Plans to increase testing in care homes have been accelerated this week in response to the new strain of COVID-19.
To aid increased testing, £149m has been made available in a new grant for costs associated with staff and visitor testing. The funds can be used for setting up testing areas, staff training and for staff time. Allocations will be announced early next year.
The changes to testing in care homes have been made in order to prevent the spread of the virus and protect the health and wellbeing of residents and staff.
In addition, a new summary of the evidence for Lateral Flow Devices (LFD) in relation to care homes and based on research by PHE Porton Down, University of Oxford, University of Liverpool and the DHSC is available now.
This evidence should be read with the Coronavirus (COVID-19) lateral flow testing of visitors in care homes guidance.
Read the updated guidance on testing
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Following the email you received on Wednesday 25 November, regarding the expansion of Lateral Flow Device (LFD) test kits to all care homes, we would like to inform you that the guidance and instructions on visitor and visiting professional LFD testing is now available online.
Please access via the following link:
https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-testing-of-visitors-in-care-homes
The online guidance and instructions include:
- Care home guidance with instructions on the testing process and preparing for testing
- Visitors guidance to explain the testing process
- A visitor letter template that can be sent to visitors before their first visit
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All of these materials can be downloaded and shared with testing staff, visitors and visiting professionals.
We ask that you do not commence testing until Monday 14th December.
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Before commencing visitor testing, you will also need to watch our webinar and complete NHS online training. Further detail about how to access the recording of the webinar and information on training can be found further down.
The key objective of this effort is to support the on-going safety of the entire care home community. This information relates to using the tests for testing visitors to your care home. We will provide further guidance about using the tests for anyone else.
While testing can reduce the risk associated with visiting, it does not completely remove the risk of infection. These tests should be used alongside robust Infection Prevention and Control (IPC) measures, such as PPE, to safely maintain a balance between infection control and the vital benefits of visiting to the health and wellbeing of residents.
What are Lateral Flow Device (LFD) test kits?
Lateral Flow Device (LFD) test kits are a new technology which enable rapid display of Covid-19 test results in 30 minutes and do not require a lab to process. The LFD swabs can be self-administered via nasal and throat swabs similar to the current PCR tests but must be processed by a trained staff member.
What will you receive?
On your delivery date, your care home should expect to receive a delivery of:
- One box of 675 LFD test kits
- One box of universal PCR test kits (to be used if someone tests positive with LFD)
- One box of supplementing kit
In the box of supplementing kits, you will receive registration cards and barcodes. The registration cards are A4 size sheets of paper that include a QR code and are meant to support the visitor for registering their test kits.
PLEASE MAKE SURE YOU DO NOT USE THESE CARDS.
This is due to the fact that we have moved to a new registration form, so these cards are no longer relevant within this process. They can be recycled once you receive them.
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Results management
As part of this rollout, you will be using an online form to register and log results. The form needs to be used each time someone in the care home tests with an LFD test kit. The form will require contact information for the individual to link the test subject to the test device.
The link to the form will be shared with you once you are eligible to begin testing. The link can be accessed through any device with a browser (e.g. phone, tablet, laptop, desktop computer).
The process of using the online form will be explained in further detail via the webinar and guidance.
Please note you may have been asked to perform a Quality Assurance exercise that entails doing both a PCR swab (tests you already do for routine whole-home testing) and a LFD test. This will be done as part of regular staff testing in order to measure concordance between results (e.g. that the result on the LFD matches the PCR result). You will receive further details on how this works in the guidance and webinars. Performing QA is the only scenario in which you should not register the result of your LFD. All other tests undertaken with a LFD need to be registered and logged on the web-based solution.
Webinars
The webinars can be accessed here and they last 60 minutes and give detailed information about all aspects of care home lateral flow testing.
All staff who will be processing testing should view the webinar recording. They follow a similar format to previous care home webinars you may have attended.
If you have been unable to attend the live webinars, please sign up and a recording of the session will be made available to you.
Training
To prepare testing staff to use this new device, NHS Test and Trace has created an online training portal. The training videos last about 15 minutes followed by a competency assessment. It is critical that each care home manager identify staff members that need access to the training portal.
You will receive an email that will include a link and a token that will provide you with access to the online training portal. You will need to share the link and token provided with the individuals who require the training.
Testing staff can complete this training before or after the webinar, but it is critical that your home does not begin testing until all relevant staff have completed the assessment.
Once access is granted and training is complete, screengrabs of the competency assessment can be sent to the care home manager to be stored for internal records.
PPE for visitors
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To ensure you have enough PPE for safe visits to care homes, as a first step, DHSC will be sending out a one-off push of PPE to every CQC-registered care home provider by December 2.
If you are already registered on the PPE portal, you do not need to take any action in order to receive this PPE.
The delivery of this PPE will take place in a staggered manner and you should have received it by December 18. This will be in addition to any PPE you order through the PPE Portal. We will use the details you have provided on the PPE portal to make these deliveries.
If you are not registered on the PPE portal, and have not registered (you do not have to place an order) before 2 December, you will not receive this one-off push of PPE to support visiting.
You can register on the PPE portal here with the email address that your care home has used to register with the CQC. If you have any issues with this, please contact the PPE portal customer support service on 0800 876 6802.
Following this initial push of PPE, we will look to raise the order limits on the PPE portal, so you can simply increase the amount of PPE you order here to support visiting in future.
