Update November 2020

At Amica Care Trust, we will soon be allowing nominated visitors to meet safely and comfortably with their loved ones via specially designed ‘Visitor Pods’ in our care homes.   Whilst we have encouraged garden visits, window visits and specially arranged visits when one of our residents has been unwell, this improves opportunities for families of our residents.

We have recognised both the sadness and distress that has been experienced by families since the start of this pandemic, particularly as Amica Care Trust took the decision to close their Homes earlier than the Government advised, to help ensure their residents remained safe and well.

We understand the importance of opening up our Care Homes to visitors as this supports our care, knowing that family members can be a huge part of the care team, as well as supporting the wellbeing of our residents, emotionally, physically and for improvement in their mental health.  That is why we are so pleased about this new development of creating ‘Visitor Pods’ in our Homes.  Each Home is unique in its layout, and of course the needs of our residents vary, so we have given a great deal of thought to come up with the best solutions locally.

Visitor Pods have been created at each Home and the Home will use an appointment system, whilst ensuring a member of the care team is always on hand to support where required.   Both sides of the Pods will be deep cleaned between each visit – hence the importance of having staggered appointments.

Our priority is to keep all of our residents, visitors and staff safe during these unprecedented times; we are committed to continue to provide the best care and support for everyone.

We are working closely with the Local Authorities, Public Health England, CCGs and Government advice to ensure that any risks of COVID-19 are well managed and people are protected.

We have robust COVID-19 protocols in place, staff have received training and we have adequate supplies of quality Personal Protective Equipment.

HOMES STATUS

New Admissions:

All of our homes are open to new residents and we welcome any enquiries if you are requiring support to care for your loved one. Please contact the home directly for up to date information.

Visitors:

We understand how important it is for both residents and their loved ones to receive visits. Please can you contact the home directly to find out what their visiting arrangements are. 

 
 

 

Document Date:               23 December 2020

Document Owner:             Operations

Approved By:                    Chief Executive

Date Approved:                 29 December 2020

Review Date:                     14 July 2021

Visiting during a Pandemic

Policy Statement

The policy aims to ensure safe visiting during the COVID-19 pandemic and the easement on visiting those who are vulnerable as a result of the sustained transmission of the Corona virus.  

The policy thus aims to minimise the risks to residents’, the employees of the Trust and to the visitors themselves, the Government has released guidance and this policy outlines out compliance with the dynamic risk assessment approach. 

Amica Care Trust’s Care Homes and services have a duty of care to protect its residents and staff from intruders and anyone who threatens their safety and security.

This policy is to be used in conjunction with the visiting and visitor’s policy and the COVID 19 Testing policy.

The policy is also in line with Care Quality Commission guidance, the Department of Health and public Health England.

This policy is intended to assist decision making during the COVID-19 outbreak, which is anticipated to last for a sustained period, compared to the usual period for other infectious outbreaks. As we see other parts of our community experiencing a small degree of easement of the lockdown rules in England, it is important to recognise that for those in our care settings, there is a need to balance the continued management of COVID-19 risk, with a cautious approach to enabling the opportunity to receive visitors, the prevalence of this is highlighted again with the new strain of the Covid-19 virus and the known enhanced spread of the virus.

Scope

Closure of the home to visitors

In certain circumstances the management of the home may decide to close to all visitors as they have always done so in the interest of safeguarding residents; this could be due to an infectious outbreak such as:

  1. Diarrhoea & or vomiting (Gastroenteritis)
  2. Norovirus
  3. Clostridioides Difficile (C-Diff)
  4. Respiratory outbreak such as flu or chest infections
  5. During any pandemic in recent times such as COVID-19
  6. Discretion of management during any disaster or major event

During these times the home will operate a traffic light system Red, Amber or Green

  1. Green – open for visitors in line with the Covid-19 testing policy
  2. Amber – suspected cases – managers discretion – option to close the home 
  3. Red – confirmed cases of either staff / residents / Major incident affecting the home – home closed

 

As a result of the global pandemic all the Trust services have previously been closed to all visitors as residents are classified as extremely vulnerable and have been shielding on the advice of the Government. 

In order to ensure the residents safety, it has been necessary to limit visiting to open spaces such garden visits at these times when the homes were unable to accommodate in door visits, these visits have been important for the emotional wellbeing of the residents in our care.

