Testing and tracing updates

23 November 2020

Testing and vaccination

We are engaging with MHCLG and DHSC to make the case for extending whole-scheme coronavirus testing to all supported housing settings (beyond Extra Care and CQC registered schemes), and testing for both residents and staff.

To support this, we are working to help the relevant departments of both ministries understand the specifics of supported housing, as well as how their setup can be similar to other settings that have been prioritised for testing, such as care homes.

This includes feeding into guidance around the use of restaurants and communal spaces and making a case for prioritising this because of the resident profiles.

We also encourage members to engage with key decision makers at local level who can help target testing on the ground and feed back to government. This includes directors of public health and local authorities that will identify providers in their data returns

Weekly testing for homecare workers

Care workers working for CQC-registered providers and looking after people in their own homes, will be able to test themselves on a weekly basis from 23 November 2020. This will soon be extended to unregistered providers. We have again pressed the government to extend regular testing to all supported housing providers on this basis.

Rapid testing roll out

The government announced that 600,000 rapid testing kits will be issued to directors of public health across England from 9 November 2020. Each director will receive 10,000 devices as part of a pilot to begin testing priority groups, and will then be followed by a weekly allowance of tests. Directors of public health will determine how to prioritise the allocation of these new tests, based on the needs of their communities.

We recommend supported housing members make contact with their local public health teams to make the case for prioritising their residents and staff.

Accessing a coronavirus test

The government has expanded the eligibility criteria for coronavirus testing. All the tests currently available are diagnostic tests, designed to find out whether someone currently has coronavirus. Antibody tests, to find out whether someone has previously had the virus, are not yet widely available. Full details of who can access a test and how to order one can be found on the government's website, the key points are:

  • Everyone in England with coronavirus symptoms can now get tested.
  • Essential workers and their family members will still take priority when it comes to allocating tests. This includes frontline workers in supported housing schemes.
  • All NHS and social care staff and care home residents can get tested whether or not they have symptoms.
  • Whole-scheme testing is being repeated in care homes.
  • Whole-scheme testing will be extended to some extra-care schemes and supported living schemes where there is a clinical need. The preparatory round of testing in these settings is underway and providers should receive notification to register for it in October.

We have heard from our members that the ease of accessing tests and the length of time it takes for results to come back varies across regions, with some organisations now finding it relatively easy to get symptomatic staff tested and others still facing substantial backlogs. To share your feedback, please email us.

In addition, our members who run care homes, and have therefore been able to access testing for staff without symptoms, have started to report substantial numbers of positive test results even among asymptomatic staff. Because of this we have been making the case to government testing of asymptomatic people should be expanded to include frontline workers in supported housing settings.

The initial round of asymptomatic whole-scheme testing for staff and residents at the extra-care housing and supported living settings at most clinical risk is underway, commencing in October 2020. This round of testing is to understand prevalence and user needs to inform future decision-making about testing in Extra Care and supported living settings across England.

The Department of Health and Social Care (DHSC) will deliver tests to Extra Care and supported living settings that meet the following criteria:

  • A closed community with substantial facilities shared between multiple people.
  • Where most residents receive the kind of personal care that is Care Quality Commission (CQC) regulated (rather than help with cooking, cleaning and shopping).

They will also deliver tests to services delivering home care for them to distribute to their staff (see above). An invitation to register for testing will be sent to providers via the email address given in data returns to local authorities. DHSC will only register providers identified by their local authority so you are advised to contact your local authority for clarity on whether you can be registered and if you feel your service was missed off the data return.

DHSC is running a series of webinars for providers on the testing process.

We are making the case to government that the DHSC and local public health directors should consider the full range of supported housing services when deciding which schemes to prioritise for testing, including short-term complex needs services with shared facilities, as well as long-term schemes for older and disabled people.

Test and Trace System

The government published guidance on 27 May 2020 about how its ‘Test and Trace’ service would operate, including guidance for employers on how to support workers who have to self-isolate.

The service went live on 1 June 2020 and is designed to:

  • Provide testing for anyone who has symptoms of coronavirus to find out if they have the virus.
  • Get in touch with anyone who has had a positive test result to help them share information about any close recent contacts they have had.
  • Alert those contacts, where necessary, and notify them if they need to self-isolate to help stop the spread of the virus.

The government Test and Trace app is now available to download.

Employers should:

  • Encourage their staff to order a test for coronavirus if they have symptoms.
  • Encourage employees to comply with notifications to self-isolate and support them to do so.

This guidance does not include healthcare workers and others working in health and social care settings, who should follow separate guidance on when to self-isolate and when to return to work.

We know that some supported housing members are concerned about the potential impact of the Test and Trace system on their services. Especially the disruption that could be caused if one team member's test result shows they have coronavirus and they have been in contact with other team members running an essential service.

Contact tracers should be following up with people who are ‘close contacts’ of someone who has tested positive for coronavirus, meaning someone who:

  • Spends significant time in the same household.
  • Is a sexual partner.
  • Has been within one metre of someone who has tested positive for coronavirus for one minute, has been coughed on or had skin-to-skin contact.
  • Has been within two metres of someone who has tested positive for coronavirus for more than 15 minutes.
  • Has travelled in a vehicle with someone who has tested positive for coronavirus.

MHCLG has advised that the best approach is to minimise the risk of infection by ensuring PPE is used appropriately and face masks worn where contact is likely to happen. You should also minimise opportunities for contact across wider teams, for example reducing staff working across sites where possible and minimising the number of staff each worker has contact with.

Advice for supported housing providers

MHCLG recommend that supported housing providers should review services and operating practices regularly to reduce the risk of spreading the infection through measures such as:

  • Undertaking ongoing risk assessments of each setting, including the vulnerability of residents, those who may find changes in routine challenging, the levels of support and care provided and the physical conditions in the operating environment.
  • Ensuring that lists of people in supported living are up to date.
  • Communicating information with residents/service users in a way that they are most likely to understand.
  • Continuing to adapt services and practices and adopt social distancing measures wherever possible.
  • Using hand and respiratory hygiene principles and self-isolation where needed.
  • Continuing to use PPE where needed, including providing personal care, or if the person supported has behaviours and needs which make social distancing difficult, and ensure workers are regularly updated on how to use PPE (especially donning and doffing).
  • Minimising and carefully managing visits where feasible.
  • Where possible, avoiding or minimising staff deployment to more than one location.
  • If a local risk assessment identifies service delivery issues caused by low staffing, supported living and care/support providers can work with local authorities to establish plans for mutual aid, including limited sharing of the workforce.

To inform planning ahead of a possible outbreak, providers and local authorities should work together to facilitate mutual aid, care and support plans across their areas.

Where there are suspected or identified cases of infection, supported housing providers and staff should comply with the published guidance on testing and tracing workplaces.

Where there is a risk of multiple cases of coronavirus, or the risk of an outbreak across a whole team providing an essential service, providers should work with the contract tracing team to seek tailored advice if possible from the outbreak control team, the local authority or Public Health England, to help manage the outbreak.

If an outbreak is suspected in a supported living setting, this should be reported to the local Health Protection Team (HPT) immediately.

Who to speak to

Suzannah Young, Policy Officer