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Preparing your home for visitor testing
While you await more information, please consider how your home can prepare for this new testing process in order to test visitors. Key things to consider include:
- Preparing a designated entrance where visitors can put on PPE before interacting with others. If a visitor must come through the same entrance as others to access this area, they will need to put PPE on outside first before entering
- Preparing a designated area for testing where a visitor can also wait whilst waiting for their result. This area will need to be away from the main part of the home, so a visitor does not interact with any other staff or residents prior to receiving their result. The testing area may be set up either indoors or outdoors. The specific configuration of your care home’s testing area will depend on infrastructure and environmental constraints
- Taking stock of your PPE and ensuring you have enough for visitors if required (see PPE section above)
- Making space in your home to store LFD kits separately from your other kits
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Further preparation considerations will be highlighted in the webinar, but please consider where to set up the testing area in your home and which staff will undertake the training.
If you have any queries, please call the coronavirus testing contact centre on 119.
Infection prevention and control are essential to prevent the spread of coronavirus (COVID-19). This video-based course for care providers in care homes and home care will teach you about the spread of infection and what you can do to protect both yourself and the people you care for.Understanding infection control will provide you with the tools to help prevent COVID-19 from spreading.
Course content
- What is coronavirus (COVID-19)?
- Preventing the spread of infection
- Managing the environment
- About your general health
Learning Outcomes
- Understand how infections spread and how to prevent it
- Learn about hand hygiene and guidance
- Manage the care environment
- Manage laundry safely
- Keep safe with personal protective equipment
- Understand waste disposal
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To access this free course, please click here.
Delivery of the COVID-19 Pfizer-BioNTech vaccine and the Oxford AstraZeneca vaccine for care homes residents and staff is well under way.
By local arrangement with Primary Care Networks, teams of GPs, practice nurses, community pharmacists, and other trained vaccinators are bringing the vaccine to care homes and administering it to residents and staff.
Larger care homes with 50-70 beds will be prioritised at first, with around 2,900 care homes of this size in England. Over the coming weeks and months the rate of vaccination will increase as more doses become available and the programme continues to expand, with more vaccines being delivered directly to care homes.
To ensure the teams can deliver the vaccine safely care homes will need a suitable space and setup for all activities, including:
- Enabling privacy for clinical assessment, seeking consent, and managing circumstances where people lack mental capacity.
- Preparation of vaccines close to where residents will be vaccinated to minimise risk of deterioration when transported following reconstitution/drawn up.
- Supporting patient flow around the care home to enable social distancing for residents and minimising delay between vaccinations.
- Agreed arrangements for 15 minutes post-vaccination observation.
Homes will also need to ensure a COVID-safe environment when residents are moving round the home for vaccination.
The teams administering the vaccine will have a range of measures in place to keep staff and residents safe from COVID-19. They will be wearing the necessary protective equipment and there will be regular cleaning and disinfecting in between vaccinations.
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 There is a lot more work to do in all the workstreams as vaccination offer and delivery continues to be rolled-out but please be assured conversations are taking place to ensure that appropriate consideration of the needs of people with a learning disability and autistic people in an at-risk group, along with their families and carers, are considered within all settings. This work will help safeguard that those eligible for vaccination are invited and supported to do so, appropriately.
The COVID-19 vaccination has now started rolling out to at-risk as outlined below:
- Residents in a care home for older adults and their carers
- all those 80 years of age and over and frontline health and social care workers
- all those 75 years of age and over
- all those 70 years of age and over and clinically extremely vulnerable individuals
- all those 65 years of age and over
- all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
- all those 60 years of age and over
- all those 55 years of age and over
- all those 50 years of age and over
Unless someone with a learning disability by reason of age, fits in to priority groups 1-3, then people with a learning disability and autistic people in at risk group will generally fit in to groups 4 or 6 for vaccination priority.
Group 4 – All those aged 70 and over, and those deemed clinically extremely vulnerable individuals (not including pregnant women and those under 16 years of age);
Group 6 – Adults aged 16 to 64 years in an at-risk group ( this will include individuals with downs syndrome, those with a severe or profound learning disability, those with other underlying health conditions such as diabetes, morbid obesity -BMI >40; chronic respiratory disease, chronic kidney, liver, heart, vascular or neurological disease, immunosuppression, asplenia dysfunction or severe mental illness, such as schizophrenia, bipolar disorder or any mental illness that causes severe functional impairment).
What you can expect from us
NHSEI, with input from lived experience colleagues and stakeholder groups, are developing a range of information materials, including easy read versions.
Additionally, several films are being developed covering a wide range of issues such as supporting the understanding and awareness of vaccinations more broadly, general information on the covid-19 vaccination and the importance of reasonable adjustments.
Invitation letters and other associated materials are also being developed in easy read versions. As soon as materials are available then these will be shared.
Further information:
Please also view this short video about vaccines for people with a learning disability and autistic people.
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Making Friends with your Face Mask, This video is for people with learning disabilities to help them understand why wearing a face mask is important, how to find a face mask that suits them and how to get used to wearing it.
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Supporting a person with a learning disability to wear a face mask. This video is for family members or carers of people with learning disabilities to help them understand why wearing a face mask is important, how to find a face mask that suits the person they support and how to help them get used to wearing it.
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DHSC has written to local authorities and care providers to remind them that care workers should receive normal wages if they need to self-isolate. Payments for self-isolating staff is set out in the Winter Plan and additional guidance can be found for the Infection Control Fund here.
Health Education England with NHS England and NHS Improvement have produced a series of animations to help explain getting to and from work, test and trace, and what to wear aimed at social care staff.
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