Human rights recognise that all people living in care settings have the right to freedom of movement and association, including the right for residents to see their families.

This policy and guidance seeks to balance the rights of an individual with the rights of the others within the care setting (residents and staff) and the duties and responsibilities of Amica care Trust.

The Trust will work within the guidance set out by the Government which states:

The decision on visiting will be based on the advice from the director of public health, as well as any additional advice or guidance from the local infection-control lead from the CCG, and the local PHE HPT.

Role of providers and directors of public health (DPH) in providing a dynamic risk assessment

The priority is making sure those in care homes receive the care and support they need. This includes making sure that residents are not put at avoidable risk of contracting COVID-19, which can have such a devastating impact if it spreads through a care home, infecting vulnerable residents and potentially care staff.

Therefore, in order for visits to happen, the provider needs to assess and balance the risk of local prevalence and the ability of the care home to manage the visit safely. This dynamic risk assessment must formally take into account the advice of the local DPH. The DPH may choose to provide this through a dedicated care home outbreak management team or group, often in partnership with local social care commissioners. 

The role of the DPH includes formally leading efforts to suppress and manage outbreaks, and the local outbreak plan (overseen by the DPH) includes care homes. DPHs also have powers to issue directions to homes to close to visiting, or to take further specific steps.

Care homes must also take into account the significant vulnerability of residents in most care homes, as well as compliance with obligations under the Equality Act 2010 and the Human Rights Act 1998, as applicable.

The care home’s visiting policy is made available and communicated to residents and families, together with any necessary variations to arrangements due to external events.

In the event of an outbreak in a care home, the home will rapidly move to stop visiting (except in exceptional circumstances such as end of life) to protect vulnerable residents, staff and visitors. There may be local policy and outbreak management arrangements, which will be important to follow. These restrictions may continue until such time as it is understood that the outbreak has been brought under control and the care home has recovered – at this point visiting may be restarted but with the usual infection prevention and control measures and any enhancements required due to any risks identified following the recent outbreak.

In making their judgement the director of public health should consider as a minimum:

  1. local testing data, including test and trace data, to form a view on the accuracy of local outbreak information including data on uptake, results and frequency of testing in the local area, as well as to form a view of community prevalence
  2. any national oversight taking place in an area due to transmission risks

In addition, in making their decision about visiting policy, providers and the director of public health should, where possible, consider:

  1. any testing that takes place outside of the care home, for example community or home testing.  Staff must inform the care home so that the result is factored into the decision-making process to help inform the visiting policy
  2. results from weekly testing of staff and monthly testing of residents. This data will enable the risk assessment to be well informed. Evidence of outbreaks and recovery from outbreaks should also be considered (a recovered outbreak is defined as 28 days or more since the last suspected or confirmed case reported)
  3. local intelligence on risk factors relevant to transmission in the care home, for example a nearby concentration of locations where there is a higher potential risk of transmission (for example, food processing plants)
  4. readiness of the care home to respond quickly when there is a confirmed or suspected COVID-19 case within the care home, to immediately return to essential visits only (for example, end of life), with no exceptions. This assessment of readiness may be based on Care Quality Commission reports, experience of a care home’s responsiveness throughout the pandemic and other local qualitative information

In order to enable visits to happen safely it is vital that the DPH has a live view of the local conditions. The Capacity Tracker is a timely and rich source of information which will help inform the DPH’s advice on visits. Completing the Capacity Tracker daily will help provide assurance and early warning if there were to be an outbreak, as well as helping to provide confidence on regular reporting and that any new cases would be rapidly reported to the local PHE Health Protection Team.

Visits should always take place with appropriate infection-control precautions.

