertake a confirmatory PCR test and self-isolate at home until they receive their result.

Do staff all need to test on the same day each week?

We understand that staff may work different shift patterns and that you will need to adjust individuals’ testing days to fit with these. Care homes should stick as closely as possible to the policy while taking into account shift patterns.

You do not need to test all your staff on the same day as each other, and staff do not need to come into the care home on their days off for testing.

After a positive PCR test, I wait 90 days before re-testing with a PCR test. Does that also apply to an LFD test?

No, the 90 day period does not apply to the LFD test.

PCR tests measure the viral RNA and amplify its signal as part of the laboratory testing process, so even if you have traces of it in your system you could still get a positive result for up to 90 days after you initially tested positive.

LFD tests measure a person’s infectiousness, so after someone tests positive and has completed their isolation, they should re-start the twice weekly lateral flow testing immediately on their return to the care home.

After 90 days from their positive PCR test they should then restart their weekly PCR testing as well.

Do staff and residents still need to test if they have been vaccinated?

Yes, we do not know enough about the vaccine at this point to stop testing.

Do I still need to contact my local health protection team to arrange outbreak testing?

Yes, please contact them as soon as possible if you get any positive results from either an LFD or PCR test.

You can find your health protection team here: https://www.gov.uk/health-protection-team

Can our staff test at home using LFD kits?

At the moment we do not have MHRA approval for the LFD tests to be used at home by anyone other than NHS staff.

We are working on getting that approval as soon as possible, as well as packaging our kits into individual packages so staff can take them home. We will keep you updated on progress with both of these.

How do we access the online training portal for LFD training?

All staff that are conducting lateral flow testing should complete the NHS online training course.

Do we need to register all of our LFD results?

As per the announcement at the start of this email:

  • for the next two weeks only positive, indeterminate and void results need be registered, as we have implemented a grace period to support care homes adjust to this increase in testing.
  • from 16th January all LFD results must be recorded, whether positive, negative, void or indeterminate.

To register a lateral flow device result visit: https://www.gov.uk/report-covid19-result

Please note, this is a different link from where you register your PCR test. We do not currently have a bulk upload available for registering lateral flow test results but are working on improving the way both test results are registered.

What should I do if my LFD result is positive and my confirmatory PCR test is negative?

If the confirmatory PCR test result is negative then you do not have coronavirus. If two tests were conducted at the same time and return different results, then please always refer to the PCR result.

Whereabouts should we carry out the LFD testing?

The designated testing area for LFD testing should be away from residents and other staff. Care homes will need to determine the most suitable place based on the layout and facilities in their home.

Are we expected to test all professionals that enter the building?

All visiting professionals, including NHS staff, non NHS staff, maintenance workers and others should be tested prior to entry unless they are already part of a separate regular testing regime, such as NHS workers and CQC inspectors.

NHS workers and CQC inspectors all have access to their own testing and they should be able to confirm that they have had a test within the last few days (if LFD) or week (if PCR).

Anyone who hasn’t accessed their own testing should be given an LFD test before they enter the home.

Do we return LFD kits anywhere?

No – there is no need to return lateral flow tests to labs, please dispose of with your healthcare waste or clinical waste once you have a result.

How do we return our confirmatory PCR kits?

The difference between the confirmatory PCR test kits that we send you with your LFD kits, and the PCR test kits that you order for your weekly staff and monthly resident testing is that the confirmatory tests have:

  • a Royal Mail return label with every kit
  • a set of instructions with every kit

To return the confirmatory tests, please use the Royal Mail return label and post them in a priority mailbox. To find your nearest priority mailbox, visit: https://www.royalmail.com/priority-postboxes

If you have a courier booked anyway for that day, or you do not have return labels, or you have run out of confirmatory PCR tests and need to use your standard PCR supply, you can return the confirmatory tests via courier. If you need to arrange an urgent courier because you do not have one booked and have no return labels, please call 119.

What should I do if I haven’t received part of my kit e.g. barcodes, the LFD kits themselves or confirmatory PCR kits?

If you have not received bar codes, then please use the QR code on each LFD test cartridge. There is a number underneath the QR code which you enter when registering the kit.

If you have not received, or have run out of, your confirmatory PCR tests, then please use your standard care home supply of PCR tests and return via courier. You can request an urgent courier by calling 119.

If you have not received the lateral flow devices or have run out of them, please call 119 who will arrange an urgent delivery

How do I order more lateral flow devices?

You do not need to order your next round of LFD test kits. We are sending another delivery of a month’s supply of LFD test kits to every care home in England during January, with the first deliveries arriving on Monday.

We are prioritising homes in areas of high prevalence and tier four areas. You will receive an email confirming when your kits will arrive a few days before.

If you are running low and haven’t received your next order, please call 119.

We are building a digital ordering portal for LFD kits so care homes can order more lateral flow devices when they need them. This will launch in January.

You should continue to order your regular PCR tests in the usual way.


Important links and where to go for more information

To access a recording of the recent webinars on the increase to staff testing: https://event.webcasts.com/starthere.jsp?ei=1369434&tp_key=296e54cdc9

These webinars give an overview of the testing policy, but do not go into detail about how to conduct a lateral flow test.

To see the full updated care home testing guidance:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/947786/Care_Home_Testing_Guidance_England_v23-12_-_1.pdf

For more information on conducting a lateral flow test:

View our lateral flow device webinars here: https://event.webcasts.com/starthere.jsp?ei=1408929&tp_key=d2a77c17e3

See our written guidance here: https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-testing-of-visitors-in-care-homes

The NHS training, which all staff members who are carrying out lateral flow testing must complete, can be accessed at:

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

The token for this portal is: 3wkcVi4UTX

Please note that the token is not your password. Please follow the link, create your own username and password and then you will be prompted to add the token.

To register your completed test kits:

Lateral flow test registration: https://www.gov.uk/report-covid19-result

PCR test registration: https://organisations.test-for-coronavirus.service.gov.uk/register-organisation-tests/

Care home visitors registering confirmatory PCR tests should register using the link in the instructions in their confirmatory PCR test kit pack: https://test-for-coronavirus.service.gov.uk/register-kit

To book a courier:

https://test-kit-collection.test-for-coronavirus.service.gov.uk/

 

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