 

Types of visiting

The Trust’s services have engaged in a variety of visiting options which have included:   

  1. Window visits:  ground floor window access for both residents and their visitors and the relevant social distancing and PPE measures have been observed.
  2. Garden visits: Relevant PPE measures and social distancing have been used, and these visits have been pre-booked to ensure distancing is observed.
  3. Designated areas within a care setting where settings allow for this: depending on the physical layout of the care setting, we have enabled visits to an identified location inside our services reserved for this purpose, these areas have been made to the best of our abilities COVID-19 secure
  4. In-room visits: These visits have been implemented as appropriate, in line with national guidance in relation to essential / end of life visits to ensure the person can die with dignity and comfort, taking into account their physical, emotional, social, and spiritual support needs.
  5. Visiting Pods: the pods have been designed for Covid secure visiting with a screen between the resident and visitor, visitors are still required to have a lateral flow test for Covid-19, where possible visiting pods are the preferred visiting option as these are the safest option; this is also due to the current new strain of the virus and its ability to spread more easily and quickly between person to person.    

All visits have and will continue to have the to follow the visiting code / guidelines

  1. book visits in advance for a specific day and time, visits will be for one hour only – this must be adhered to; visitors are expected to also give their up-to-date contact details, and consent to having a lateral flow test (ad hoc visits will not be enabled)
  2. check in with the care service on the day prior to their visit, to ensure the situation in the service has not changed
  3. be free of any COVID-19 symptoms on the day of their visit
  4. must be well on the day of their visits
  5. provide the necessary information required by the service at the visits (e.g., honest response to screening requirements about COVID-19 risk factors)
  6. comply with the infection prevention and control measures, including a temperature test, mandatory hand hygiene, the use of PPE as required and social distancing requirements, remaining in the designated visiting area
  7. ensure they visit with a face covering / face mask
  8. ensure that any gifts brought to give to the individual they are visiting can be sanitised, in line with relevant infection prevention and control (IPC) guidance
  9. Wherever possible, visitors should try to walk or travel by car and avoid public transport when visiting the home, in line with the latest Government advice on travel during COVID-19

The Trust continues to adopt the current Government guidance (updated 23rd December 2020), which is based on the following principles:

  1. The trust welcomes that the default position set out in the December 2020 guidance is that visits should be supported and enabled wherever it is safe to do so.
  2. The Trust will do so based on a dynamic risk assessment taking into consideration the needs of individuals within their homes and with regard to the advice of the local Director of Public Health (DPH) through their outbreak management team or group.

It will continue with its policy of:

  1. “outdoor” visits as indicated by the risk assessments, including those made using temporary facilities such as pods.
  2. “indoor” visits to dedicated areas that can be supported by rapid testing (see section on Indoor Visiting Supported by Testing)
  3. the homes will continue to enable “essential” visiting needed in exceptional circumstances such as when a person is receiving end of life care
  4. the home will ensure that all visits are conducted in a risk-managed way that considers the needs of our service users and the practicalities arising from the physical features and layout of the home
  5. it will continue to assess the rights and needs of individual residents, particularly those with specific vulnerabilities as outlined in their care plans and will consider the importance of visits in promoting their health and wellbeing
  6. it will continue to make appropriate best interest decisions with the help of all involved in their care in respect of residents who lack mental capacity and who might be subject to deprivation of liberty authorisations
  7. it will follow all government and local guidance in respect of the arrangements needed to ensure safe visiting of residents under the new testing procedures
  8. the home accepts that there is more flexibility for the home if is placed in a Tier 1 area with visitors also from a Tier 1 area, however, if in that position, it will always ensure safety is never compromised and will adopt government advice that visits supported by testing is always the preferred approach
     

Additional measures

Each service will risk assess their environment to be able to accommodate visiting in areas of the home, each service will also take the following measures.

  1. Where an area is available, staff will facilitate the visit. This will be to ensure the area has been disinfected before and after the visit, (visiting spaces must be used by only one resident and visiting party at a time. Between visits there must be appropriate cleaning and an appropriate time interval) but also to support PPE requirements, and residents’ needs.
  2. Although every effort is made to provide privacy for visiting due to the risk of some residents’ staff need to support them. For example, if a resident poses high risk of falls, staff need to be close by to reduce the risk and support mobility.  Should a fall occur, to ensure compliance with social distancing, family members would be unable to support.    
  3. Staff will ensure the visitor have washed their hands / used the alcohol hand gel when they arrive and leave the area.
  4. Visitor numbers will be limited to a single constant visitor wherever possible, with an absolute maximum of 2 constant visitors per resident. This, for example, means the same family member visiting each time to limit the number of different individuals coming into contact. This is to limit the overall number of visitors to the care home and/or to the individual, and the consequent risk of disease transmission from multiple different routes. Any adaption to this would be discussed with the senior management of the Trust and circumstances considered for approval measuring the risk factors, home managers will complete an Ethical decision tool in collaboration with the senior management team.
  5. Only 3 visitors per day and at least 2 hours apart to ensure touch points have been disinfected again
  6. Social distancing (between visitors and residents, staff, and visitors from other households) must be always maintained – during the visit, and around the care home building and grounds
  7. Visitors temperatures are taken, and questions asked about their general health 
  8. If refreshments are offered / required, an allocation of disposable crockery will be supplied and disposed of in the provided pedal waste bin
  9. The visitor should have access to their own face covering and will not be permitted to visit without this
  10. Where it is appropriate and the resident understands it’s use, a shield screen may be used during the visit (whereby the visit is not held in a visiting pod)
  11. Any items brought into the home will be placed in a designated area to be sanitized by the staff team
  12. Where a visitor appears unwell / has a temperature the home / service will request the visitor leave and re book their visit.
  13. If the “R” rate increases the home / service will cease visiting and remain closed, this could also be a local increase in the “R” rating and may not apply to all the Trust services, this also includes changes in current tiers of local Areas.

If at any time visitors break the visiting protocol, they may be asked to leave, and a meeting arranged with the management of the home.

The health and wellbeing risks arising from the needs of our residents will be taken into consideration. This will include both whether their needs make them particularly vulnerable to COVID-19 and whether their needs make visits particularly important (for example, people living with dementia, may be permitted visitors when restricting visitors could cause some of the residents to be distressed) each resident will have a care plan detailing visiting information / requirements and a risk assessment.


Implementation

 

The Trust recognises that its visiting policy and arrangements will be very much subject to local circumstances and tiering and will have to be adjusted to meet any changes in these. These changes include:

  1. the circumstances of the care home in terms of, for example, its location, resident needs, current staffing situation and its experiences with the COVID-19 outbreak
  2. the local circumstances of the COVID-19 epidemic, including past and current incidence and transmission risks

Any arrangements made by the home will apply only when safe to do so, with the approval of the local Public Health authority and on the basis its “dynamic risk assessment”.

Its decisions will continue to be based on balancing the benefits to its residents (and reducing harm because of lack of visits) against the risks of increasing COVID-19 infections and their consequences to a vulnerable group of people.

The home recognises that decisions to allow visiting and under what circumstances will be made in line with local intelligence from testing on the community and of residents and staff, transmission risks in the local community and other information provided by the home, for example, through its Capacity Tracker updating.

Indoor Visiting Supported by Testing

Testing Process:

  1. Visitors will be provided with a letter from the care home and a copy of the Visitors Guidance, prior to the test being completed
  2. Consent forms will also be provided to gain formal consent for testing and sharing results
  3. The Care home will prepare a scheduled date and time for visitor testing

 

Testing Area:

  1. A separate area within the care home will be made available for visitors to enter, test and await results without entering other parts of the care home
  2. Where possible, the area will have a separate entrance. Where this is not possible, visitors will be requested to don PPE before entering the care home
  3. Other key aspects will be considered, to include social distancing, disability access, and fire safety regulations

Day of Testing:

  1. Visitors will be provided with PPE upon entrance and consent gained to be tested
  2. Antibacterial wipes will be available for visitors to wipe down the seat including any arms of the chairs before and after the test.
  3. Hand washing facilities, a mirror (for throat swabbing) and tissues will be available in this area
  4. The care home will display the homes, Unique Organisation Number (UON) to enable visitors to register their test results
  5. The care home will prepare test kits including the swabs, extraction materials, test tube racks, LFD devices, and barcodes
  6. The care home will also ensure, devices are available to register tests and results if required for the visitor (the visitor may not have a smart phone /device to add these details) 
  7. Support will be available to support visitors with registering their kit online, if needed
  8. Once the test is completed, visitors will need to follow the instructions given by the home manager/person in charge.

Visiting Professionals:

All visiting professionals who are not regularly tested through another route such as NHS staff or CQC inspectors, should be tested on every visit in the same manner as visitors via the LFD test.

For further visitor guidance please see the link below:

https://www.gov.uk/government/publications/coronavirus-COVID-19-lateral-flow-testing-of-visitors-in-care-homes

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/942015/care-home-LFD-testing-of-visitors-guidance-12-2020.pdf


Visiting Schedules


Under the present circumstances, the home recognises that all visits will have to be pre-booked and with limited availability some order of priority might need to be established.

It will base its priorities on the following.

  1. the importance to the wellbeing of the individual to have a resumption or continuation of visits
  2. the degree of harm that might occur without any visits
  3. the risk factors that are involved including the vulnerability to infection for the person concerned
  4. the degree of compassion that is involved, e.g., if the person is receiving end of life care or is likely to be receiving it in the near future
  5. the importance of visiting to the person in the context of their overall care plans
  6. the effectiveness of the current contact or visiting arrangements in place
  7. the willingness of prospective visitors to go through the new testing procedures if and when adopted by the home.

The home will ensure that the visiting arrangements will be planned, including times, frequency, and duration, and agreed in consultation with residents and their families and with professionals involved in a person’s welfare.

Visitors will need to be tested on entry every time they visit the care home, regardless of the date of their previous visit


Communicating with Families and Visitors

The Trusts homes will follow Government guidance in respect of enabling visits to be conducted safety and successfully, including supporting visitors on how to prepare for a visit, including where testing is being carried out.

The Trusts homes accepts that the arrangements for each set of visits will vary and need to be highly individualised.


Visitors’ Risk Assessments


When visiting our care homes as an agreed “essential visitor” we will still ask you to:

  1. check with us before visiting that everything is in order and that you do not have any symptoms for COVID-19
  2. check if you might have had any contact with anyone who might have been in contact with an infected person or someone carrying the virus and take a decision about visiting based on your assessment of any risks
  3. sign a short disclaimer to this effect
  4. be extra careful about being in physical contact with the person you are visiting and other people whom you might meet by:
  5. avoiding close contact with people, particularly if they are unwell
  6. avoiding touching their eyes, nose, and mouth with unwashed hands
  7. keeping to designated areas of the building which we will inform you about
  8. carry out stringent hand hygiene practice by always washing hands carefully before and after any contacts made - using the soap and hand sanitiser gels and paper towels provided
  9. help staff to carry out the procedures that have been put in place to keep everyone safe from the virus and its spread
  10. report and discuss with us any concerns you have about the health of the person whose welfare is your concern

We are confident that with these precautions in place we will be able to keep our residents safe.

The home will update this visiting policy in the light of further developments and the easing of restrictions as the risk decrease. It will, however, return to a tightening- up if there are further cases of COVID-19 in the home or evidence of increased risk from community transmission that has been identified by local Public Health.
 

Ability to suspend visiting

In the event of any suspected or actual outbreak of COVID-19, or a suspected or known case of COVID-19 within the home / service, visitor restrictions may need to be immediately implemented which suspend some of these enabling approaches and will include exclusion of any non–essential visitors. (this includes any contractors visiting the home).

This will be implemented in a transparent manner with open and clear communication to residents and relevant family members; this could mean that a visitor will be turned away if a suspected case has come to light during the time it has taken them to travel t the home.

Rights and responsibilities

This policy includes the rights and responsibilities for both Amica Care Trust and visitors which put the welfare and wellbeing of residents/ people receiving care at the heart of the approach when developing this visiting policy.

Rights

Amica Care Trust has the right to

Visitors have the right to

Mitigate risk of infection by refusing entry to their home to anyone, or requesting that a person leave the premises, for any justifiable reason consistent with this policy / protocol.

Access care homes in accordance with the entry requirements set out in the visiting policy of the care setting.

Consider increased visitor restrictions when an outbreak (including non-COVID-19) occurs within the home or declared outbreak / clusters have occurred within the home's local area or if there are other extraordinary circumstances that require it, and usage of such circumstances will be closely monitored.

Be notified by timely and regular updates and information about what is happening in the home, in relation to visiting and local COVID-19 prevalence and transmission risk.

Be provided and supported with additional ways to connect such as video conference or telephone calls in addition to a limited number of in-person visits.

 

Responsibilities

Amica Care Trust has the responsibility to

Visitors have the responsibility to

Provide a clear policy and information on how they will facilitate visitors, using a dynamic risk-based approach, and make this publicly available as needed.

Follow the home's visiting policy and Visitor Code, including booking in advance.

Provide clear information about how the visit will work and the infection and prevention control measures that must be followed.

Not to visit when unwell or displaying any signs of a cold/flu, respiratory or COVID-19 symptoms.

Appropriately support staff to facilitate visits including written processes and procedures.

Respond truthfully to COVID-19 screening questions asked by the home's staff and to sign the checklist / visitor.

Treat all visitors with respect and courtesy, and to provide clear instructions about the visiting policy.

Treat all staff with respect and courtesy, and to follow their instructions on the visitor policy.

Proactive communication with residents and families where an outbreak occurs, and the impact on the visiting policy.

Follow visiting requirements including, infection and prevention control measures such as washing hands, use of visiting windows, remaining designated areas and social distancing requirements – as directed by the care home staff – and that failure to do so may affect the future ability to visit.

 

The Trust will have the right to change and adapt this policy in line with Government guidance at any time.

Visitors have the right to express their concerns through the Amica Care Trust complaints and concerns policy.

The Trust will not accept liability for any illnesses the visitor may contract following a visit to its services including COVID-19 as a global pandemic.

Amica Care Trust services will request that visitors complete the questionnaire and give consent provided by the services and this is a true and honest reflection.

Each of the Trust’s service will keep a visitor log in line with the Track and trace initiative.  

 

 

 

Document Date:         23 December 2020   

Document Owner:      Operations    

Approved By:             Chief Executive Officer 

Date Approved:          29 December 2020   

Review Date:              15 March 2021

 

Testing for COVID-19

The Government has released its lasted guidance for care home testing of employees, residents, visitors and visiting professionals.

Employees and Residents:

Employees will continue to be tested for coronavirus twice every week, while residents will receive a test every 28 days to prevent the spread of coronavirus in social care.

All visitors and various categories of visiting professionals, will now be tested on each visit to the care home via a Lateral Flow Device (LFD)Test.

The new testing strategy comes following the latest advice from SAGE and new evidence from the Vivaldi 1 study indicating a higher prevalence in care homes, and therefore a case for frequent testing in care homes, their staff and visitors, and various categories of visiting professionals.

Employees:

  1. Care home staff will be given a coronavirus tests twice every week. One LFD test on the same day as the PCR test, ideally at the beginning of a shift followed by an additional LFD test 4-5 days later.  
  2. If any staff test positive, they will need to undertake a confirmatory PCR and then self-isolate at home immediately until they receive their result.
  3. Any employee returning to work after a period of leave, absence due to illness or have worked within another setting, will be required to undertake an LFD test at the beginning of their shift.
  4. Repeat testing will be initially prioritised for care homes primarily looking after over 65s or those living with dementia before being rolled out to all adult care homes.
  5. The Government’s Vivaldi 1 care home study highlights the importance of regular staff testing while there is a higher prevalence in care homes.
  6. Tier 4 testing: If there are any positive cases, PCR or LFD, found in a tier 4 care home, staff should also:
  7. Undertake daily LFD testing of all staff for 7 days
  8. If any staff test positive, they will need to undertake a confirmatory PCR and then self-isolate at home immediately until they receive their result (This only needs to happen the first time you have a confirmed positive via PCR test -this is a one-off to help identify all asymptomatic cases, and you will not need to repeat this again if you later get another positive PCR result in the home.)
  9. This additional 7-day testing should be in addition to any outbreak testing that may be necessary from local Health Protection Teams.

An area in the home will be allocated for testing and, if staff are attending work on their day off, they will be paid. It may be that the Trust need staff to extend their shift times so that they can be tested before the commencement of their shifts.

Process:

  1. Staff will attend to complete their tests on the days allocated by the home manager.
  2. Staff will be given a consent form for completion prior to the test.
  3. Staff will register their attendance and collect their test kits.
  4. Staff will then proceed to the testing area, guidance on how to administer the tests will be available.
  5. Antibacterial wipes will be available staff are to wipe down the seat including any arms of the chairs before and after the tests.
  6. Staff will have access to PPE, hand washing facilities, a mirror (for throat swabbing) and tissues in this area.
  7. Once the tests are completed, staff will need to follow the instructions given by the home manager.

Employees who wish to have support administering their tests will be able to book a slot with an allocated member of staff provided by the home manager.  Bookings for these slots will be available with the management of the home to ensure someone is available to support with the testing. 

If staff have any concerns in relation to the required testing, they are to see their home manager in the first instance. 

For more information on testing staff can visit the Government website: https://www.gov.uk/guidance/coronavirus-covid-19-getting-tested#care-home

Residents:

In all tiers, all residents within a care home setting will be tested every 28 days via a PCR test, this will also include any new admissions and immediately if any resident develops symptoms, do not wait for the next retesting cycle.

All residents should be tested with PCR, even those who have previously tested positive for Covid-19, in either a previous setting or prior to the past 90 days. If residents develop new symptoms, they should be isolated immediately and tested, and the local Health Protection Team should be notified.  

Individuals who have previously tested positive, within the care home should only be tested again with PCR after 90 days have passed from the positive result unless they develop an onset of new symptoms. (The LFD test can be used straight away after the isolation period currently 14 days for residents of a care setting.)

As far as possible, residents should be offered the choice to either self-administer the PCR test themselves or to have the test administered by a suitable member of staff


For further guidance please see the link below:

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

Visitors:

All visitors (Family/Friends) to care homes will be tested each time they visit with an LFD test. If a visitor receives a negative result, visits can proceed, as per the Trusts visiting during a pandemic policy. They will be required to wear appropriate PPE throughout the visit and follow all infection prevention and control measures.

If a visitor receives an invalid result, then a retest will be carried out via an additional LFD test. If the result received is an invalid result again, visitors may be permitted have a visit similar to someone who has not been tested, in line with the below:

  1. Outdoors – which can include at a window
  2. In a visiting pod or similar type of arrangement.
  3. Indoors as long as there is a substantial screen between the resident and visitor.

If a visitor receives a positive result, they will be requested to conduct a confirmatory PCR test and register this at the care home using the ‘home’ registration route. The visitor will be advised to go home to self-isolate immediately and await their result.

**Please note ** visitors will need to be tested on entry every time they visit the care home, regardless of the date of their previous visit**

 

Testing Process:

  1. Visitors will be provided with a letter from the care home and a copy of the Visitors Guidance, prior to the test being completed.
  2. A consent form will also be provided to gain formal consent for testing and sharing results.
  3. The Care home will prepare a scheduled date and time for visitor testing.

Testing Area:

  1. A separate area within the care home will be made available for visitors to enter, test and await results without entering other parts of the care home.
  2. Where possible, the area will have a separate entrance. Where this is not possible, visitors will be requested to don PPE before entering the care home.
  3. Other key considerations will be taken into account, to include social distancing, disability access, and fire safety regulations.

Day of Testing:

  1. Visitors will be provided with PPE upon entrance and consent gained to be tested
  2. Antibacterial wipes will be available for visitors to wipe down the seat including any arms of the chairs before and after the test.
  3. Hand washing facilities, a mirror (for throat swabbing) and tissues will be available in this area.
  4. The care home will display the homes, Unique Organisation Number (UON) to enable visitors to register their test results.
  5. The care home will prepare test kits including the swabs, extraction materials, test tube racks, LFD devices, and barcodes.
  6. The care home will also ensure, devices are available to register tests and results.
  7. Support will be available to support visitors with registering their kit online, if needed.
  8. Once the test is completed visitors will need to follow the instructions given by the home manager/person in charge.

 

Visiting Professionals:

All visiting professionals who are not regularly tested through another route such as NHS staff or CQC inspectors, should be tested on every visit in the same manner as visitors via the LFD test.

For further visitor guidance please see the link below:

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

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/942015/care-home-LFD-testing-of-visitors-guidance-12-2020.pdf

 

Suspected or Current Outbreak

Where any employee or residents have been diagnosed with COVID-19, they will not be included in the regular PCR testing until 90 days after onset of symptoms or testing positive.  The LFD test can be used straight away after the isolation period currently 10 days for health and social care workers and 14 days for residents of a care setting. 

After the agreed isolation period there will be no need for the 90 day wait time for LFD tests to be carried out.


Suspension of Visits

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